Project uses biomarkers to prevent infections and injuries in Paralympic athletes
In a presentation at FAPESP Week Netherlands, a researcher highlights the use of biochemical variables to tailor athletes’ rest periods and guide young talent, with a focus on the 2028 and 2032 Paralympic Games
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José César Rosa Neto, coordinator of the Multidisciplinary Center for Paralympic and Para-Sports Studies, during his lecture at FAPESP Week Netherlands
view moreCredit: Elton Alisson/Agência FAPESP
During a competitive cycle, a Paralympic athlete is 20 times more likely to contract an infection and 11 times more likely to be hospitalized due to such complications than an Olympic athlete. In addition, 30% of Paralympic athletes suffer from infections in the upper respiratory tract – an area that includes the nose, mouth, and throat – compared to just 2% of Olympic athletes. Among wheelchair users, up to 30% experience recurrent urinary tract infections.
To mitigate this immune vulnerability and protect the health of competitors, researchers affiliated with the Multidisciplinary Center for Paralympic and Para-Sports Studies (CMEPP) – a Science Center for Development (SCD) funded by FAPESP – are investigating how the immune response (the body’s defense mechanism) is altered in each sport and for each type of disability, such as spinal cord injuries or visual and intellectual impairments.
The team’s main goal is to replace traditional training control – based on the athlete’s subjective perception of exertion – with objective physiological and metabolic biomarkers – measurable biological indicators analyzed in blood and saliva – explained José César Rosa Neto, a professor at the Biomedical Sciences Institute at the University of São Paulo (ICB-USP) and coordinator of CMEPP, in a lecture given during FAPESP Week Netherlands.
“Many athletes underestimate muscle exhaustion and risk suffering serious injuries or severe episodes of immunosuppression [a temporary drop in the body’s immune defenses], so continuous analysis of blood and saliva samples will allow technical commissions to accurately calibrate each athlete’s loads and rest periods,” Rosa Neto explained to Agência FAPESP.
By monitoring these biochemical variables in direct collaboration with the Brazilian Paralympic Committee (CPB), the scientists aim to provide coaches with precise information on the exact moment to intensify training loads or grant rest, thereby preventing injuries and new severe episodes of immune system decline.
“Some athletes underestimate the effort: the muscle is exhausted, but they say they’re fine – and they risk injury. Then there are athletes who report significant fatigue, but the muscles are fine and could handle more,” said Rosa Neto.
Future generations
In parallel with the study focused on high performance, the center’s training division works to train professionals and monitor children and adolescents across the four stages of the CPB Paralympic Sports School. The researcher explained that the team will use salivary hormone kits – noninvasive tests conducted using saliva samples – to assess the biological maturation of young people (the individual rate of physical development during puberty) and guide them with scientific precision toward strength or aerobic sports, thereby preventing the premature loss of talent.
Another line of research at the new center investigates the use of “exergames” – interactive video games that require movement and physical effort from the player to progress in the game – in the at-home training of young athletes, overcoming urban barriers to accessibility and transportation.
The integration of these efforts aims to ensure the athletes’ immune health and boost Brazil’s performance leading up to the 2028 Los Angeles and 2032 Brisbane Olympic and Paralympic Games.
“The idea is to assist in deciding which sport is best suited for a particular athlete, helping to train new generations so we can be even stronger at the 2028 and 2032 Paralympic Games,” the professor explained.
Efficient management
Brazil has established itself as a global Paralympic powerhouse, ranking 5th overall at the most recent Paralympic Games, held in 2024 in Paris, France. According to Rosa Neto, the country’s competitive edge lies in the CPB’s financial and administrative management structure. Unlike the Olympic model, the CPB centralizes management and the direct allocation of funds to sports with the highest medal potential – such as track and field, swimming, and boccia – ensuring control and efficiency in both public and private investments.
With the support of science and the refinement of training load monitoring through biomarkers, Brazil’s planning is already focused on the upcoming global sporting cycles.
“Our internal goal for 2028 is to increase the total number of medals and consolidate our position among the top five. For 2032 in Brisbane, the goal is to approach the United States and compete for second place overall,” said Rosa Neto.
Adapting smartwatches
In addition to initiatives involving Paralympic athletes, another project planned for development within the SCD is to adapt smartwatch algorithms to the specific needs of people with disabilities – for example, by adjusting the measurement of daily caloric expenditure for wheelchair users.
“Conventional algorithms for counting steps and measuring calorie expenditure were designed for people without disabilities and fail to accurately measure the exertion of wheelchair users,” Rosa Neto explained.
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