Transcript Slide 1

Understanding the Disabled Athlete
Mary Donahue, MEd, ATC, PT
Sports for the Disabled Athletes
Participation in sports is based on the disability or
diagnosis in these general categories:
Amputations
Blind or Visually Impaired
Cerebral Palsy
Deaf or Hearing impaired
Intelligently Impaired
Spinal Cord Injuries
Others are grouped into a category called Les Autres
Competition
Athletes compete in the local, regional,
national and international levels
Paralympics Games are the pinnacle of sports
for disabled athlete with Amputations,
Blindness, Cerebral Palsy, Les Autres and
Spinal Cord Injuries and are recognized by the
USOC
Deaf athletes compete in the Deaflympics
Intelligently Impaired athletes compete in the
Special Olympics
Deaflympics
The first organized disabled sport competition
was held in 1924 in Paris for athletes with
hearing impairment or deafness
Longest reigning international games outside
the Olympics
4000 athletes and officials from 77 countries
competed in Taipei during the summer games
and 600 athletes and officials were at the winter
games in Salt Lake City, 2007
Special Olympics
 Special Olympics were founded in 1968 by
Eunice Shriver and were for athletes with
Intellectual Disabilities
 The first International games were held in
1977 in Colorado and are held every 2
years alternation summer and winter
games
 2500 athletes from 100 countries
competed in the 2009 winter games and
7500 from 165 countries complete in the
2007 summer games
Sport for the Physical Disabled Athlete
Sir Ludwig Guttmann the “Father” of Disabled Sports
Instituted sports as a component of rehab of spinal cord
injured service men/women in 1944
Sir Guttmann felt sport participation was as important
for the patients as learning proper skin/bladder care.
First competition for disabled athletes was held in 1948
Athletes with Physical Disabilities
Archery was the first
sport, followed by track
First team sport was
wheelchair polo
Due to high injury rate
with polo wheelchair
basketball was
developed
The first “Olympics for the Paralyzed”
Held in 1960 in Rome with 400 athletes from
23 countries and were the precursor of the
Paralympics games
Paralympics are from the word Para in Greek
meaning “attached to” the Olympic
The first “Paralympic Games
were held in Japan in 1964
The Beijing games hosted
3951 athletes from 146 countries
•Paralympics were held in
many of the same
countries as the Olympics
between
1960 – 1984
•In Seoul, Korea the
Olympic host city also
became the host city for
the Paralympics.
•Since 1988 a host city
must submit a bid to host
both the Olympic and
Paralympic Games
The winter Paralympics were first held in 1976 in
Sweden and have been in the same Olympic Host
city since 1992 - Albertville
Paralympic Competitors
Wheelchair Sport, USA
(WSUSA) – an USOC
recognized organization
Founded as National
Wheelchair Athletic Association
(NWAA) in 1956, became WSUSA
in 1994
Represents athletes who are
physically disabled and use
wheelchairs for locomotion and
sports
Mostly spinal cord injured
athletes
Paralympic Competitors
Disabled Sport, USA
(DA/USA) - a member of the
USOC
Represents athletes with
amputations, spinal cord injury,
dwarfism, multiple sclerosis,
head injury, cerebral palsy, and
other neuromuscular and
orthopedic conditions.
Started as NASA in 1972,
became NHSRA in 1976 and NHS
in 1992 and DS/USA in 1996
Paralympic Competitors
United States
Association of Blind
Athletes (USABA)
founded in 1976 - A
member of the USOC
Represents blind
athletes and ones with
visual impairments
Paralympic Competitor
•BlazeSports, America (a
member of the USOC)
represents athletes with
Cerebral Palsy as well as
others with physical
disabilities such as TBI and
stroke impaired athletes
•The NASCP was the initial
organization for the CP
athletes and was reorganized
to USCPAA
Category of Paralympic Disabilities
Amputations
Les Autres (the others)
 Traumatic
 Disease
 Muscular Dystrophy
 Multiple Sclerosis
 Ehler’s Danlos Syndrome
Arthrogryposis
Blindness/Visual
impairment
Cerebral Palsy
Dwarfism
Friedreich's ataxia
Osteogenesis Imperfecta
Spinal Cord Injuries
 Traumatic
 Disease
Spina Bifida
Classification System
Designed to equalize competition
By Disability
Spinal Cord: based on
motor innervations
Amputation: based on
level of limb loss
Blind: based on level of
vision loss or total
blindness
Cerebral Palsy: most
complicated, based on
presentation , type of CP
and involvement
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
•Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Classification System
By Function based sport
Alpine Skiing
Basketball
Cycling
Power lifting
Quad Rugby
Swimming
Table Tennis
Track and Field
Volleyball
Common injuries by Disability
Spinal Cord Injured/Wheelchair athletes
Overuse injuries
Biceps Tendonitis
Rotator cuff tendonitis
Elbow epicondylitis
Radial and/or Ulnar nerve entrapment
Carpal Tunnel syndrome
Common injuries by Disability
Spinal Cord Injured - Other conditions
Autonomic Dysreflexia
Impaired thermoregulatory system
Skin problems
Osteopenia/Osteoporosis
Common injuries by Disability
Amputee athletes
Skin breakdown of residual limb
Lower limb strains and sprains
Low back pain
Contusions
Injuries to the intact limb
Injures to the amputated limb due to osteopenia
or osteoporosis
Common injuries by Disability
Cerebral Palsy Athletes
Strains and sprains of all joints
Overuse injuries of all joints
Fall risk
Osteopenia/osteoporosis
Seizure disorders
Common injuries by Disability
Blind athletes
Injuries similar to able bodies athletes except
increase lower extremity injuries secondary
to trauma.
Injuries due to reduced proprioception
Special Olympic Athletes
Athletes with Down Syndrome are the most
common intellectual disabled athlete
participating in the Special Olympic
Common medical problems:
•
•
•
•
Atlanto-Axial instability
Cardiac problems
Visual problems
Seizure disorder
Special Olympic Athletes
Athletes undergo a radiologic exam to
determine the stability of Atlanto-Axial joint
– If the instability is found, contact sports
should be avoided
Cardiac malformation occur in 40-50% of
Down syndrome individuals
Increased laxity of joints is also common
Care of the Disabled Athlete
Initial treatment and rehabilitation for the
disabled athletes is very similar to the ablebodies athlete.
Differences include monitoring the athlete
and being aware of the unique disability
related medical conditions
Special attention should be given to the
following situations:
Care of the Spinal Cord
Injured Athlete
Hypertension due to Autonomic Dysreflexia
Hypothermia or Hyperthermia
Skin checks
Fracture awareness secondary to increased
rate of osteopenia and osteoporosis
Injuries related to impaired sensation
Care of the Amputee Athlete
Check for skin problems in stumps and over
boney prominences
Evaluate for stains or sprains of the intact limb
Maintain lower extremity muscle flexibility and
strength to avoid and care for lumbar spine
injuries
Core strengthening
Be award of the increased incidence of
osteopenia or osteoporosis in the amputated
limb
Care of the Cerebral Palsy Athlete
Evaluate for soft tissue injuries
Be aware that manual muscle testing my not
be a good measurement of strength
secondary to abnormal tone of muscles
Be cognizant of potential for fractures due to
osteopenia and osteoporosis
Contusions, abrasions and lacerations occur
due to the increased fall potential
If a seizures occurs, minimize injury by
protecting the athlete
Care of the Blind Athlete
• The care if these athletes is the same as the
able bodied athlete
• Injuries occur due to trauma from contact
with items in their environment
• Care of contusions, abrasions and lacerations
due to reduced proprioception secondary to
lack of visual input
Care of Special Olympic Athlete
Athletes with AA instability should already
have cervical x-rays so they should not be in
contact sports
- Have this awareness if a cervical spine injury has
occurred
Have the athlete evaluated for cardiac
problems
Be aware of the increased laxity of the joints
If a seizures occurs, minimize injury by
protecting the athlete
Summary
The athlete with a disability are more similar
to the able bodies athlete.
Evaluation, treatment and rehabilitation
utilize the same techniques with a extra
considerations
In most circumstanced it is wise to ask the
athlete of any special care that might be
needed, after all they have lived with the
disability for a good part of their lives
It is important to
see the person,
not the disability
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