Implementing environmental ergogenics in Paralympic athletes: overlooked health issues indicate that this is not merely a replication of evidence-based practices in Olympians

The use of altitude/hypoxia or heat 1 is one of the key ergogenic factors that needs consideration to ensure optimised preparation (either as training methods or acclimatisation/acclimation process) of major nondisabled sport events such as Olympic Games. Paralympic athletes and their accompanying staff are tempted to integrate such approaches in their preparation. They are supported by empirical observations, although only a few scientific evidences2–4 are available for this particular population. Still, depending on their impairment (ie, the loss or abnormality of a function that can be anatomical, biological, physiological or psychological) and disability (ie, the inability or restriction in performing activities due to the impairment), paralympic athletes may face unique physical and physiological challenges (eg, oxygen delivery, thermoregulation) when exposed to altitude/hypoxia or heat, thereby increasing health issues. We identify major impairment-related health issues associated with these challenging environmental stressors in reference to the International Paralympic Committee (IPC) impairment classification system5 and discuss the overlooked issues Paralympic athletes may face when using environmental ergogenics.