Background This study assessed whether anthropometry, physical fitness and sport-specific sprint performance vary across the three groups of sitting volleyball (SV) athletes (athletes with a disability (VS1), athletes with a minimal disability (VS2) and able-bodied SV athletes (AB)) in order to explore the validity of the current system of classification. This study also investigated how the anthropometric and physical fitness characteristics of athletes relate to their sprint performance. Methods Thirty-five SV male athletes aged 37.4 ± 10.8 years and practicing SV at a national/international level volunteered for this study. Testing consisted in the evaluation of linear anthropometry, physical fitness (body composition by-means of dual-energy X-ray absorptiometry and upper-body strength) and sprint performance (5-meter sprint tests, agility test and speed and endurance test). Results Athletes in the three groups differed in fat mass percentage (%FM) which was higher in VS1 versus AB at the sub-total level (+9%), in the arms (+15%) and in the non-impaired leg (+8%) regions. Greater hand span, greater length of the impaired lower leg, lower %FM at both the sub-total and regional level and a higher level of strength in the upper body are all associated with better performances in the considered sprint tests (P < 0.05 for all). These results do not confirm the validity of the current system of classification of athletes adopted in SV. Professionals dealing with SV athletes should include specific exercises aimed at improving whole-body and regional body composition and the strength of the trunk and upper limbs in their training programs.

Background: Mediterranean diet (Med-D) has been previously suggested for athletes, but Paralympics usually have a low intake of plant foods. Orthorexia nervosa (ON) can drive dietary intake of both athletes and gym attendees. Objective: We aimed to compare dietary intakes and food habits of elite wheelchair basketball athletes (WBA) and able-bodied individuals who practice or not sport activity and with different fat mass percentage (FM%). Methods: We recruited 15 WBA from the Italian National team and 3 control groups (15 each group): healthy individuals who do not practice any sport activity (NSA) and gym attendees with low (GAL, FM%18) FM%. Food consumption was monitored by 3-d diary, while Med-D scores and ON score were evaluated through standardized questionnaires. In WBA we also assessed Neurogenic Bowel Dysfunction (NBD), GastroEsophageal Reflux Disease (GERD), allergy questionnaire for athletes (AQUA) and Starvation Symptoms Inventory (SSI). Results: In WBA, ON correlated with GERD and SSI. WBA and GAH with eating behavior of ON had higher adherence to Med-D, whereas NSA had less adherence to Med-D. Sub-score including fruits, vegetables and legumes, was higher in the GAL and GAH groups compared to the WBA and NSA groups. Med-D was inversely related to animal protein intake (PRO-AN) in NSA and GAL. FM% was inversely related to PRO-AN in WBA and GAH, and to ON only in GAH. In WBA PRO-AN and vegetable protein intake correlated with both carbohydrate and energy intakes. Conclusions: In WBA, commitment to wellness (ON and Med-D adherence) could be a response to gastrointestinal and starvation symptoms. WBA should be involved in setting their own individualized dietary strategies.

Background/Objectives: The body mass index (BMI) is considered a key method for the classification of individuals’ weight status, according to cut-off points proposed by the World Health Organization (WHO); however, the use of this classification is still the subject of debate and criticism. We aimed to evaluate the accuracy of the WHO BMI classification in reflecting true adiposity in the Italian general population. Methods: This cross-sectional study included 1351 adults of mixed gender aged between 18 and 98 years, comprising 19 (1.4%) underweight individuals, 787 (58.3%) normal weight, 354 (26.2%) overweight, and 191 (14.1%) with obesity according to the WHO BMI. After that they were re-categorized according to adiposity based on body fat percentage (BF%) measured by dual-energy X-ray absorptiometry (DXA). The agreement between the two classification systems was tested using the kappa statistic (κ), with the system based on BF% being considered the gold standard. Results: According to the BMI classification, 78.1% of the individuals who were in the normal weight range were correctly classified. However, 53.4% of the overweight group and 68.4% of the underweight group were misclassified according to the BMI, as the majority of those misclassified fell within the normal weight range according to their BF%. Finally, regarding the obesity group, 34% who were classified as having obesity according to the BMI were misclassified, since they were revealed to be only affected by overweight according to adiposity status. Conclusions: Despite the fact that the BMI seems to be reliable in determining body weight status in the normal weight range, over a third of the general population was misclassified, as the current BMI classification appears to inflate the prevalence of underweight, overweight, and obesity among the general population. Accordingly, this may warrant consideration of revising the National Guidelines in Italy related to weight status classification. Healthcare practitioners should be advised not to rely solely on the BMI, and should integrate its use with adiposity measures (i.e., BF%) or alternative surrogate indicators (i.e., waist-based) in routine evaluations, especially in those with a BMI below or above 18.5 kg/m² or 25 kg/m².

Introduction: This study was planned to assess the association between serve efficacy and match outcome, and to investigate which factors are associated with serve efficacy in high-level male and female Sitting Volleyball players.Methods: The study sample was comprised of a total of 3,664 serving actions, performed during the 2020 Paralympic Games and the 2022 Sitting Volleyball World Championship. For each serving action, we considered serve efficacy (i.e., Point lost, Negative Serve, Positive serve and Point won), serve zone, type of serve technique, target zone of the serve, type of reception, receiving player and match outcome (i.e., match won, or match lost).Results: The Mixed-effects logistic regression model showed that serve efficacy is significantly associated with the match outcome, increasing serve efficacy being associated with increased chances of winning the game. The ratio between the probability of winning and losing the game started at 0.86 for a Point lost and increased to 1.67 for a Point won. Compared to Negative serves, Positive serves were associated with a higher probability that the opponent team would use a low reception rather than a high reception. In turn, a low reception was associated with a higher chance (from 45.1% to 58.3%) of the receiving team committing an error in the side-out phase.Discussion: Based on these results, it is recommended that high-level coaches focus on improving their players' serve efficacy by instructing them on managing risk, avoiding serves to the front zone, and reducing the likelihood of overhead receptions.

There is lack of information about bone mineralization at the lumbar spine and bilateral hips of athletes with unilateral lower limb amputation. The present study assessed for the first time the areal bone mineral density at the lumbar spine and at the hip of the able and impaired leg by means of Dual-Energy X-Ray Absorptiometry using a large sample (N = 40) of male athletes. Results showed that bone demineralization in athletes with unilateral lower limb amputation is found at the impaired hip but not at the lumbar spine and may therefore be site-specific. The extent of hip demineralization was influenced by the level of amputation, with about 80% of athletes with above knee amputation and 10% of athletes with below knee amputation showing areal bone mineral density below the expected range for age. Nevertheless, a reduced percentage of fat mass and a lower fat-to-lean mass ratio in the residual impaired leg as well as a greater amount of weekly training was positively associated with bone mineralization at the impaired hip (partial correlation coefficients = 0.377–0.525, p = 0.040–0.003). Results showed that participation in adapted sport has a positive effect on bone health in athletes with unilateral lower limb amputation but is not sufficient to maintain adequate levels of bone mineralization at the impaired hip in athletes with above-knee amputation. Accordingly, physical conditioners should consider implementing sporting programs, according to the severity of the impairment, aimed at improving bone mineralization at the impaired hip and improve body composition in the residual impaired leg.