This study investigated performance and physiology to understand pacing strategies in elite Paralympic athletes with cerebral palsy (CP). Six Paralympic athletes with CP and 13 able-bodied (AB) athletes performed two trials of eight sets of 10 shuttles (total 1600m). One trial was distance-deceived (DEC, 1000 m + 600 m) one trial was nondeceived (N-DEC, 1600 m). Time (s), heart rate (HR, bpm), ratings of perceived exertion (RPE, units), and electromyography of five bilateral muscles (EMG) were recorded for each set of both trials. The CP group ran slower than the AB group, and pacing differences were seen in the CP DEC trial, presenting as a flat pacing profile over the trial (P < 0.05). HR was higher and RPE was lower in the CP group in both trials (P < 0.05). EMG showed small differences between groups, sides, and trials. The present study provides evidence for a possible pacing strategy underlying exercise performance and fatigue in CP. The results of this study show (1) underperformance of the CP group, and (2) altered pacing strategy utilization in the CP group. We proposed that even at high levels of performance, the residual effects of CP may negatively affect performance through selection of conservative pacing strategies during exercise.
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