INTRODUCTION: Although the questions of postural control and stability are widely studied in competitive shooting in the able-bodied, no study has quantified these aspects on Paralympic athletes [1]. While the goal of postural stability may seem similar, the approach is quite different. Indeed, in the context of para-shooting, the handicap of each athlete requires an individualized and multimodal response. We have selected 2 cases of athletes to illustrate this multimodal approach. METHODS: For each of the athletes, we have quantified the impact of spasticity on the posture by a comparative biomechanical analysis (100hz, Motive, Optitrack) of the movement in a match situation: the performance of 10 shots at 10m (Scatt MX02) before and after intramuscular infiltration of anesthetic. Athlete 1, international SH1 level, hemiplegic, is a specialist in pistol shooting at 10m. In his practice but also in his professional life, the athlete is disabled by an almost continuous contraction of the elevator muscles of the shoulder. This hyperactivity becomes painful in stressful situations such as important competitions. We have specifically quantified the shoulders angle in relation to the horizontal axis. Athlete 2, international SH2 level, hemiplegic, is a specialist in 10 and 50 meters rifle shooting. As part of his practice, the athlete is disabled by dystonia of the finger flexors of the hand which allows the rifle to be held on the gallows. This dystonia presents at random during the pre-shot aiming, making the athlete apprehensive with each shot. We specifically quantified the range of the area of the polygon formed by the fingers of the hand. RESULTS: Regarding athlete 1, we observe an increase in the angle of the shoulders (13 ° vs 18 °) which is explained by the lowering of the shoulder by 4cm (133 vs 129cm from the ground). At the shooting performance, we see an improvement: 88 points versus 82, 38 versus 34.6 mm for the stability of aiming. Regarding athlete 2, we observe a decrease in the opening of the hand (6.1% versus 1.4%). In terms of shooting performance, we do not observe any changes in the 104 score versus 102 points, but a decrease in the stability of aiming 15.5 versus 9.2 mm. This decrease is explained by a less unstable trace due to the barrel movement suppression by the involuntary contraction of the fingers. CONCLUSION: These two multimodal analyses (ie. the combination of anesthetic block, movement analysis, Scatt analysis and performance results) highlight the relevance of a common reflection involving the technical staff, the athlete, and the medical staff. The management of disability-related underperformance factors requires that the medical staff appropriates the performance criteria of each sport in regard to its regulatory constraints.
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