Emerging assistive technologies in paralympic sports: a systematic review

This systematic review aims to consolidate and critically assess current evidence on emerging assistive technologies in Paralympic and adaptive sports. Specifically, it examines how devices such as prostheses, wheelchairs, exoskeletons and digital tools influence athletic performance and injury mitigation across diverse impairment types and sport disciplines.

A comprehensive search of PubMed, Web of Science, IEEE Xplore, SPORTDiscus and ScienceDirect was conducted through August 2025. Eligible studies included peer-reviewed articles evaluating technologies used by para-athletes or in simulated adaptive sport contexts, with outcomes related to performance or injury risk.

A total of 42 studies from 18 countries were included, spanning various technologies and Paralympic sports. Key findings revealed that advanced prosthetics (e.g., carbon-fibre running blades), customised sports wheelchairs, and wearable digital tools improve propulsion mechanics, energy efficiency and overall performance. Several technologies also contributed to injury prevention through biomechanical optimisation and real-time monitoring. However, research remains geographically imbalanced, heavily concentrated in high-income countries, and focused predominantly on mobility impairments such as spinal cord injury and amputation. Underrepresented areas included athletes with neurological or visual impairments and sports outside wheelchair disciplines. Most studies were descriptive or feasibility-based with limited sample sizes and short-term evaluations.

Emerging assistive technologies show significant potential in improving athletic performance and safety for para-athletes. To advance the field, future research should emphasise inclusivity, long-term impact, cost-effectiveness and broader impairment coverage. Strengthening international collaboration and prioritising user-centred, scalable innovation will be essential to ensure equitable access and performance integrity in adaptive sports.