SPORT-RELATED MUSCULOSKELETAL PAIN IN POWERCHAIR SPORTS: A COMPARATIVE STUDY BETWEEN POWERCHAIR FOOTBALL AND POWERCHAIR HOCKEY ATHLETES

S.C. Longo¹, F. Quarta², L. De Palma³, G. Frasca³, R. Lopes⁴, S. Lanza¹, M. Cavallo¹, M. Floridia¹, G. Sicuso¹, G. Farì⁵ | ¹Rehabilitation Unit, M. Paternò Arezzo Hospital, Provincial Health Authority, Ragusa, Italy; ²Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy; ³Unit of Physical, Rehabilitation Medicine and Spinal Cord, Polyclinic of Bari, Italy; ⁴Department of Biomedical and Biotechnological Sciences, University of Catania, Italy; ⁵Department of Experimental Medicine (Di.Me.S.), University of Salento, Lecce, Italy

Background. Powerchair sports (PS) offer an important opportunity for structured physical activity, competition, social participation, and psychosocial well-being in individuals with severe motor impairments. However, participation may expose athletes to sport-related musculoskeletal pain (MSP), mainly due to repetitive mechanical demands, prolonged wheelchair use, and discipline-specific tasks during training and competition (1,2). In this study, sport-related MSP was defined as self-reported musculoskeletal pain occurring during or in relation to training or competition over the previous 12 months. Powerchair Football (PF) and Powerchair Hockey (PH) both use a powered wheelchair, but differ in technical gestures, game dynamics, contact patterns, and upper-body involvement. This study assessed the 12-month prevalence and anatomical distribution of sport-related MSP in Italian PF and PH athletes and compared pain patterns between disciplines.
Methods. A cross-sectional observational study was conducted using a retrospective self-reported questionnaire administered to competitive Italian PF and PH athletes affiliated with the Italian Paralympic Powerchair Sport Federation. The questionnaire collected demographic and sport-related data and sport-related MSP over the previous 12 months. Pain was classified by anatomical region: upper limbs, spine, and lower limbs. Between-group comparisons were performed using chi-square or Fisher’s exact tests.
Results. A total of 233 athletes were included: 65 PF and 168 PH athletes. Overall, 85 athletes reported sport-related MSP during the previous 12 months. MSP prevalence was significantly higher in PH than PF athletes (42.9% vs 20.0%; p = 0.001). Upper limb pain was also significantly more frequent in PH athletes (32.1% vs 13.8%; p = 0.005). Spinal pain showed a higher occurrence in PH, whereas no significant between-group differences were observed for lower limb pain. Anatomically, PH athletes mainly reported upper limb and spinal pain, while PF athletes showed a more homogeneous distribution.
Conclusions. Sport-related MSP is frequent among powerchair athletes and shows discipline-specific differences between PF and PH. PH athletes appear to be at greater risk of upper limb and spinal pain, possibly because of higher mechanical demands, repeated upper-limb involvement, and greater game intensity. These findings support systematic sport-specific pain surveillance, targeted preventive strategies, and individualized rehabilitation-oriented monitoring to protect athlete health, reduce sport-related pain, and support long-term participation in powerchair sports (2,3).