Paralympic boosting and International Paralympic Committee regulation / 1990s-2000s
Boosting is a dangerous performance-enhancement practice used by some athletes with spinal cord injuries to trigger autonomic dysreflexia, a potentially life-threatening surge in blood pressure and heart rate. Because spinal injuries can disrupt the body's normal control of circulation during intense exercise, competitors may deliberately create a painful stimulus or otherwise stress the lower body to provoke this response. The resulting spike can increase oxygen utilization and endurance. A 1994 simulated-race study found that wheelchair marathon athletes improved their performance by an average of 9.7 percent after conditions such as an over-distended bladder or prolonged sitting in the racing chair; the practice has been estimated to offer performance gains of as much as 15 percent. The same physiological jolt can cause a stroke, heart attack, or other cardiovascular crisis, making the tactic resemble a form of self-inflicted doping rather than a harmless competitive trick. The International Paralympic Committee banned deliberate induction of autonomic dysreflexia in 1994. Its rules allow officials to withdraw an athlete whose systolic blood pressure remains at or above 180 mmHg after a recheck and require disqualification for any deliberate attempt to induce the condition, regardless of the measured pressure. Yet enforcement has been difficult: in an IPC survey conducted during the 2008 Games, 16.7 percent of 99 respondents said they had tried boosting in training or competition, with more than half of those respondents competing in wheelchair rugby. Twenty athletes were tested immediately before events, but none produced a positive result, illustrating how a banned practice can remain difficult to detect when it relies on manipulating the athlete's own autonomic response rather than introducing a conventional drug.
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