If Dr. Andrei Krassioukov gets his way, the days of some Paralympic athletes putting their lives in danger to increase their athletic performance may be over.
Despite an international ban on the practice, some Paralympic athletes with spinal cord injuries are using a dangerous technique called “boosting” to increase their blood pressure in the heat of competition.
Dr. Krassioukov (pictured), an associate professor in UBC’s Department of Medicine, Division of Physical Medicine and Rehabilitation, aims to change the standards by which Paralympic athletes compete. Through research at the International Collaboration On Repair Discoveries (ICORD), he is lobbying for new Paralympic classifications that recognize some athletes with spinal cord injuries cannot regulate blood pressure and heart rate in the same way as able-bodied people.
Dr. Krassioukov studies autonomic dysfunctions, which are dysfunctions in the parts of our bodies not under our conscious control. People with spinal cord injuries experience not only paralysis and loss of sensation, but often have trouble with autonomic functions such as blood pressure, heart rate and bladder and bowel control.
Consequently, during competition a wheelchair athlete’s heart rate doesn’t increase according to the body’s demands, leading to low blood pressure, fatigue, poor performance and a loss of endurance.
“That’s a big disadvantage to people with spinal cord injuries,” he says.
Yet many athletes learn they can subvert these cardiovascular dysfunctions by causing some pain or discomfort in the area below their injury. Known as autonomic dysreflexia, the process stimulates the spinal cord and boosts arterial blood pressure.It also puts their life in jeopardy.
Some athletes will tighten or block their catheter, a tube used to drain urine from the bladder through the urethra.
Some men will break their big toe before the competition. Others will sit on their testicles during a match.
“They know if they sit on their genitalia, their blood pressure will go up,” he says.
Others use less dramatic methods: abdominal binders or pressure stockings on legs that help increase blood pressure.
Despite documented deaths and the potential for a stroke or intracranial hemorrhage, some Paralympic athletes injure themselves just to improve performance, Dr. Krassioukov says.
“Unfortunately the physiological condition of the body predisposes them to poor cardiovascular responses to exercise, but they’re trying to ameliorate or improve their exercise with these horrific measures.”
The International Paralympic Committee condemns the practice, yet it’s difficult to enforce.
Last year, Dr. Krassioukov and his colleagues submitted a proposal to the International Paralympics Committee to develop additions to Paralympic classifications that would include an evaluation of a Paralympic athlete’s autonomic functions. (Presently, the committee reviews only a person’s physical capacity, such as hand functioning, range of motion and balance in a wheelchair).
To this effort, researchers last year examined five Paralympic rugby teams, from Canada, Germany, Russia, Britain and Australia, during competitions in Burnaby, just before the Beijing Games. Basketball players are next on the agenda.
This year, Dr. Krassioukov has proposed an assessment of members of the sledge hockey and curling teams at the upcoming 2010 Winter Paralympic Games. The findings will be used to make recommendations to the International Paralympic Committee regarding the addition of autonomic components to athlete classifications.
“If we will introduce an autonomic component to classification, maybe this will allow a more fair and safe competition for all Paralympians,” he said.
