ArticleFrontiers in sports and active living2026
Upper-Limb asymmetry in wheelchair para-athletes: a comparative analysis across sports disciplines.
Article in Frontiers in sports and active living, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Wheelchair use has increased globally, with many individuals relying on wheelchairs not only for mobility but also for participation in sport. However, upper-limb (UL) asymmetries are common among wheelchair athletes and may contribute to overuse injuries. Limited evidence exists regarding how asymmetry differs among athletes in para-sports who use wheelchairs to compete. This study aimed to compare UL asymmetry levels among wheelchair para-athletes across different sports disciplines through an exploratory analysis. Methods: A cross-sectional study was conducted with 30 wheelchair para-athletes (27 men, 3 women; 18-40 years) competing in six disciplines: powerlifting, wheelchair rugby, table tennis, wheelchair basketball, boccia, and wheelchair handball. Muscle strength and range of motion (ROM) were assessed using a validated portable dynamometer/inclinometer across seven UL movements. Asymmetry was calculated as the percentage difference between dominant and non-dominant limbs, with values ≥15% classified as asymmetric. Results: Wheelchair handball (10%), basketball (12%), and powerlifting (10%) demonstrated predominantly symmetric profiles, whereas table tennis (17%), boccia (30%), and wheelchair rugby (26%) exhibited greater asymmetry. Significant differences between symmetric and asymmetric groups were observed in strength (shoulder abduction, flexion, extension, and internal rotation; Conclusion: UL asymmetry indices ranged from 10% to 30% across disciplines, with table tennis, boccia, and rugby surpassing the 15% threshold. These differences in shoulder strength and ROM suggest that unilateral technical demands and impairment level are key determinants of musculoskeletal adaptation in wheelchair sport.
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