Background A rare case of systematic comprehensive assessment of endurance abilities of a multiple Paralympic medalist.

Objective To assess the morpho-functional abilities and health condition of a multiple Paralympic medalist and to design a comprehensive assessment model based on the changes in physical endurance and health condition in the context of the athlete's disability and relating to the systematic physical training.

Design Ten-year follow-up.

Setting Paralympic Games in 2002, 2006 and 2010 and the relevant preparatory periods.

Participant A disabled cross-country skier who competed in three consecutive PGs (2002, 2006, 2010). At the age of four, the athlete lost both her upper limbs in a farming accident. She is planning to compete for the fourth time in 2014.

Risk factor assessment None.

Main outcome measurements Endurance was assessed with the cycloergometer test. Measurements included: lung minute ventilation (VE), oxygen consumption (VO2), carbon dioxide volume (VCO2), heart rate (HR), maximal oxygen uptake (VO2max) and lactate threshold (LAT).

Results There was a gradual increase in the athlete's endurance capacity, reaching the optimal value just before PG. The comparison of all results demonstrates their sinusoidal character - HR: 175-188-185 in 2002; 187-192-188 in 2006, and 189-184-180 in 2010; VO2, ml/kg: 40.20-47.00-51.30 in 2002, 51.78-45.50-51.30 in 2006 and 36.1-51.30-53.8 in 2010; VE, l: 74.9-90.5-90.0 in 2002, 95.0-99.6-107.4 in 2006 and 67.6-95.9-104.5 in 2010.

Conclusions Test results depended on the training-related level of endurance at particular points of the follow-up and the general health condition. The increase in endurance parameters shortly before PGs reflects the peak fitness level. The obtained results facilitated a precise analysis of the athlete's adaptation mechanisms. As a result, optimal training was offered, leading to the Paralympic podium three times.