In force

Boosting in elite athletes with high spinal cord injury: Awareness, knowledge and attitudes of athletes, coaches and trainers

Principal investigator
Y. Bhambhani
J. Mactavish
S. Warren
W. Thompson
A. Webborn
University of Alberta
Year approved
Attitudes toward doping, International-level, Elite, High Performance, Para-athletes

Project description

In 1994, the International Paralympic Committee (IPC) deemed boosting to be illegal and banned its practice during competition because research had demonstrated that it was a method that significantly improved performance. Their primary concern was the health and safety of the athlete. Currently, there is no research that has systematically examined the incidence, knowledge and attitudes of competitive athletes pertaining to boosting. The objectives of this research study were to:

(1) Examine the incidence of boosting in competitive high level spinal cord injured athletes.

(2) Evaluate their knowledge and beliefs with respect to the effects of boosting on sport performance and overall health.

(3) Document their attitudes towards boosting and other performance enhancement strategies in competitive sport.


This research study was implemented in four phases. In Phase I, a comprehensive boosting questionnaire designed to evaluate the incidence, knowledge and beliefs, and attitudes towards boosting was developed and validated by the International Paralympic Committee Sport Science Committee (IPCSSC), in conjunction with experts in the field of questionnaire design. In Phase II, a pilot study was conducted to evaluate the questionnaire for content and readability in 15 competitive spinal cord injured athletes. In Phase III, data were collected in three ways: (i) an online version of the questionnaire was posted on the IPC website so that athletes could complete this at their convenience; (ii) the questionnaire was sent to members of the International Network for the Advancement of Paralympic Sports through Science (INAPSS) for distribution to eligible athletes, and (iii) during the Paralympic Games in Beijing from 6th to 17th September 2008. In Phase IV, the data were statistically analyzed using the Fisher Exact test to obtain information pertaining to specific questions on the incidence, knowledge and beliefs, and attitudes toward boosting.


Of the 99 participants who completed the survey, 54 (54.5%) had heard of boosting prior to reading about it in the questionnaire. Approximately 41% of the participants felt that boosting was more useful in some sports  compared to others, while 15% indicated the opposite. The remaining 44% of the participants were unsure whether boosting was more useful in some sports compared to others. Majority of the  participants reported that boosting was most useful in middle distance events (78.6%), long distance  events (71.4%), marathon racing (64.3%) and wheelchair rugby (64.3%). Majority of the participants indicated that boosting was “completely unacceptable” for improving training capacity (61.3%), maximizing performance in competition (64.5%), because of knowledge of other competitors were boosting (57.4%), or boosting itself (60.3 %).


Significance for Clean Sport

It is recommended that:

(1) Educational materials pertaining to boosting be developed in conventional and electronic media to educate the athletes, coaches and trainers about this banned doping method,

(2) A concerted effort should be made to target geographical regions where the awareness of boosting is likely to be low and sports in which the likelihood of boosting is high,

(3) The frequency of boosting tests at the Paralympic games and other IPC sanctioned events be increased considerably so that the trends in this method of coping can be systematically evaluated, and

(4) Further research be conducted on a larger number of male and female Paralympic athletes with high level spinal cord injuries in order to increase the generalizability of the study findings.

Related publications

Boosting in athletes with high-level spinal cord injury: knowledge, incidence and attitudes of athletes in paralympic sport

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