Introduction
The objectives of this study were to determine: (1) the prevalence and type of NS used by athletes; (2) the frequency and dosage of use, and the reasons for their use; (3) where athletes obtain their information regarding supplements; (4 ) if age, nationality, gender, sport category, training hours, performance level and disability influence an athlete’s use of NS; (5) how athletes perceive NS use; and (6) the knowledge of disabled athletes on topics relating to doping/anti-doping in sport.
Participants
A total of 399 participants completed the questionnaire (296 (74%) male and 103 (26%) female) all aged above 18 years. The majority (87%) of athletes’ ethnic origin was reported as white. Athletes were represented from 21 different nationalities across 28 different sports with a large proportion from the wheelchair court sports (20% Wheelchair Rugby, 12% Wheelchair Basketball, 10% Wheelchair Tennis), Athletics (8%), Sitting Volleyball (7%) and Cycling (6%). The number of years the athletes’ reported playing their main sport (experience) was 8.1 ± 7.1 y, with 64% and 36% playing at an elite (National or International) and non-elite (club, regional or development) performance level, respectively.
Key findings
We provide data on a total of 28 sports with participants competing across the exercise continuum. These data suggest the use of NS is common with over half of the 399 athletes reporting the use of at least one NS. Despite the majority of athletes understanding the risks of using NS, it is of great concern that 33% of elite level athletes report never having attended an anti-doping or NS workshop. It is clear that this should be mandatory for all elite athletes and that education needs to be improved.
Overall the findings in this report suggest that more information should be readily available to athletes and their coaches on the use of NS for disabled people. The participants in the current study specifically requested information on topics such as effective NS and their dosage recommendations, anti-doping issues, personalised information and how their needs compare to AB athletes. Athletes are currently guided by sport scientists and/or nutritionists/dietitians on the use of NS but unfortunately not all athletes have access to such practitioners, especially below the elite level. Disabled athletes who are undertaking a training and competition schedule that pushes their body to the limits of their ability may benefit from the use of NS. However, given the limited evidence base they must perform a personal cost-benefit analysis prior to using them to help prevent any negative effects or complications. Consequently, over time we should seek more evidence-based recommendations and practice in this specific population. The outcomes from such disabilityspecific NS research would help reduce the issue of a ‘lack of understanding’ and ‘trial and error’, which is currently reported.
Recommendations
- WADA education workshops should be mandatory for all elite level disabled athletes and should include information that is aimed at this specific population.
- Information on topics such as NS and their effectiveness, how to adapt the dosage to suit an individual’s disability and to help prevent the possible negative effects of some NS should be highlighted during education sessions. This type of information could initially be provided in an online and leaflet format.
- Education should be aimed at both athletes and their coaches. It should also be considered whether a factsheet could be produced for other medical professionals such as doctors, general practitioners and physiotherapists in the event that they are
approached by athletes with questions on the topic of NS.
- Where possible, education should also be provided to those below the elite level of performance.
- Further research should be conducted into the use of specific NS and the dose, effectiveness and possible negative effects of NS for athletes who have a variety of disabilities including SCI, CP, amputations, multiple sclerosis and dwarfism.
