Evolution of Polish Paralympians’ Opinions on Medical Care in the Context of the National Legal Framework: A Longitudinal Study from Athens 2004 to Paris 2024

The aim of the study was to assess changes in athletes’ opinions on medical care in Polish Paralympic sport in 2004–2024 in the context of the evolution of the national legal framework. Against this background, to identify potential discrepancies between formal guarantees and functional access, the study analysed: (i) the evolution of Polish legal and organisational solutions governing medical care for Polish Paralympic athletes, and (ii) the longitudinal change in the opinions of Polish Paralympic athletes concerning the availability and quality of care in 2004–2024. The scope of the national legal framework was limited to statutory acts and regulations adopted by Polish institutions, understood as primary legal sources; the exegesis of normative material was supplemented with relevant documents from the legislative process. A total of n = 522 athletes with visual and locomotor impairments were examined, representing 97.4% of all Polish representatives who participated in the Summer Paralympic Games between 2004 and 2024. The study used a diagnostic survey protocol employing a questionnaire, as well as descriptive statistics, chi-square tests, and Student’s t-tests. The results indicate a clear increase in the percentage of athletes declaring participation in regular preventive examinations, as well as a significant improvement in evaluations of cooperation with physicians and physiotherapists when comparing 2004 with the period 2012–2024. At the same time, empirical data demonstrate that the introduction of legal solutions does not ensure full access to specialised medical care, and that the formal establishment of obligations and procedures does not automatically translate into the immediate adaptation of organisational practices.