Boosting of Performance in the Athlete with High-Level Spinal Injury

Abstract

Autonomic dysreflexia is a common response to painful stimuli following high level spinal injuries. Loss of normal control of sympathetic reflexes leads to large increases in blood pressure, accompanied by headache and occasional more dangerous sequelae. Although now officially banned, intentional dysreflexia ("boosting") is still exploited by some competitors to gain an unfair advantage. It is thus important to consider physiological mechanisms, consequences for health and performance, and methods of controlling this abuse. Boosters perceive the practice as frequent, performance enhancing, and of low immediate risk. Effective methods of eliminating the practice may include more stringent control of competitors, evaluating and publicizing short-and long-term risks, and countering arguments that boosting is an ethically acceptable method of restoring a normal physiological response.