Data_Sheet_1_Case Report: Training Monitoring and Performance Development of a Triathlete With Spinal Cord Injury and Chronic Myeloid Leukemia During a Paralympic Cycle.zip

IntroductionParatriathlon allows competition for athletes with various physical impairments. The wheelchair category stands out from other paratriathlon categories, since competing in swimming, handcycling, and wheelchair racing entails substantial demands on the upper extremity. Therefore, knowledge about exercise testing and training is needed to improve performance and avoid overuse injuries. We described the training monitoring and performance development throughout a Paralympic cycle of an elite triathlete with spinal cord injury (SCI) and a recent diagnosis of chronic myeloid leukemia (CML).
Case Presentation/MethodsA 30-year-old wheelchair athlete with 10-years experience in wheelchair basketball contacted us for guidance regarding testing and training in paratriathlon. Laboratory and field tests were modified from protocols used for testing non-disabled athletes to examine their physical abilities. In handcycling, incremental tests were used to monitor performance development by means of lactate threshold (POBLA) and define heart rate-based training zones. All-out sprint tests were applied to calculate maximal lactate accumulation rate (V˙Lamax) as a measure of glycolytic capabilities in all disciplines. From 2017 to 2020, training was monitored to quantify training load (TL) and training intensity distribution (TID).
ResultsFrom 2016 to 2019, the athlete was ranked within the top ten at the European and World Championships. From 2017 to 2019, annual TL increased from 414 to 604 h and demonstrated a shift in TID from 77-17-6% to 88-8-4%. In this period, POBLA increased from 101 to 158 W and V˙Lamax decreased from 0.56 to 0.36 mmol·l−1·s−1. TL was highest during training camps. In 2020, after he received his CML diagnosis, TL, TID, and POBLA were 317 h, 94-5-1%, and 108 W, respectively.
DiscussionTL and TID demonstrated similar values when compared with previous studies in para-swimming and long-distance paratriathlon, respectively. In contrast, relative TL during training camps exceeded those described in the literature and was accompanied by physical stress. Increased volumes at low intensity are assumed to increase POBLA and decrease V˙Lamax over time. CML treatment and side effects drastically decreased TL, intensity, and performance, which ultimately hindered a qualification for Tokyo 2020/21. In conclusion, there is a need for careful training prescription and monitoring in wheelchair triathletes to improve performance and avoid non-functional overreaching.

引言
残奥铁人三项（Paratriathlon）面向各类身体残障运动员开放赛事资格。其中轮椅组别与其他残奥铁人三项组别截然不同，因为游泳、手摇自行车竞速与轮椅竞速赛事均对上肢提出极高要求。因此，掌握运动测试与训练相关知识，对提升运动表现、避免过度使用损伤至关重要。本研究记录了一名脊髓损伤（SCI）且近期确诊慢性髓系白血病（CML）的精英铁人三项运动员，在整个残奥周期内的训练监控与表现变化情况。

病例报告/研究方法
一名拥有10年轮椅篮球赛事经验的30岁轮椅组运动员，就残奥铁人三项的测试与训练问题向本团队寻求指导。本研究针对非残障运动员的测试方案进行调整，以此开展实验室与现场测试，评估该运动员的身体能力。在手摇自行车项目中，本研究通过乳酸阈值（POBLA）指标监测表现变化，并据此划定基于心率的训练区间。针对各项目开展全力冲刺测试，以计算最大乳酸累积速率（V˙Lamax），以此评估糖酵解供能能力。2017年至2020年间，本团队对该运动员的训练进行全程监控，量化训练负荷（TL）与训练强度分布（TID）。

研究结果
2016年至2019年，该运动员在欧洲锦标赛与世界锦标赛中均跻身前十。2017年至2019年，年度训练负荷从414小时升至604小时，训练强度分布也从77-17-6%调整为88-8-4%。同期，POBLA指标从101瓦升至158瓦，而V˙Lamax则从0.56 mmol·l−1·s−1降至0.36 mmol·l−1·s−1。训练营期间的训练负荷达到峰值。2020年，即该运动员确诊CML后，其训练负荷、训练强度分布与POBLA指标分别为317小时、94-5-1%与108瓦。

讨论
本研究中的训练负荷与训练强度分布，分别与此前残奥游泳及长距离残奥铁人三项的相关研究数据相近。相较而言，训练营期间的相对训练负荷超出文献报道水平，并伴随身体应激反应。长期增加低强度训练量，被认为可提升POBLA指标，同时降低V˙Lamax水平。慢性髓系白血病的治疗方案及其副作用大幅降低了训练负荷、训练强度与运动表现，最终导致该运动员未能获得2020/21东京残奥会参赛资格。综上，轮椅组铁人三项运动员需要制定精细化的训练方案并开展严格训练监控，以此提升运动表现，避免出现非功能性过度训练。