Kearney, who won four golds at last year's World Championships in Glasgow, was selected in March on a medical dispensation as she has been managing the injury since the start of the year.

Despite her best efforts and those of the British Para-Swimming support team, Kearney has not fully recovered and has therefore chosen to pull out of the Games, which are due to get underway on September 7.

"I’m devastated not to be able to represent GB at the Paralympic Games in Rio," said the 19-year-old, who has cerebral palsy and generalised dystonia, impacting her lower limbs and the left side of her body. 

"I have worked incredibly hard in training for many years to get to this point in my career and last year was fantastic for me - becoming four-time world champion was more than I’d ever dreamt of.

"I have been battling a recent progression in my condition and this, coupled with an ongoing shoulder injury over the past six months, has massively affected my ability to train this season.

"I have fought really hard to find a way back from this and know that I did everything in my power to get to Rio, but it just wasn’t to be.

"Obviously, I hope that there will be a way for me to continue to compete in the sport I love so much next season and beyond.

"I would like to wish the team all the best for Rio and thank the staff from British Para-Swimming and the EIS [English Institute of Sport] for their support."

At the 2015 World Championships, Kearney topped the podium in the 100 metres butterfly S9, 400m freestyle S9, 200m medley SM9, and 4x100m medley 34 points.

She also won silver in the 100m backstroke S9 and bronze in the 4x100m freestyle relay 34 points.

Two years earlier in Montreal, she claimed her first world medal with bronze in the 400m freestyle S10.

"We all share in Tully’s disappointment in this news," said Chris Furber, national performance director for British Para-Swimming.

"As a team we worked closely with Tully to ensure she had the right support and as much time as possible.

"Our whole medical and coaching team has and will continue to provide the best support possible for Tully.

"We all wish her a speedy return to competition."

Kearney will not be replaced in the swimming team.