The feasibility of a randomized controlled crossover trial to assess the effect of probiotic and prebiotic supplementation on the health of elite wheelchair athletes.

Hertig-Godeschalk, Anneke; Glisic, Marija; Ruettimann, Belinda; Valido, Ezra; Capossela, Simona; Stoyanov, Jivko; Flueck, Joelle L (2023). The feasibility of a randomized controlled crossover trial to assess the effect of probiotic and prebiotic supplementation on the health of elite wheelchair athletes. Pilot and feasibility studies, 9(1), p. 99. BioMed Central 10.1186/s40814-023-01339-6

s40814-023-01339-6.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview


Gastrointestinal (GI) problems represent a health burden in Para athletes and can ultimately reduce athletic performance. This study aimed to evaluate the feasibility of a randomized controlled crossover trial (RCCT) assessing the effects of probiotic and prebiotic supplementation on the health of Swiss elite wheelchair athletes.


The RCCT was conducted between March 2021 and October 2021. Athletes were randomized to receive either a daily probiotic (3 g of probiotic preparation, including eight bacterial strains), or a daily prebiotic (5 g of oat bran) supplementation first. After the first supplementation phase (4 weeks), a washout period (4 weeks) and the second crossover supplementation phase (4 weeks) followed. Data were collected at four study visits (every 4 weeks) and included 3-day training and nutrition diaries, the Gastrointestinal Quality of Life Index (GIQLI) questionnaire, stool samples, and fasting blood samples. The study assessed the feasibility criteria such as recruitment rate, retention rate, success of data collection, adherence to the protocol, willingness to participate, and safety.


This pilot study met the majority of the predefined minimum requirements for the feasibility criteria. Out of 43 invited elite wheelchair athletes, 14 (33%) consented (mean (standard deviation) age: 34 (9) years, eight females, 11 with a spinal cord injury). The desired sample size was not reached, but the achieved recruitment rate was modest, especially considering the population studied. All participating athletes completed the study. With the exception of one missing stool sample and two missing diaries, data were successfully collected for all athletes at all four visits. Most athletes adhered to the daily intake protocol for at least 80% of the days, both for probiotics (n = 12, 86%) and prebiotics (n = 11, 79%). Ten (71%) athletes would be willing to participate in a similar study again. No serious adverse events occurred.


Despite the limited number of elite wheelchair athletes in Switzerland and the modest recruitment rate, the implementation of a RCCT in elite wheelchair athletes is feasible. The data collected in this study provide essential information for the design of the subsequent study which will include a larger cohort of physically active wheelchair users.


Swiss Ethics Committee for Northwest/Central Switzerland (EKNZ), 2020-02337).


gov, NCT04659408.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Glisic, Marija, Stoyanov, Jivko


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




BioMed Central


[223] Swiss Paraplegic Foundation = Schweizer Paraplegiker-Stiftung ; [134] Swiss Olympic




Pubmed Import

Date Deposited:

16 Jun 2023 15:49

Last Modified:

17 Jul 2023 19:42

Publisher DOI:


PubMed ID:


Additional Information:

Anneke Hertig‑Godeschalk and Marija Glisic shared the first authorship (contributed equally).
Jivko Stoyanov and Joelle L. Flueck shared the last authorship.

Uncontrolled Keywords:

Bowel Feasibility Gastrointestinal problems Microbiome Paralympic Prebiotic Probiotic Spinal cord injury




Actions (login required)

Edit item Edit item
Provide Feedback