The Sports Clinic at Japan Institute of Sports Sciences (JISS) Medical Center has three main roles to conduct medical checkups, medical treatments and athlete rehabilitation. Our clinic has been accepting Paralympic athletes who do not need special care and daily medical care and have highly medal potential for Paralympic Games since 2016. The number of Paralympic athletes who visit our clinic is increasing year by year. Medical checkup for Paralympic athletes, contains both the screening items which JISS had determined for Olympic athletes and the screening items which Japanese Paralympic Committee (JPC) require to certify athletes for annual screening.We do not distinguish doctors and hours of consultation for their medical treatments between Paralympic athletes and Olympic athletes. By March 2018, the athletes of 15 Paralympic sports have visited our clinic. We respond to the problems unique to Paralympic athletes, such as urinary tract infections that are common in Paralympic athletes and questions about the impairment they have. We also try to create the medical diagnostics forms for their classification as much as possible. If necessary, they are introduced to athlete rehabilitation and nutrition consultation in our medical center. The support from the specialists and the primary care doctors are indispensable as there are some limitations at the JISS Medical Center. With their support, we will continue to support Paralympic athletes on the basis of understanding their impairments and their sports characteristics.

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The purpose of this article was to introduce fitness testing for Japanese para-athletes conducted at Japan Institute of Sports Sciences (JISS). Additionally, current challenges we face and our approaches for those challenges will be explained. Since 2015, fitness check-up for para-athletes have been carried out at JISS. The accumulated knowledge from scientific researches and know-how for supporting the Olympic sports for long time at JISS have been applied for Paralympic sports. Therefore, main fitness check-up services provided for the para-athletes have been similar to the Olympic athletes, which include body composition measurements, muscle strength tests, and aerobic and anaerobic capacity tests. However, the test protocols are modified and customized based on physical characteristics, or the types and degree of disabilities of each para-athlete. Their fitness levels and skills needed for their sports are assessed through tests that are specific to the sports. Our next challenges are to develop a testing method that can be customized for various types of disabilities for every sport and to establish fitness testing method with high accuracy for para-athletes.

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At the Japan Institute of Sports Sciences training gym, the use of para-athletes began in stages from 2015, we are working hard to improve the performance of para-athletes through individual training support. In this paper, after describing preparations for the first trial FC implementation that was accepted and considerations after the implementation, the facility use status of the para-athletes of the training gym and the summary and characteristics of individual training support are described.

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The Japan Institute of Sports Sciences (JISS) supports Paralympic athletes using information and communication technology (ICT) systems. We provide a video database system (JISS nx), a file sharing system (JISS share), and a physical condition data management system (AthletesPort) to National Federations (NFs) and athletes. The JISS nx has been used by 14 NFs; the total number of uploaded videos is 16,285 and the total number of users is 397. The JISS share has been used by 9 NFs; the total amount of uploaded data is 233 GB and the total number of users is 112. The AthletesPort is being gradually introduced to Olympic Athletes who train at the High Performance Sport Center, and some Paralympic athletes have also started using it. With the increase in the use of ICT systems for Paralympic athletes in the future, it is considered that the demand on the functions specific to Paralympic athletes will also increase.

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Estimating energy requirements is important in developing an athlete's nutrition plan. However, it may not be appropriate to calculate energy requirements for Paralympic athletes, or even people with disability by substituting the prediction equation of the non-disabled person as it is from the physical characteristics. Therefore, the aim of the study was to review methods of estimating energy requirements of Paralympic athletes which has been used in practice. The point of the estimation of the energy requirements is considered to estimate basal metabolic rates and to set physical activity levels. The evidence is currently confirmed in amputees, spinal cord-injured persons, and those with cerebral palsy. There have not yet been enough studies on athletes with other physical disabilities such as brain injury. For amputees, the method of estimating the basal metabolic rate by supplementing the lost limbs is used. The method is based on the concept of rehabilitation nutrition. For spinal cord-injured persons, it is known that the amount of basal metabolic rates depends on the damaged levels of the spinal cord. Among the persons with cerebral palsy, some can walk and the others use wheelchairs. The method of estimating the basal metabolic rates is considered by their movements. Therefore, there have much evidence to support that it is currently available to actually measure basal metabolic rates in Paralympic athletes. In the future, it will be necessary to collect evidence and contribute to the body of knowledge to estimate the energy requirements for Paralympic athletes.

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The uniqueness of Paralympic sport or para-sport is evident in the practical tasks necessary for athletes with physical disabilities to participate in para-sport and to continue to being involved. Classification is also an unique system to promote para-sport participation by minimizing the impact of impairment on the outcome of competition. Thus, the inclusive and quality participation framework is needed, and the classification system is the integral part of the process of athlete development in para-sport. The aim of the study was to conduct an environmental scan in para-sport and discuss talent identification and development for Japanese Paralympic athletes. The National Talent Identification and Development (NTID) program in Olympic sport was strategically implemented by Japan Sport Council (JSC) in 2012 as a new national project to identify, confirm, and develop pathways of medal potential athletes. Before implementing the NTID program in para-sport, the 3C’s (Customer, Company, and Competitor) model was used as a marketing tool to analyze the current sporting environment in para-sport. Based on the current analysis, a biological and inclusive approach was taken in NTID by considering sports science testing and classification for para sports etc. Ten athletes were identified by National Federations from 56 participants over 2 years from 2017 to 2018, and they are currently aiming to become future medalists. Ultimately, NTID is an entry point to high performance sport and is a part of whole of the athlete development pathway for Japanese Paralympic athletes. In future, JSC will continue to work on talent identification and development programs with key stakeholders by integrating Olympic sport and para-sport to promote participation and increase the talent pool in para-sport.

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