Ci a ion: Hen íquez, M.; de Campos,
L.F.C.; Muñoz-Hin ichsen, F.;
Co nejo, M.I.; Yanci, J.; Reina, R.
Neu omuscula Fa igue in Ce eb al
Palsy Foo ball Playe s a e a
Compe i i e Ma ch Acco ding o
Spo Classi ica ion and Playing
Posi ion. In . J. En i on. Res. Public
Heal h 2022,19, 6070. h ps://
doi.o g/10.3390/ije ph19106070
Academic Edi o s: Paul
B. Tchounwou and Romuald Lepe s
Recei ed: 18 Ma ch 2022
Accep ed: 10 May 2022
Published: 17 May 2022
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In e na ional Jou nal o
En i onmen al Resea ch
and Public Heal h
A icle
Neu omuscula Fa igue in Ce eb al Palsy Foo ball Playe s a e
a Compe i i e Ma ch Acco ding o Spo Classi ica ion and
Playing Posi ion
Ma ías Hen íquez 1,* , Luis Felipe Cas elli de Campos 2, Fe nando Muñoz-Hin ichsen 3,
Ma ía Isabel Co nejo 1, Ja ie Yanci 4and Raul Reina 1
1Spo Resea ch Cen e, Depa men o Spo s Sciences, Miguel He nández Uni e si y, 03202 Elche, Spain;
[email p o ec ed] (M.I.C.); [email p o ec ed] (R.R.)
2Depa men o Educa ion Sciences, Facul y o Educa ion and Humani ies, Uni e si y o Bío-Bío,
Chillan 3780000, Chile; [email p o ec ed]
3Depa men o Kinesiology, Me opoli an Uni e si y o Sciences Educa ion, San iago 7500000, Chile;
[email p o ec ed]
4
Socie y, Spo s and Physical Exe cise Resea ch G oup (GIKAFIT), Physical Educa ion and Spo Depa men ,
Facul y o Educa ion and Spo , Uni e si y o he Basque Coun y (UPV/EHU), 01007 Vi o ia-Gas eiz, Spain;
ja ie [email p o ec ed]
*Co espondence: [email p o ec ed]; Tel.: +34-96-522-2437
Abs ac :
This s udy aimed o de e mine he a ed pe cei ed exe ion (RPE) and ma ch load
(RPE-ML)
o compa e p e-pos -ma ch e ical jump (VJ) capaci y acco ding o ce eb al palsy (CP) playe s’ spo
classes (i.e., FT1–FT3) and playing posi ions and o explo e whe he he neu omuscula pe o -
mance a ia ion is associa ed wi h he in e nal load o pa a- oo balle s wi h CP. Fi y-six male
pa a- oo balle s pe o med wo VJ es s be o e and immedia ely a e a compe i i e CP oo ball
ma ch, ollowed by measu emen s o he playe s’ RPE and RPE-ML. The e we e no signi ican di -
e ences (p> 0.05) in he pai wise compa isons o RPE and RPE-ML acco ding o spo classes and
playing posi ion. A signi ican educ ion in he VJ pe o mance was ound o each playe spo
class and playing posi ion in squa jump (SJ) (p< 0.01; 0.24 < d
g
< 0.58) and coun e mo emen jump
(CMJ) (p< 0.05; 0.22 < d
g
< 0.45). Rega ding he pai wise compa isons, playe s wi h he minimal
impai men c i e ia (FT3) ob ained highe de ici sco es du ing SJ han hose belonging o he FT1
and FT2 (p= 0.003; 1.00 < d
g
< 1.56). De ende s expe ienced he lowes pe o mance compa ed o
mid ielde s and a acke s in SJ pe o mance (p= 0.027; 0.94 < d
g
< 1.28). Signi ican co ela ions we e
ob ained be ween
∆
SJ o
∆
CMJ and RPE o RPE-ML ( =
−
0.58 o
−
0.75; p< 0.001). These indings
p o ide no el in o ma ion suppo ing he no ion ha a igue induced a e a compe i i e ma ch
causes no able impai men s in VJ pe o mance di e en ia ed acco ding o spo class and playing
posi ion in pa a- oo balle s wi h CP.
Keywo ds: pa a- oo ball; physical capaci y; b ain inju y; e ical jump; Pa alympic
1. In oduc ion
Ce eb al palsy (CP) oo ball is a eam pa a-spo ha is played 7-a-side on
a 70 m ×50 m
pi ch (goals 5 m
×
2 m), whe e pa icipan s mus p esen a pe manen neu ological impai -
men o hype onia, a axia, o a he osis [
1
]. These body unc ion de iciencies a e p o oked
by congeni al CP o ela ed unde lying heal h condi ions (e.g., acqui ed b ain inju y), a ec -
ing he pe o mance o mo o ac i i ies [
2
]. In addi ion, CP is desc ibed as he mos common
mo o disabili y o childhood, and i is conside ed o encompass a g oup o condi ions wi h
a iable se e i y, o en accompanied by seconda y dis u bances in di e en body sys ems
and unc ions such as balance, coo dina ion, o muscle one [
2
]. Cu en ly, CP oo ball
classi ica ion comp ises h ee spo s classes acco ding o he impac o he eligible impai -
men s on gene al and oo ball-speci ic skills pe o mance [
3
]. Hence, pa a- oo balle s a e
In . J. En i on. Res. Public Heal h 2022,19, 6070. h ps://doi.o g/10.3390/ije ph19106070 h ps://www.mdpi.com/jou nal/ije ph
In . J. En i on. Res. Public Heal h 2022,19, 6070 2 o 12
classi ied as FT1, FT2, o FT3 acco ding o he se e i y o he ac i i y limi a ion
(i.e., om
mo e o less se e e impac ), bu also conside ing hei unc ional p o ile [i.e., bila e al spas-
ici y o diplegia, o e all coo dina ion impai men (i.e., a he osis o a axia), and unila e al
spas ici y o hemiplegia]. The spo class alloca ion is assigned a e physical, echnical, and
obse a ional assessmen s p io o he compe i ion [
1
]. O e all, people wi h CP p esen he
ollowing: comp omise o he descending neu al pa hways ha con ol body mo emen ,
ec ui men o mo o uni s, p oduce muscle one al e a ions,
co-con ac ion,
and p og es-
si e seconda y musculoskele al complica ions o e he
li e ime [2]
. Speci ically, CP oo ball
playe s (CPFPs) p esen neu omuscula comp omise a ec ing endu ance
capaci y [4]
, mus-
cula s eng h [
5
], change o di ec ion abili y [
6
], epea ed sp in abili y [
7
], accele a ion
and decele a ion pe o mance [
8
], jump capaci y [
9
], and whole physical pe o mance
du ing aining o compe i ion ins ances [
3
,
10
]. Gi en ha CP oo ball equi es mul iple
ac ions o e y high in ensi y and high neu omuscula capaci y [
7
,
11
], which mus be
main ained h oughou he compe i i e ac ions, i may be ele an o know he muscle
a igue o pa a- oo balle s induced by ma ches. The e a e se e al me hods o quan i y
a igue in oo ball [
12
,
13
]; despi e his, one o he mos used is e ical jump (VJ) a ia ion
(p e- o pos -ma ch pe o mance di e ence) analysis as an indi ec neu omuscula a igue
indica o induced om ma ch play [
14
–
17
]. P e ious s udies sugges ha changes in VJ
pe o mance ollowing oo ball ma ches a e ela ed o neu omuscula a igue due o he
speci ic demands and he equi emen s o he anae obic capaci y in he lowe limbs [
18
–
20
].
In his sense, se e al s udies ha used VJ assessmen , such as squa jump (SJ) and coun-
e mo emen jump (CMJ) o moni o simula ed o eal pos -ma ch a igue, demons a ed
declines in heigh jump pe o mance, using hese as and easy p ocedu es [15,17,18,21].
Al hough SJ and CMJ p o ocols ha e been used and alida ed wi h CPFPs [
9
,
22
], o
he bes o he au ho s’ knowledge, no p e ious s udy has analyzed he use o hese es s
o desc ibe he impac o ma ch demands on neu omuscula a igue in his pa a-spo .
Mo eo e , conside ing he di e ences o he physical capaci y o CPFPs acco ding o hei
spo classes [
11
,
23
], i could be pe inen o know whe he he a igue p esen s a simila
magni ude o impac in he di e en playe unc ional p o iles. On he o he hand, e en in
egula oo ball [
24
,
25
], a igue could be condi ioned acco ding o he playing posi ion and
he esponse ac i i y p o ile o ma ch demands. Wi h ega d o his a iable, no p e ious
s udies ha e analyzed how he playe s’ playing posi ion in luences he neu omuscula
a igue o CPFPs. Knowing he moni o iza ion o pos -ma ch a igue by using quick and
simple me hods, such as jump assessmen , in pa a- oo balle s wi h CP could be essen ial o
managing he eco e y-p ocess s a egies planning aining load sessions and iden i ying
possible indi idual impai men -p o ile di e ences in a igue- ela ed esponses [12].
The e o e, his s udy aimed (1) o de e mine he pe cei ed ma ch load acco ding o
spo classes and playing posi ion, (2) o compa e neu omuscula ma ch-induced a igue
(i.e., p e-pos -ma ch jumping capaci y a ia ion) acco ding o playe s’ spo classes and
playing posi ions, and (3) o explo e whe he he neu omuscula pe o mance a ia ion is
associa ed wi h he pe cei ed a igue and ma ch load o CPFPs.
2. Ma e ials and Me hods
2.1. Pa icipan s
A con enience sample o 56 male CPFPs (25.0
±
7.0 yea s, 68.7
±
11.7 kg,
1.70 ±0.07 m,
23.9
±
4.1 kg
·
m
−2
) pa icipa ed in his s udy. All he playe s compe ed in he Chilean CP
oo ball league, and 15 o hem belong o he na ional eam. The pa icipan s’ spo classes
a e desc ibed acco ding o he classi ica ion ulebook o he In e na ional Fede a ion o
Ce eb al Palsy Foo ball (IFCPF) [
1
] and hei egula playing posi ion (i.e., de ende (DEF),
mid ielde s (MF), and a acke (AT)) (Table 1). The inclusion c i e ion o he s udy was o
comple e mo e han 50 min o he en i e ma ch playing ime (i.e., o icial ma ch
ime 60 min
).
Goalkeepe s we e excluded om his s udy due o he specializa ion o hei posi ion. All
he playe s we e gi en de ailed e bal ins uc ions and we e ully amilia ized wi h he
p ocedu es be o e es ing. The s udy’s cha ac e is ics we e de ailed in an o al explana ion
In . J. En i on. Res. Public Heal h 2022,19, 6070 3 o 12
o he pa icipan s, and hei w i en in o med consen was ob ained in conco dance wi h
he decla a ion o Helsinki (2013). The Human E hics Commi ee o he San o Tomas
Uni e si y ( e e ence no. 63.20) app o ed all he p ocedu es o his s udy.
Table 1.
Ce eb al palsy oo ball playe ’s cha ac e iza ion acco ding o spo s classi ica ion and
playing posi ion.
FT1 FT2 FT3
Numbe o playe s 7 (12.5%) 40 (71.4%) 9 (16.1%)
Impai men
Bila e al Spas ici y 2 (3.6%) – –
Coo dina ion Impai men s 4 (7.1%) – 1 (1.8%)
Unila e al Spas ici y 1 (1.8%) 40 (71.4%) 8 (14.2%)
Playing Posi ion
De ende 2 (3.6%) 7 (12.5%) –
Mid ielde 1 (1.8%) 23 (41.1%) 4 (7.1%)
A acke 4 (7.1%) 10 (17.8%) 5 (8.9%)
FT1–FT3: ce eb al palsy oo ball spo class.
2.2. P ocedu es
All he pa icipan s belonged o CP oo ball club eams, which compe ed in a local
ou namen held in Chile. Six compe i i e ma ches we e played on di e en days on
he same ield o no mal size and in conco dance wi h he o icial equi emen s o he
IFCPF [
26
]. The ma ches consis ed o 14 playe s (2 goalkeepe s and 12 ou ield playe s)
and we e played in a egula compe i ion en i onmen . All ma ches we e pe o med
ou doo s on a syn he ic g ass pi ch, wi h an ambien empe a u e be ween 20 and 23
◦
C
and a ela i e humidi y o 54.2
±
5.2%. The pe cei ed load exe ion was assessed in he
playe s ollowing each compe i i e ma ch. In o de o de e mine neu omuscula a igue
as conduc ed in p e ious s udies wi h oo ball playe s [
14
,
15
], he pa icipan s pe o med
wo VJ es s
30 min be o e s a ing he ma ch du ing he eam wa m-up and immedia ely
a e he compe i i e CP oo ball ma ches.
2.2.1. Ma ch In ensi y and Load
The a ed pe cei ed exe ion (RPE) has inc easingly been used o measu e in e nal
load and o de e mine he pe cei ed e o in non-impai ed oo ball playe s [
13
,
24
,
25
,
27
]
and p e iously u ilized in playe s wi h CP [
10
,
28
]. This me hod has been desc ibed as
being alid o quan i ying e o s du ing aining and oo ball ma ches [
29
–
31
] and has
been p oposed o use in he con ex o oo ball and o he eam spo s [
32
,
33
]. Fo example,
Fos e e al. [
34
–
36
] p oposed he RPE o assess he “ha dness” o he en i e aining
session and o e alua e in e nal load in endu ance and eam-spo a hle es. In addi ion,
he RPE p o ides in o ma ion in a simple, p ac ical, and low-cos way [
37
]. Especially
in high-le el pe o mance con ex s, whe e he use o echnology is cons ained due o
he discom o when playe s a e a peak pe o mance in compe i ion, he RPE can be
an excellen
non-in asi e
me hod applied once he ma ch is o e [
36
], minimizing he
in usion in he collec ion o in o ma ion. Due o he alidi y o his me hod and i s acili y,
e sa ili y, and low cos , he RPE was used in his s udy o quan i y he in e nal load o he
playe s du ing he ma ches. All he pa icipan s esponded wi h ega d o hei pe cep ion
on a 0- o-10-poin scale [
36
], ollowing 30 min o he o icial ma ch o ensu e ha he
pe cei ed e o was e e ed o he whole session [
31
]. The playe s esponded sepa a ely,
wi hou he p esence o o he playe s, o he RPE scale, which was adminis e ed by he same
wo pe sons (i.e., au ho esea che s) [
15
,
24
]. Addi ionally, he in e nal ma ch load was
calcula ed by using he p oposed me hod by Fos e e al. [
36
] and
Impellizze i e al. [31],
as ollows: [pe cei ed ma ch load (RPE-ML) = RPE alue
×
ma ch ime (min)], exp essed
in a bi a y uni s (AU). The ma ch ime was conside ed, excluding wa m-up and es
pe iods [
38
]. This ma ch load quan i ica ion me hod was also used in a p e ious s udy
wi h CPFPs [28].
In . J. En i on. Res. Public Heal h 2022,19, 6070 4 o 12
2.2.2. Neu omuscula Capaci y
The neu omuscula capaci y was analyzed by assessing VJ pe o mance [
14
,
17
], whe e
SJ and CMJ we e conside ed. The VJ es was pe o med by using a jump pla o m
(2.5, DMJUMP, San iago, Chile)
on a s able su ace and using he same p o ocol desc ibed
p e iously in CPFPs who used he CMJ [
9
] and he SJ [
22
]. These es s we e selec ed o a
as and s aigh o wa d applica ion assessmen , as has been pe o med in o he s udies
analyzing he in luence o ma ch demands on physical pa ame e s [
14
,
17
,
18
,
21
]. In he SJ,
pa icipan s we e ins uc ed o pe o m wo maximum VJs om an ini ial posi ion wi h
a knee lexion angle o 90
◦
main ained o 2 s, be o e jumping wi hou any ebound o
coun e mo emen [
39
]. Du ing he s a ing o inal jump posi ion, he hands s ayed on
hips, and in he akeo phase, he pa icipan s emained wi h hei legs ully ex ended.
In he landing phase, pa icipan s ouched down wi h bo h ee oge he in an up igh
posi ion. Wi h ega d o he CMJ, he pa icipan s s a ed in a s anding posi ion, wi h
ixed hands-on hips and knees ully ex ended, sus aining his posi ion du ing he jump
execu ion wi hou using a m swing [
22
]. F om his posi ion, all pa icipan s pe o med a
as lexion-ex ension downwa d mo emen un il he knee angle eached 90
◦
, ollowed by
pe o ming a maximum VJ e o wi h legs ully ex ended and plan a lexion du ing he
akeo phase and landing on he s a ing place. Fo bo h es s, he jumps we e made in
wo a emp s, wi h es in e als o one min be ween ials, egis e ing he highes heigh
ob ained (cm). Those a hle es who p esen ed spas ic hemiplegia and di icul y main aining
hei hands on hei hips we e allowed o keep hei hands a he sides o hei body [22].
2.3. Da a Analysis
All esul s we e calcula ed as mean
±
s anda d de ia ion (SD). Kolmogo o –Smi no
and Le ene’s es s we e applied o e i y he dis ibu ion and homogenei y o da a. A mixed
2
×
3
×
3 epea ed-measu es analysis o a iance (ANOVA) was conduc ed, conside ing
he ma ch (p e-ma ch s. pos -ma ch measu emen s) as a wi hin-g oup ac o and he
CP oo ball spo classes (i.e., FT1, FT2, and FT3) and he playing posi ions (i.e., DEF, MF,
and AT)
as he be ween-g oup ac o s. A Tukey’s pos hoc analysis was used o examine he
pai wise di e ences among spo classes and playing posi ions. S uden ’s pai ed - es was
applied o de e mine he di e ences be ween p e- and pos -VJ heigh pe o mance in each
subg oup o playe s acco ding o hei spo class and playing posi ion. The del a alue o
heigh jumps’ a ia ion (
∆
cm) in SJ and CMJ was calcula ed by using he ollowing o mula:
∆
= (pos -ma ch jump heigh )
−
(p e-ma ch jump heigh ). Two e ec -size indexes we e
used o assess he p ac ical wi hin- and be ween-g oup di e ences. On he one hand, pa ial
e a-squa e (
ηp2
) alues we e calcula ed as a measu e o e ec size o mean di e ences wi h
he ollowing in e p e a ion: abo e 0.26, be ween 0.26 and 0.02, and lowe han 0.02 we e
conside ed as la ge, medium, and small, espec i ely [40]. On he o he hand, o calcula e
he e ec size o pos hoc wi hin-g oup di e ences, Hedges’ gindex was used [
41
]. This
index is based on Cohen’s dindex [
42
], bu i p o ides an e ec -size es ima ion, educing
he bias caused by small samples (i.e., subg oups wi h n < 20). In e p e a ions o Hedge’s
g ha we e abo e 0.80, be ween 0.50 and 0.79, be ween 0.25 and 0.49, and lowe han
0.25 we e conside ed la ge, mode a e, small, and i ial, espec i ely [
41
]. The p e-pos
pe o mance di e ences we e also calcula ed o explo e pai wise di e ences acco ding
o spo classes and playing posi ions wi h hei espec i e uppe and lowe con idence
in e als. The ela ionship be ween VJ a ia ion and pe cei ed ma ch load a iables was
calcula ed by using linea Spea man’s co ela ion ( ). The co ela ion coe icien s we e
quali a i ely in e p e ed as ollows: <0.09, i ial; 0.10–0.29, small; 0.30–0.49, mode a e;
0.50–0.69, la ge; 0.70–0.89, e y la ge; and >0.90 nea ly pe ec [
43
]. Da a analyses we e
pe o med by using he s a is ical package G aphPad P ism (G aphPad So wa e, e sion 8
o Windows, San Diego, CA, USA) and he S a is ical Package o Social Sciences (SPSS Inc.,
e sion 26.0 o Windows, Chicago, IL, USA). S a is ical signi icance was se a p< 0.05.
In . J. En i on. Res. Public Heal h 2022,19, 6070 5 o 12
3. Resul s
In gene al, he o e all sample esul s showed a mean RPE-ML o 370
±
89 AU and
RPE o 6.3
±
1.5. The mean played ime o he pa icipan s was 58.9
±
2.1 min. The
RPE and
RPE-ML
esponses o he pa icipan s among spo classes and playing posi ions
a e p esen ed in Figu e 1. Wi h ega ds o he spo classes, he ob ained sco es we e
376 ±77 AU
and
6.4 ±1.3 o FT1
, 365
±
89 AU and 6.2
±
1.5 o FT2, and
387 ±104 AU
and 6.4
±
1.7 o he FT3. In e ms o he playing posi ions, he obse ed alues we e
328 ±93 AU
and 5.5
±
1.6 o he de ende s, 370
±
88.2 AU and 6.3
±
1.5 o he mid ielde s,
and 390
±
86 AU and 6.6
±
1.4 o he a acke s. No signi ican di e ences we e ound o
he o e all and pai wise compa isons o he RPE and RPE-ML a iables acco ding o he
wo be ween-g oup ac o s o his s udy (i.e., spo classes and playing posi ion).
In . J. En i on. Res. Public Heal h 2022, 19, x FOR PEER REVIEW 5 o 13
uppe and lowe con idence in e als. The ela ionship be ween VJ a ia ion and pe -
cei ed ma ch load a iables was calcula ed by using linea Spea man’s co ela ion ( ). The
co ela ion coe icien s we e quali a i ely in e p e ed as ollows: <0.09, i ial; 0.10–0.29,
small; 0.30–0.49, mode a e; 0.50–0.69, la ge; 0.70–0.89, e y la ge; and >0.90 nea ly pe ec
[43]. Da a analyses we e pe o med by using he s a is ical package G aphPad P ism
(G aphPad So wa e, e sion 8 o Windows, San Diego, CA, USA) and he S a is ical
Package o Social Sciences (SPSS Inc., e sion 26.0 o Windows, Chicago, IL, USA). S a-
is ical signi icance was se a p < 0.05.
3. Resul s
In gene al, he o e all sample esul s showed a mean RPE-ML o 370 ± 89 AU and
RPE o 6.3 ± 1.5. The mean played ime o he pa icipan s was 58.9 ± 2.1 min. The RPE and
RPE-ML esponses o he pa icipan s among spo classes and playing posi ions a e p e-
sen ed in Figu e 1. Wi h ega ds o he spo classes, he ob ained sco es we e 376 ± 77 AU
and 6.4 ± 1.3 o FT1, 365 ± 89 AU and 6.2 ± 1.5 o FT2, and 387 ± 104 AU and 6.4 ± 1.7 o
he FT3. In e ms o he playing posi ions, he obse ed alues we e 328 ± 93 AU and 5.5
± 1.6 o he de ende s, 370 ± 88.2 AU and 6.3 ± 1.5 o he mid ielde s, and 390 ± 86 AU
and 6.6 ± 1.4 o he a acke s. No signi ican di e ences we e ound o he o e all and
pai wise compa isons o he RPE and RPE-ML a iables acco ding o he wo be ween-
g oup ac o s o his s udy (i.e., spo classes and playing posi ion).
Figu e 1. Pe cei ed ma ch load (RPE-ML) and pe cei ed exe ion (RPE) o pa icipan s among spo
classi ica ion and playing posi ion. FT1–FT3, ce eb al palsy oo ball spo classes; DEF, de ende ;
MF, mid ielde ; AT, a acke .
Fo he o e all sample, he VJ heigh was educed ollowing he oo ball ma ch, bo h
in he SJ [23.7 ± 6.5 cm o 21.0 ± 5.7 cm, Δ = −2.71 ± 1.55 cm: F(1,48) = 93.46; p < 0.001; ηp2 =
0.88, la ge] and CMJ [24.4 ± 6.7 cm o 21.6 cm ± 5.9 cm, Δ = −2.81 ± 1.87 cm: F(1,48) = 44.17;
p < 0.001; ηp2 = 0.48, la ge] measu emen s. No signi ican di e ences in he p e es o in he
pos - es we e ound in VJ pe o mance be ween playe s’ spo classes (p = 0.064‒0.216)
and playing posi ion (p = 0.381‒0.765) in each pe iod o p e- and pos -ma ch measu e-
men s. In e ac ion e ec s be ween he wi hin-g oup and be ween-g oup ac o s we e
ound only o he p e–pos measu emen o he SJ and he spo classes [F(2,48) = 4.50; p
Figu e 1.
Pe cei ed ma ch load (RPE-ML) and pe cei ed exe ion (RPE) o pa icipan s among spo
classi ica ion and playing posi ion. FT1–FT3, ce eb al palsy oo ball spo classes; DEF, de ende ; MF,
mid ielde ; AT, a acke .
Fo he o e all sample, he VJ heigh was educed ollowing he oo ball ma ch, bo h
in he SJ [23.7
±
6.5 cm o 21.0
±
5.7 cm,
∆
=
−
2.71
±
1.55 cm: F(1,48) = 93.46;
p< 0.001;
ηp2= 0.88, la ge]
and CMJ [24.4
±
6.7 cm o 21.6 cm
±
5.9 cm,
∆=−2.81 ±1.87 cm
:
F(1,48) = 44.17;
p< 0.001;
ηp2
= 0.48, la ge] measu emen s. No signi ican di e ences
in he p e es o in he pos - es we e ound in VJ pe o mance be ween playe s’ spo
classes
(p= 0.064–0.216)
and playing posi ion (p= 0.381–0.765) in each pe iod o p e- and
pos -ma ch
measu emen s. In e ac ion e ec s be ween he wi hin-g oup and
be ween-g oup
ac o s we e ound only o he p e–pos measu emen o he SJ and he spo classes
[F(2,48) = 4.50;
p= 0.016;
ηp2
= 0.16, medium]. Figu e 2A,B shows he pa a- oo balle s’ VJ
pe o mance acco ding o hei spo classes, while Figu e 3A,B illus a es hem in e ms
o conside ing hei playing posi ions. Wi h espec o he playe ’s spo class, he pai ed
- es indica ed a signi ican di e ence in VJ pe o mance be ween p e–pos -ma ch mea-
su emen s in all he classes o SJ (Figu e 2A) in FT1 ( (6) = 6.20;
p= 0.001, dg= 0.30,
small),
FT2
( (39) = 11.37;
p< 0.001, d
g
= 0.42, small), FT3 ( (8) = 7.05;
p< 0.001, dg= 0.58,
mode -
a e), and CMJ (Figu e 2B) in FT1 ( (6) = 2.69; p= 0.036, d
g
= 0.31, small), FT2
( (39) = 9.51;
p< 0.001, dg= 0.45, small), and FT3 ( (8) = 5.82; p< 0.001, dg= 0.45, small).
In . J. En i on. Res. Public Heal h 2022,19, 6070 6 o 12
In . J. En i on. Res. Public Heal h 2022, 19, x FOR PEER REVIEW 6 o 13
= 0.016; ηp2 = 0.16, medium]. Figu e 2A,B shows he pa a- oo balle s’ VJ pe o mance ac-
co ding o hei spo classes, while Figu e 3A,B illus a es hem in e ms o conside ing
hei playing posi ions. Wi h espec o he playe ’s spo class, he pai ed - es indica ed
a signi ican di e ence in VJ pe o mance be ween p e–pos -ma ch measu emen s in all
he classes o SJ (Figu e 2A) in FT1 ( (6) = 6.20; p = 0.001, dg = 0.30, small), FT2 ( (39) =
11.37; p < 0.001, dg = 0.42, small), FT3 ( (8) = 7.05; p < 0.001, dg = 0.58, mode a e), and CMJ
(Figu e 2B) in FT1 ( (6) = 2.69; p = 0.036, dg = 0.31, small), FT2 ( (39) = 9.51; p < 0.001, dg =
0.45, small), and FT3 ( (8) = 5.82; p < 0.001, dg = 0.45, small).
Figu e 2. Ve ical-jump heigh pe o mance ollowing oo ball ma ch on squa jump (A), and coun-
e mo emen jump (B) among spo classes. FT1–FT3, ce eb al palsy oo ball spo classes, dg = e -
ec size; ** (p < 0.01) and * (p < 0.05) a e signi ican di e ence be ween p e- and pos -ma ch.
Wi h ega ds o playing posi ion, a e he ma ches signi ican di e ences we e ound
o he SJ (Figu e 3A) pe o mance o DEF ( (8) = 4.36; p = 0.002, dg = 0.24, i ial), MF
( (27) = 9.27; p < 0.001, dg = 0.47, small), and AT ( (18) = 9.75; p < 0.001, dg = 0.42, small).
These di e ences we e also ound o CMJ (Figu e 3B) in he playing posi ions o DEF
( (8) = 2.42; p = 0.042, dg = 0.22, i ial), MF ( (27) = 7.93; p < 0.001, dg = 0.48, small), and AT
( (18) = 9.50; p < 0.001, dg = 0.44, small).
Figu e 2.
Ve ical-jump heigh pe o mance ollowing oo ball ma ch on squa jump (
A
), and coun e -
mo emen jump (
B
) among spo classes. FT1–FT3, ce eb al palsy oo ball spo classes, d
g
= e ec
size; ** (p< 0.01) and * (p< 0.05) a e signi ican di e ence be ween p e- and pos -ma ch.
In . J. En i on. Res. Public Heal h 2022, 19, x FOR PEER REVIEW 7 o 13
Figu e 3. Ve ical jump heigh pe o mance ollowing oo ball ma ch on squa jump (A) and coun-
e mo emen jump (B) among playing posi ion. DEF, de ende ; MF, mid ielde ; A , a acke , dg =
e ec size; ** (p < 0.01) and * (p < 0.05) a e signi ican di e ence be ween p e- and pos -ma ch.
Table 2 shows he VJ pe o mance dec emen and pai wise compa ison a e he
ma ch in ela ion o CP oo ball spo classes and playing posi ions. Wi h ega d o spo
classes, signi ican di e ences we e ound o he SJ pe o mance de e io a ion. Obse ing
he pai wise compa isons, playe s wi h he minimal impai men c i e ia (FT3) ob ained
highe de ici sco es du ing SJ capaci y han hose belonging o he FT1 and FT2 spo
classes. Table 2 also epo s he VJ de ici s acco ding o he playing posi ions. A e he
ma ches, signi ican di e ences we e also ound o he SJ pe o mance de e io a ion,
whe e de ende s expe ienced he lowes pe o mance compa ed o mid ielde s and a -
acke s.
Table 2. Ve ical jump pe o mance a ia ion (Δ cm, p e-ma ch s. pos -ma ch assessmen s) acco d-
ing o spo classes and playing posi ion.
FT1 FT2 FT3 dg Pai wise Compa isons (LCI‒UCI) p
FT1 s. FT2 FT1 s. FT3 FT2 s. FT3
ΔSJ (cm) −1.8 ± 0.8
(−9.4%)
−2.5 ± 1.4
(−10.9%)
−4.2 ± 1.8
(−14.7%)
0.51
(−0.45‒1.57)
1.56 **
(0.42‒2.70)
1.00 **
(0.02‒1.99) 0.003
ΔCMJ (cm) −2.3 ± 2.3
(−12.1%)
−2.8 ± 1.9
(−11.4%)
−3.1 ± 1.6
(−11.0%)
0.25
(−0.55‒1.06)
0.39
(−0.61‒1.39)
0.16
(−0.56‒0.88) 0.733
DEF MF AT DEF s. MF DEF s. AT MF s. AT p
ΔSJ (cm) −1.4 ± 1.0
(−6.1%)
−2.9 ± 1.7
(−12.4%)
−3.0 ± 1.3
(−12.1%)
0.94 *
(0.15‒1.72)
1.28 *
(0.41‒2.14)
0.06
(−0.52‒0.64) 0.027
ΔCMJ (cm) −1.6 ± 2.0
(−6.8%)
−3.0 ± 2.0
(−12.3%)
−3.1 ± 1.4
(−12.3%)
0.68
(−0.08‒1.45)
0.91
(0.08‒1.74)
0.06
(−0.53‒0.64) 0.099
Δ, de ici change; SJ, squa jump; CMJ, coun e mo emen jump; FT1–FT3, ce eb al palsy oo ball
spo classes; DEF, de ende ; MF, mid ielde ; AT, a acke ; LCI, lowe in e al o con idence; UCI,
uppe in e al o con idence. Repea ed-measu es ANOVA signi ican di e ences be ween FT clas-
ses o playing posi ions: ** p < 0.01 and * p < 0.05.
Looking a he associa ions be ween he ΔVJ pe o mance wi h RPE and RPE-ML, we
see ha la ge in e se co ela ions (p < 0.001) we e ob ained be ween ΔSJ and RPE ( =
−0.59) and RPE-ML ( = −0.58). Simila esul s we e ob ained be ween ΔCMJ and RPE ( =
−0.75, p < 0.001) and RPE-ML ( = −0.74, p < 0.001).
Squa jump heigh (cm)
Coun e mo emen jump heigh (cm)
Figu e 3.
Ve ical jump heigh pe o mance ollowing oo ball ma ch on squa jump (
A
) and coun e -
mo emen jump (
B
) among playing posi ion. DEF, de ende ; MF, mid ielde ; AT, a acke , d
g
= e ec
size; ** (p< 0.01) and * (p< 0.05) a e signi ican di e ence be ween p e- and pos -ma ch.
Wi h ega ds o playing posi ion, a e he ma ches signi ican di e ences we e ound
o he SJ (Figu e 3A) pe o mance o DEF ( (8) = 4.36; p= 0.002, d
g
= 0.24, i ial),
MF ( (27) = 9.27;
p< 0.001, d
g
= 0.47, small), and AT ( (18) = 9.75; p< 0.001, d
g
= 0.42,
small). These di e ences we e also ound o CMJ (Figu e 3B) in he playing posi ions o
DEF ( (8) = 2.42;
p= 0.042, d
g
= 0.22, i ial), MF ( (27) = 7.93; p< 0.001, d
g
= 0.48, small),
and AT ( (18) = 9.50; p< 0.001, dg= 0.44, small).
Table 2shows he VJ pe o mance dec emen and pai wise compa ison a e he
ma ch in ela ion o CP oo ball spo classes and playing posi ions. Wi h ega d o spo
classes, signi ican di e ences we e ound o he SJ pe o mance de e io a ion. Obse ing
he pai wise compa isons, playe s wi h he minimal impai men c i e ia (FT3) ob ained
highe de ici sco es du ing SJ capaci y han hose belonging o he FT1 and FT2 spo
classes. Table 2also epo s he VJ de ici s acco ding o he playing posi ions. A e he
ma ches, signi ican di e ences we e also ound o he SJ pe o mance de e io a ion, whe e
de ende s expe ienced he lowes pe o mance compa ed o mid ielde s and a acke s.
In . J. En i on. Res. Public Heal h 2022,19, 6070 7 o 12
Table 2.
Ve ical jump pe o mance a ia ion (
∆
cm, p e-ma ch s. pos -ma ch assessmen s) acco ding
o spo classes and playing posi ion.
FT1 FT2 FT3
dgPai wise Compa isons (LCI–UCI) p
FT1 s. FT2 FT1 s. FT3 FT2 s. FT3
∆SJ (cm) −1.8 ±0.8
(−9.4%)
−2.5 ±1.4
(−10.9%)
−4.2 ±1.8
(−14.7%)
0.51
(−0.45–1.57)
1.56 **
(0.42–2.70)
1.00 **
(0.02–1.99) 0.003
∆CMJ (cm) −2.3 ±2.3
(−12.1%)
−2.8 ±1.9
(−11.4%)
−3.1 ±1.6
(−11.0%)
0.25
(−0.55–1.06)
0.39
(−0.61–1.39)
0.16
(−0.56–0.88) 0.733
DEF MF AT DEF s. MF DEF s. AT MF s. AT p
∆SJ (cm) −1.4 ±1.0
(−6.1%)
−2.9 ±1.7
(−12.4%)
−3.0 ±1.3
(−12.1%)
0.94 *
(0.15–1.72)
1.28 *
(0.41–2.14)
0.06
(−0.52–0.64) 0.027
∆CMJ (cm) −1.6 ±2.0
(−6.8%)
−3.0 ±2.0
(−12.3%)
−3.1 ±1.4
(−12.3%)
0.68
(−0.08–1.45)
0.91
(0.08–1.74)
0.06
(−0.53–0.64) 0.099
∆
, de ici change; SJ, squa jump; CMJ, coun e mo emen jump; FT1–FT3, ce eb al palsy oo ball spo classes;
DEF, de ende ; MF, mid ielde ; AT, a acke ; LCI, lowe in e al o con idence; UCI, uppe in e al o con idence.
Repea ed-measu es ANOVA signi ican di e ences be ween FT classes o playing posi ions: ** p< 0.01 and
*p< 0.05.
Looking a he associa ions be ween he
∆
VJ pe o mance wi h RPE and RPE-ML,
we see ha la ge in e se co ela ions (p< 0.001) we e ob ained be ween
∆
SJ and RPE
( =−0.59)
and RPE-ML ( =
−
0.58). Simila esul s we e ob ained be ween
∆
CMJ and RPE
( =−0.75, p< 0.001) and RPE-ML ( =−0.74, p< 0.001).
4. Discussion
The pu pose o his s udy was o compa e he RPE and RPE-ML in oo ball ma ches
epo ed by CPFPs o di e en spo classes and playing posi ions o de e mine he impac
o a compe i i e CP oo ball ma ch on he VJ pe o mance a ia ion as a neu omuscula
a igue indica o , also aking in o accoun he playe s’ spo classes and hei playing
posi ions, and o desc ibe he associa ion be ween VJ heigh a ia ion and he RPE-ML o
RPE. The majo indings we e as ollows: (1) no di e ences we e ob ained o RPE-ML and
RPE be ween spo classes and playing posi ion; (2) CPFPs ha e signi ican dec emen s
in SJ and CMJ pe o mance ac oss spo classes and playing posi ions a e a compe i i e
CP oo ball ma ch, e idencing an al e ed neu omuscula pe o mance ha a ec s jumping
capaci y; (3) du ing he SJ, FT3 had a highe jumping de e io a ion han FT1 and FT2
ollowing he ma ch, and MF and AT had a highe jumping de e io a ion han DEF; and
(4) signi ican associa ions we e ound be ween VJ es dec emen s and RPE o RPE-ML.
The p esen esul s showed no signi ican di e ences be ween spo classes in he
RPE-ML and RPE. In his ega d, Hen íquez e al. [
10
] ound no di e ences be ween he
spo classes in he RPE and he hea a e o CPFPs ollowing he pe o mance o wo
small-sided games and a simula ion ma ch, ein o cing he possibili y ha he men ioned
ac o s may explain he absence o di e ences in he in e nal load ac oss unc ional p o iles.
Con a y o he ob ained esul s, p e ious s udies obse ed di e ences in he ex e nal
load o playe s’ spo classes du ing in e na ional ma ches, showing he in luence o he
impai men p o iles on physical esponse pa ame e s [
3
,
11
]. Possibly, due o he unc ional
di e ences be ween classes and despi e he lowe ex e nal load o FT1 and FT2 (mo e
a ec ed classes) han FT3, he in e nal load o he pe cei ed exe ion could be simila
ollowing a ma ch. These esul s show ha he playe spo classes wi h mo e impai men ,
despi e ha ing a lowe physical esponse han he mo e unc ional p o iles, ha e a simila
pe cei ed pe cep ion e o [
10
]. The e o e, i would be in e es ing o quan i y in CPFPs
no only he ex e nal ma ch esponse bu also he in e nal o pe cei ed load, because his
could p o ide complemen a y ma ch load in o ma ion. Fo u u e s udies, o con i m
whe he he in e nal load is simila , i would be necessa y o quan i y his by using me hods
such as hea a e moni o ing in compe i i e condi ions [
16
]. Wi h ega d o he playing
posi ions, no di e ences we e ound in he pe cei ed load a iables in he compe i i e
In . J. En i on. Res. Public Heal h 2022,19, 6070 8 o 12
ma ch. These indings a e consis en wi h wha has been ound in p e ious s udies du ing
ma ches wi h nondisabled p o essional oo ball playe s [
44
,
45
]. Howe e , o he s udies
epo ed di e ences acco ding o he pe cei ed load exe ion and playing posi ion du ing
compe i i e ma ches [
24
,
25
,
46
]. Ne e heless, he pa a-spo speci ic pa icula i ies mus
be conside ed in he analysis, whe e he playing posi ions a e no en i ely delimi ed, he e
is no o side ule, he e is a p esence o a lowe numbe o playe s (7-a side), and he e is
a smalle ield size han egula oo ball, ac o s which could in luence ac ical s a egies
and he pe cei ed exe ion load du ing ma ches [
11
,
47
]. E en hough he p esen s udy did
no ind di e ences in he RPE and ML acco ding o spo s classes and playe posi ions,
he use o hese me hods could be help ul in a p ac ical se ing o pe o m a pos -ma ch
indi idual moni o iza ion conside ing he speci ic CP oo ball cha ac e is ics.
A e a compe i i e ma ch o CP oo ball, he o e all sample esul s indica ed a dec ease
in VJ pe o mance (SJ and CMJ). Simila o hese esul s, a dec ease in he VJ pe o mance
was also demons a ed a e oo ball ma ches wi h nondisabled
oo balle s [12,14,16,17]
and
in a g oup o ampu ee pa a- oo balle s [
48
]. The compe i i e demands o CP oo ball
ma ches equi e high-in ensi y ac i i ies in ol ing sho - e m ac ions by playe s who
p esen speci ic impai men s ela ed o neu ological condi ions [
11
,
47
]. These high neu-
omuscula demands and he necessi y o main aining a wo k a e o e he compe i i e
ma ch ime in an in e mi en ac i i y could be one cause o he de elopmen o neu omus-
cula a igue [
49
]. In addi ion, gi en ha CP a hle es ha e epo ed lowe le els o muscle
s eng h [
5
], asymme ical adap a ions o jumping asks [
50
], and pacing s a egies o
compensa e a igue componen s du ing mo o ac i i ies [
51
], hese ac o s may con ibu e
o g ea e VJ dec emen s a e oo ball-ma ch ac i i ies.
Wi h ega d o each spo class esul , a signi ican educ ion in he VJ heigh was
ound ac oss he unc ional p o iles, showing neu omuscula -induced a igue ollowing
he compe i i e ma ch on SJ and CMJ measu emen s. Fu he mo e, ega ding he pai wise
compa ison, FT3 playe s p esen ed a highe ma ked educ ion in SJ pe o mance a e he
ma ches han hei FT2 and FT1 coun e pa s. Playe s wi h he minimal impai men c i e ia
(FT3) a e desc ibed as pe o ming bes in e y high-in ensi y ac i i ies and exhibi he
bes mo o pe o mance compa ed o o he spo classes [
3
,
9
]. Conside ing ha only one
FT3 playe pe eam can play a he same ime and ha his is he p o ile wi h he g ea e
unc ionali y [
26
], hese playe s may ha e highe physical equi emen s du ing he game,
a ac o which would p oduce mo e muscle damage and a igue, a ec ing hei capaci y
o o ce p oduc ion pos -ma ch [
14
]. Howe e , ega ding CMJ, no signi ican di e ences
we e ob ained be ween spo classes. The CMJ is a widely used me hod o he assessmen
o a igue; howe e , he neu omuscula aspec s ela ed o he a igue can also mani es
as an al e na i e mo emen s a egy, a ia ions o kine ic a iables, and, in his case,
possibly he in luence o he unc ional p o ile [
52
]. Acco dingly, Reina e al. [
9
] ound ha
ho izon al jumps (i.e., s anding b oad jump, ou bounds o dis ance, and iple hope o
dis ance) p esen ed mo e di e ences be ween spo classes han VJ, based on each jump’s
speci ic demands (i.e., highe demands o coo dina ion and balance). The non-signi ican
di e ences be ween spo classes in CMJ could e lec an indi idual impai men -speci ic
esponse o he ma ch demands, whe e concen ic o ce-gene a ion was mo e a ec ed
and e lec ed du ing SJ pe o mance [
21
,
53
]. Fu he mo e, acco ding o Van Hoo en and
Zolo a jo a [
54
], indi iduals wi h an impai ed coo dina ion unc ion o inadequa e capaci y
o co ec ly ime muscle ac i a ion could ha e wo se pe o mance in SJ; howe e , hey
could pe o m a CMJ ela i ely well due o he capaci y o up ake muscle slack and he
buildup o s imula ion du ing he coun e mo emen . Thus, i is plausible o sugges ha ,
o SJ, he heigh dec emen s we e mo e ma ked acco ding o he di e en classes, hough
he impac o a igue exp essed in CMJ pe o mance had a simila in luence ac oss CP
oo ball p o iles.
When examining he playing posi ions, a signi ican dec ease was shown o SJ and
CMJ among all posi ion g oups a e he compe i i e ma ch. Fo SJ, in compa ing playing
posi ions, a lowe signi ican de e io a ion was epo ed in de ende s han mid ielde s and
In . J. En i on. Res. Public Heal h 2022,19, 6070 9 o 12
a acke s. In his ega d, Moh e al. [
55
] showed ha non-disabled oo balle s wi h a ole
as mid ielde s and a acke s pe o med mo e high-in ensi y ac i i ies (i.e., he dis ance a a
high in ensi y) han de ende s, and hey expe ienced a igue owa d he end o ma ches, as
well as empo a ily du ing he game, independen o playing posi ion. Simila ly, p e ious
s udies epo ed ha , du ing p o essional ma ches, cen al de ende s pe o med a lowe
dis ance co e ed a di e en in ensi ies compa ed o o he playing posi ions [
56
,
57
]. Indeed,
mul iple ac o s could a ec he wo k a e and p oduce a igue du ing he ma ch, such
as he ac ical ole [
58
], le el o play [
59
], and physical i ness [
49
]. Un o una ely, in
he case o CPFPs, as a as he au ho s a e awa e, no s udies ha e analyzed whe he
he ma ch load is di e en o playe s depending on he playing posi ion. Cau ion is
necessa y o in e p e he indings o his s udy due o he di e en unc ional pe o mance
based on he disabili y p o ile in he case o pa a-a hle es wi h CP and conside ing he
CP oo ball’s echnical/ ac ical pa icula i ies, which can di e om egula oo ball. The
signi ican pe o mance loss ound in VJ a e a compe i i e ma ch should conce n coaches
o add essing adequa e eco e y pe iods du ing conges ed calenda s o a e in ense
games, especially o hose who showed mo e jump heigh dec emen s, such as FT3 playe s
and hose wi h MF o AT playing oles.
The ela ionship ound in he p esen s udy be ween VJ de e io a ion and pe cei ed
load pa ame e s indica es ha playe s wi h lowe pe cei ed exe ion du ing he ma ch p e-
sen ed lowe educ ions in VJ heigh . Rampinini e al. [
60
] epo ed signi ican ela ionships
be ween playe ma ch RPE and pe iphe al a igue indica o s ela ed o a educed muscle
con ac ile capaci y. Con a y o hese indings, Bení ez-Jiménez e al. [
58
] showed no
signi ican ela ionship be ween he change in CMJ heigh and he a e age RPE ollowing
consecu i e iendly ma ches in young oo ball playe s. I seems ha hose CPFPs wi h
highe RPE o RPE-ML alues would p esen g ea e neu omuscula a igue ep esen ed
by a VJ de e io a ion ollowing a compe i i e ma ch. The e o e, om a aining poin o
iew, i could be ele an o coaches o implemen aining p o ocols o ien ed o ob aining
a supe io physical i ness o p omo e a educ ion in he ma ch pe cei ed exe ion, wi h-
ou a educ ion in physical equi emen s, and consequen ly p oduce less neu omuscula
a igue [13,46]
. These indings p o ide no el in o ma ion ega ding ela ionships be ween
pe cei ed load and neu omuscula a igue p oduced in CPFPs a e compe i i e ma ches,
app oaches which could imp o e he physical assessmen o his g oup o pa a- oo balle s.
Al hough his esea ch has been ca ied ou wi h high scien i ic s anda ds and me hod-
ological igo , he main limi a ion is ha objec i e me hods ha e no been used o quan i y
ma ch load. Taking in o accoun he possible limi a ions ha he RPE-ML may ha e, i
would be in e es ing i , in u u e s udies, he quan i ica ion o he ma ch load could be
complemen ed wi h objec i e load quan i ica ion me hods.
5. Conclusions
The VJ es ing could p o ide da a o coaches’ aining sessions, he implemen a ion o
eco e y s a egies, and he assessmen o neu omuscula a igue o pa a- oo balle s wi h
CP. The SJ and CMJ we e demons a ed o be use ul in assessing neu omuscula a igue
in CP oo balle s; howe e , he SJ should be conside ed in e ms o he cha ac e is ics o
each playe ’s spo s classes and playing posi ions. These esul s should be in e p e ed
wi h cau ion due o he numbe o pa icipan s in each g oup, acco ding o spo classes
and playing posi ions. I is also necessa y o conside he in luence o physical, echnical,
and ac ical demands speci ic o di e en classi ica ion p o iles, and he absence o he
assessmen o addi ional neu omuscula a igue a iables (e.g., epea ed sp in abili y,
sp in , biochemical ma ke s, maximal olun a y s eng h, o kinema ic ma ke s). The
p esen da a p o ide no el in o ma ion sugges ing ha VJ es s could be a use ul indi ec
measu e o neu omuscula a igue exp essed in heigh jump loss a e a oo ball ma ch,
highligh ing ha CP oo ball can be a modali y wi h high neu omuscula demands. The SJ
pe o mance poin ed ou some di e ences ega ding a igue mani es a ion, conside ing
playe s’ spo classes and playing posi ions, especially o less impai ed playe s (i.e., FT3)
