In November 2014, a 30-year-old male wheelchair athlete (ID: BL) with SCI classified as ASIA C contacted our university and asked for support regarding his athletic orientation toward paratriathlon (Figure 1). BL had participated in professional wheelchair basketball for a decade and had already finished several triathlons including national championships. He wanted to have guidance in sport-specific training and testing to achieve his ultimate goal: participating in the Paralympic Games in either Rio de Janeiro (2016) or Tokyo (2020). The athlete gave written informed consent to take part in this study. Standardized guidelines for reporting were used (refer to Supplementary Material 1).
From 1990 to 2003, BL participated in motocross races. In March 2003, at the age of 18 years, he was involved in a quad bike accident that caused lumbar spine compression (ICD10-S32.01), kidney contusion (ICD10-S37.01), and incomplete paraplegia (ICD10-S34.71) with neurogenic bladder dysfunction (ICD10-N31.1) that required the permanent use of a wheelchair (ICD10-Z99.3). Immediate surgery stabilized the spine by internal fixation of the thoracolumbar junction. BL received physiotherapy, ergotherapy, and medical care during acute rehabilitation up to June 2004. He started wheelchair basketball soon after rehabilitation and played for several teams at the national level. Regular medical check-ups remained unsuspicious. In August 2013, he participated in his first sprint-distance paratriathlon.