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Few studies have applied sport development models depicting Para athlete career development. This study utilizes the Athletic Career Pathways in Paralympic Sports framework, developed to respond to the limitations of established sport development models when applied to Para sport. Employing a mixed-methods design informed by critical realism, this study explores the career trajectories of Para track-and-field athletes while assessing the framework’s broader applicability. The findings challenge the linear pathway of traditional models, and a revised framework is presented offering flexibility to respond to the Para sport-specific and cultural context. The importance of schooling type, accessibility to nondisabled sports, and the need for specialist equipment in Para track and field offer further original insights into a Para athlete’s trajectory and validates the need for a Para sport-specific athlete career development model. These findings can be used to develop bespoke systems to support Para track-and-field athletes throughout their career trajectory.

Classification in para sports aims to create equitable competition. Footballers with vision impairments are allocated to one of three classes (B1, B2, or B3). This work aimed to understand the effectiveness and inclusivity of the current classification system. Visual acuity (VA) and/or visual field of male and female international footballers was extracted anonymously via the International Blind Sports Federation classification database. The analysis included 562 individuals. Footballers were predominantly male (88.26%); 11.74% were female. Only VA was used to classify 99.11% of footballers, and only 4.50% had visual field included in their classification. VA was nonnormally distributed for all three classes. Only 2.84% of footballers had a VA between 2.10 and 2.60 logMAR, suggesting that VAs in this range and/or visual-field impairment may disproportionately impact performance compared with other footballers within their classes. The current classification system does not appear to be inclusive or create equitable competition.

Patients with peripheral artery disease (PAD) often experience leg muscle damage, leading to noticeable walking difficulties. Using ankle foot orthosis (AFO) may enhance gait by supporting weak muscles. This study examined whether wearing AFOs improved the spatiotemporal gait characteristics of patients with PAD to be closer to those of healthy individuals, both from its first use and after a 3-month intervention. Spatiotemporal parameters were calculated from the kinematics of 26 patients with PAD captured in a biomechanics lab. Subjects walked with and without AFOs before and following a 3-month AFO intervention on a crossover basis. The immediate intervention group wore AFOs for 3 months (intervention) before switching to their control shoes (control), while the delayed intervention group followed the reverse sequence. Means and standard deviations (variability) for step width, length, time, and velocity were compared using separate linear repeated measures models. The models included group (immediate vs delayed intervention), time (before vs after intervention or baseline vs 3 mo), and condition (non-AFO vs AFO) as factors of comparison, in addition to interactions, if significant. A 3-month AFO intervention enhanced the temporal gait parameters and reduced gait variability. The mean and variability of temporal gait parameters were sensitive enough to determine whether patients walked more like healthy individuals after a 3-month AFO intervention. This may decrease fall risk and promote more efficient walking patterns in patients with PAD. The long-term benefits and adherence to AFOs and other assistive devices need further study.

Context: Detailed rehabilitation protocols after stem cell treatment are lacking. This case highlights the rehabilitation of a patient treated with human umbilical cord blood-derived mesenchymal stem cell implantation for a large osteochondritis dissecans lesion of the knee. Case presentation: A 17-year-old male adolescent wrestler experienced persistent left knee pain for 1 year, unresponsive to 6 months of conservative treatment. MRI revealed a large osteochondritis dissecans lesion (38 × 18 mm) in the lateral femoral condyle, which was treated with human umbilical cord blood-derived mesenchymal stem cell implantation. Management and outcomes: Rehabilitation was conducted in 4 phases. The protection phase (1–8 wk) emphasized weight-bearing restrictions, continuous passive motion, and early gait training. The gait recovery phase (9–12 wk) incorporated stationary cycling and open kinetic chain exercises. During the maturation phase (13–24 wk), maximal strength and proprioception exercises were introduced with antigravity treadmill running. The final recovery phase (24–52 wk) focused on plyometric drills and sport-specific activities. Team training resumed at 32 weeks, and return to full competitive training occurred at 52 weeks. The limb symmetry index for isokinetic knee-extensor strength and single-leg hop test reached 95.2% and 97.9%, respectively, by 12 months, indicating near-complete functional recovery. The modified MRI of cartilage repair tissue score improved from 40 to 60 points between 1 and 3 years postsurgery. Second-look arthroscopy revealed an International Cartilage Repair Society grade 1 at 35 months. International Knee Documentation Committee scores increased from 17.2 preoperatively to 98.9 at 2 years, while visual analog scale scores decreased from 10 to 2 over 3 years. Conclusions: Accelerated weight bearing, early gait training, and phased strength exercises facilitated substantial improvements in function and cartilage healing in an adolescent wrestler with a large osteochondritis dissecans lesion. Further studies with larger cohorts are recommended to confirm these findings.