Paralympics research

Dr. Andrei Krassioukov-headshot

Dr. Andrei Krassioukov

Dr. Andrei Krassioukov is a world-renowned expert in autonomic dysfunctions following spinal cord injury. He is the Director of the Autonomic Research Lab at ICORD, a professor at the University of British Columbia and a staff physician at the GF Strong Rehabilitation Centre in Vancouver.

Dr. Krassioukov is studying the cardiovascular and autonomic dysfunctions that predispose some paralympic athletes to be disadvantaged during competition. Dr. Krassioukov is collaborating with the International Paralympic Committee (IPC) to design a cardiovascular /autonomic classification for paralympic athletes to complement existing IPC classifications that predominantly account only for motor dysfunctions. The IPC classification of athletes is a complex and frequently challenging process, but the main goal of the classification is to allow all athletes to compete according to the paralympic values of fair play and honourable sports competition.

Dr. Krassioukov began his work at the 2008 Paralympic Games in Beijing, continued at the 2010 games in Vancouver, the 2012 games in London, and the 2014 winter games in Sochi, Russia. This ongoing project has received support from  ICORD, University of British Columbia, Vancouver Coastal Health Research Institute, General Electric (2014), Wellspect (2014), Coloplast (2012-2014), West Shore Construction (2012) and the Craig Nielsen Foundation (2010-2012), Rick Hansen Foundation, Canadian Foundation for Innovation (2010-2012).

Dr. Krassioukov’s research has been featured in various media outlets. Please visit the Paralympic Research Team News page to stay up-to-date with the research team. Pictures from the 2012 and 2014 Paralympic Games are available in the Gallery.

General overview

Paralympic athletes are exposed to tremendous physical and emotional stress during training and competition, and athletes with spinal cord injury (SCI) have unique disadvantages during competition.

One of these disadvantages is unstable blood pressure control. On a daily basis, individuals with SCI deal with either extremely low resting blood pressure, and/or uncontrolled episodes of high blood pressure.  The latter is called autonomic dysreflexia (AD).  Low blood pressure and a poor response from the heart results in significant fatigue and presents a serious problem for athletes during both training and competition. In contrast to low blood pressure, AD is a life-threatening situation whereby individuals with cervical and upper thoracic injuries experience a drastic increase in blood pressure. If left untreated, AD can lead to bleeding in the brain and/or death.

In an able-bodied athlete, a raised heart rate and blood pressure help to deliver more oxygen to the muscles in the body, increasing one’s stamina and energy and thus their performance in a sport or activity. However, many athletes who participate in the Paralympics have spinal cord injuries that limit their ability to regulate their heart rate and blood pressure. For these top-level athletes, this can be a significant competitive disadvantage, leading to some athletes deliberately spiking their blood pressure ahead of a competition – occasionally going so far as to break a toe or hold their urine. Such extreme measures lead to an increased heart rate and elevated blood pressure, which give athletes the energy and stamina they need to compete in strenuous sports. Known as “Paralympic boosting,” this is a dangerous practice that can lead to heart damage, stroke, and even death.

Additional information on AD, boosting, orthostatic hypotension, and UTIs is available in our Paralympic Brochures.