An elite runner with cerebral palsy: cost of running determines athletic performance

Background: Running performance is widely understood interms of the Joyner model (VO2max, %VO2max at ventilatorythreshold (VT), running economy (often measured as cost ofrunning (CR) as VO2 in ml.kg‑1.km‑1).Objective: To test the Joyner model by evaluating a runner inwhom one element of the Joyner model is systematically abnormal.Methods: The case of a two-time Paralympian with cerebral palsy(CP), 2nd place in the Sydney 2000 Paralympic 1500 m (T37) isreported. Incremental and steady state treadmill runs as well assimulated competitions were completed. Incremental and steadystate (50% PPO) cycling with two legs (2L), the non-affected leg(NL), and the affected leg (AL) were also completed.Results: His silver medal (2000 Sydney OG) performance for1500 m was 269 s (4:29) (77.2% of velocity in contemporary ablebodiedworld record (WR). At the time of study, his VO2maxwas 64.2 ml.min‑1.kg‑1. His cost of running (CR) (1% grade) washigher, at 257 vs 228, 211 and 188 ml.kg‑1.km‑1 (for ACSM norms,elite Europeans, elite East Africans). During cycling, his VO2maxwith 2L, NL and AL was 3.74, 3.78 and 3.71 l.min‑1, and his grossefficiency (GE) was 18.4, 12.2 and 9.3%, respectively.Conclusions: In a former elite runner with CP, there is littleevidence of a central oxygen transport limitation. The higherCR (plausibly reflected by the reduced GE of his AL) appears toaccount for much of the difference in performance compared toable-bodied runners. The results provide both insight into thephysiological limitations of runners with CP and support for theJoyner model of competitive running performance.Keywords: biomechanics, athletic training, exercise performance,exercise physiology