Boosting is a method of inducing autonomic dysreflexia with the intention of enhancing performance in sport. It can be used by an athlete with a

spinal cord injury A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. It is a destructive neurological and pathological state that causes major motor, sensory and autonomic dysfunctions. Symptoms of ...

to increase their

blood pressure Blood pressure (BP) is the pressure of Circulatory system, circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term ...

and is performed by causing a painful stimulus in the lower part of the body. The International Paralympic Committee (IPC) banned the practice in 1994, but many competitors with spinal injuries are still thought to be using it as a performance enhancer.

Method

Athletes with spinal injuries can have difficulties with autonomic functions and their bodies may be unable to control blood pressure and

heart rate Heart rate is the frequency of the cardiac cycle, heartbeat measured by the number of contractions of the heart per minute (''beats per minute'', or bpm). The heart rate varies according to the body's Human body, physical needs, including the nee ...

. Because of this their bodies do not adapt to the increased demand of physical activity. Without these changes the athlete can become fatigued and suffer from a lower level of endurance. Boosting works by tricking the body into a state of high blood pressure and heart rate, with an increased utilization of oxygen improving the athlete's performance. Athletes who perform boosting before or during an event will often

self-harm Self-harm refers to intentional behaviors that cause harm to oneself. This is most commonly regarded as direct injury of one's own skin tissues, usually without suicidal intention. Other terms such as cutting, self-abuse, self-injury, and s ...

with some taking extreme measures to achieve the desired boost level. Techniques include: *Clamping the

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

to ensure that the bladder becomes overly full *Overly tightening leg straps *Electric shocks or stress to the feet, legs, scrotum, or testicles *Breaking a bone, usually in the toe.

Effectiveness and risks

Boosting has been shown in simulated races to give noticeable improvements in the performance of wheelchair marathon athletes. In the 1994 study the athletes attained an average 9.7 percent improvement after their bladder had been over-distended or after sitting in the racing chair for 1–2 hours prior to competing. It is believed to be capable of enhancing performance by up to 15 percent. There are many possible side effects of boosting, including the occurrence of a cerebrovascular or cardiovascular event such as a stroke or heart attack. Other complications include: *

aphasia Aphasia, also known as dysphasia, is an impairment in a person's ability to comprehend or formulate language because of dysfunction in specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine, but aph ...

bradycardia Bradycardia, also called bradyarrhythmia, is a resting heart rate under 60 beats per minute (BPM). While bradycardia can result from various pathological processes, it is commonly a physiological response to cardiovascular conditioning or due ...

* cerebral haemorrhage *

epilepsy Epilepsy is a group of Non-communicable disease, non-communicable Neurological disorder, neurological disorders characterized by a tendency for recurrent, unprovoked Seizure, seizures. A seizure is a sudden burst of abnormal electrical activit ...

hypertension Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...

hyperthermia Hyperthermia, also known as overheating, is a condition in which an individual's body temperature is elevated beyond normal due to failed thermoregulation. The person's body produces or absorbs more heat than it dissipates. When extreme te ...

*neurological abnormalities *visual disturbances

Prevalence

The IPC conducted a survey during the 2008 Games with 99 responses. 16.7 percent of the participants indicated that they had tried boosting in training or during a competition, with more than half of them being competitors in

wheelchair rugby Wheelchair rugby (originally murderball, and known as quad rugby in the United States) is a team sport for Disabled sport, athletes with a disability. It is practiced in over twenty-five countries around the world and is a summer Paralympic spor ...

. The use of boosting continues in athletes but is very difficult to detect. During the Games 20 athletes were tested just before their event for evidence of boosting but there were no positive results.

IPC view

The IPC made boosting illegal in 1994. Their handbook states in Chapter 4.3:

An athlete with a systolic blood pressure of 180mm Hg or above will be re-examined approximately ten minutes after the first examination. If on the second examination the systolic blood pressure remains above 180mm Hg the person in charge of the examination shall inform the Technical Delegate to withdraw the athlete from the particular competition in question.

Any deliberate attempt to induce Autonomic Dysreflexia is forbidden and will be reported to the Technical Delegate. The athlete will be disqualified from the particular competition regardless of the systolic blood pressure.

Method

Effectiveness and risks

Prevalence

IPC view

See also

References

Further reading