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Electroceuticals for Paralympic Athletes: A Fair Play and Classification Concern?
Daniel D Hodgkiss1, Shane J T Balthazaar1,2,3, Cameron M Gee2,4
1School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Sports Medicine (Auckland, N.Z.)
|October 13, 2025
Summary
Spinal cord stimulation (SCS) enhances athletic performance in individuals with spinal cord injury (SCI). Its potential misuse raises concerns for fair play and athlete safety in parasport, warranting regulatory review.
Area of Science:
- Neuromodulation
- Sports Science
- Medical Ethics
Background:
- Electroceuticals, including spinal cord stimulation (SCS), offer novel neuromodulation strategies.
- SCS can improve motor and cardiovascular functions, particularly in individuals with spinal cord injury (SCI).
- Athletes with SCI often face physiological challenges during exercise, leading some to engage in banned practices like "boosting".
Purpose of the Study:
- To evaluate if spinal cord stimulation (SCS) meets criteria for inclusion on the World Anti-Doping Agency (WADA) Prohibited List.
- To address the potential for SCS to enhance athletic performance and create unfair advantages in parasport.
- To highlight the health risks and ethical considerations associated with SCS use in athletes.
Main Methods:
- Review of existing research on SCS effects on exercise performance in SCI.
- Analysis of SCS potential for misuse and impact on the spirit of sport.
- Assessment against WADA's criteria for prohibited substances and methods.
Main Results:
- Spinal cord stimulation (SCS) demonstrates a capacity to augment aerobic exercise performance.
- The misuse of SCS presents significant health risks and potential for unfair competitive advantage.
- Current anti-doping regulations do not adequately address the implications of SCS in parasport.
Conclusions:
- Spinal cord stimulation (SCS) use in parasport warrants consideration for the WADA Prohibited List due to performance enhancement, health risks, and ethical concerns.
- The International Paralympic Committee (IPC) and WADA need to establish clear guidelines regarding SCS.
- Increased accessibility of SCS necessitates proactive monitoring to ensure fair and safe competition.
