Post-Exercise Recovery in Paralympic Athletes: A Narrative Review of Physiological Considerations and Practical Applications

Paralympic athletes are challenged by unique systemic strain due to impairment-related physiological and psychological stressors. This study aims to synthesize the current evidence regarding post-exercise recovery modalities in Paralympic athletes, providing an overview of their physiological considerations and practical applications. A narrative review was conducted across PubMed/MEDLINE, Scopus, and Web of Science (inception to December 2025). Inclusion criteria prioritized original research on competitive para-athletes evaluated through physiological or performance-based markers. Evidence identifies four critical domains: (1) Thermoregulation: In spinal cord injury (SCI), upper-body cooling is significantly more effective than lower-body strategies for core temperature reduction; objective monitoring of playing time is essential, as subjective perception is unreliable. (2) Systemic recovery: Sleep quality is compromised by secondary complications (e.g., nocturia and spasticity), and heart rate variability (HRV) serves as a sensitive autonomic marker to validate readiness. (3) Neuromuscular restoration: The early-phase rate of force development (RFD ≤ 50 ms) is more sensitive than the peak strength for detecting neural fatigue, particularly in SCI. (4) Contextual modulators: Infrastructure accessibility and psychological resilience are primary determinants of intervention efficacy. Effective recovery in para-sports requires a shift toward “active-assisted” impairment-specific interventions. Future research must validate specialized monitoring tools and longitudinal impacts on long-term health.