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Competitive sport, therapy, and physical education: voices of young people with cerebral palsy who have high support needs
  1. Eimear Enright1,
  2. Emma M Beckman1,
  3. Mark J Connick1,
  4. Iain Mayank Dutia1,
  5. Angelo Macaro1,
  6. Paula J Wilson1,
  7. Jennifer O'Sullivan1,
  8. Jean-Michel Lavalliere1,
  9. Turner Block1,2,
  10. Leanne M Johnston3,
  11. Gaj Panagoda1,
  12. Sean M Tweedy1
  1. 1 School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
  2. 2 The Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
  3. 3 School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
  1. Correspondence to Dr Sean M Tweedy, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia; s.tweedy{at}

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People with cerebral palsy (CP) participate in significantly less physical activity than the general population and those with more severe CP and higher support needs are the most inactive.1 Anecdotally, generations of para athletes have reported that physically demanding, competitive sport enhances their general health, improves clinical outcomes and that the sports context is meaningful, enjoyable and socially engaging.2 However these views - particularly those of Para athletes with severe impairments and high support needs - are largely absent from the scientific record.3

Here are the voices of three (2M, 1F) early-career athletes with severe CP and high support needs (class IV, Gross Motor Function Classification System). Each completed 3 years in ParaSTART, a performance-focused swimming training programme. The full protocol has been published3 and a 3 min video summary is available here— At enrolment, athletes were: 15–16 years old, attending school, not meeting physical activity guidelines, not previously trained for any sport and medically fit to participate.

A multiprofessional team with skills in swimming coaching, exercise science and physiotherapy developed and delivered the swim programme, supported by a medical doctor, dietician, sports psychologist and personal support workers. A typical in-season training week comprised 3–4x30 min sessions of moderate and vigorous pool and gym-based training, a total training volume of >650 Rating of Perceived Exertion (using OMNI4) minutes.

The stories we share here are based on athlete interviews conducted by an experienced, independent, qualitative researcher, initially using a life history method …

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  • Contributors Conceptualisation: EMB, MJC, IMD, PJW, AM, LMJ and SMT. Funding acquisition: EMB, MJC, IMD, PJW, AM, LMJ and SMT. Methods and design: EMB, MJC, IMD, PJW, AM, LMJ, GP and SMT. Data collection: EE and TB. Data analysis: EE and TB. Training program development, delivery and monitoring: EMB, MJC, IMD, PJW, AM, JO, J-ML and SMT. Medical screening/medical support: IMD, PJW and GP. Writing–Drafting: EE, EMB, MJC, IMD and SMT. Writing-Review and Editing: EE, EMB, MJC, IMD, PJW, AM, JO, J-ML, TB, LMJ, GP and SMT.

  • Funding This study was funded by Centre of Excellence and Applied Sports Sciences Research, Queensland Academy of Sport; Paralympics Australia; Swimming Australia Ltd.

  • Competing interests SMT, MJC and EMB’s wider work is supported by the International Paralympic Committee (IPC) and all provide scientific leadership for the UQ-IPC Classification Research and Development Partnership; SMT is a volunteer Member of the IPC Classification Committee and the Classification Advisory Group for WPA. EMB is an accredited International Classifier with WPA, engaged on a voluntary basis; IMD is a member of the World Para Swimming High support needs Working Group.

  • Provenance and peer review Not commissioned; internally peer reviewed.