Professional Documents
Culture Documents
1
The development of the first international competition for the disabled was in 1949. The
games were held in Austria and this was the first World Winter Games for the deaf.
Subsequently international competitions involving other disabled athlete, amputees and
spinal cord injured have been taking place throughout the world. Organisations such as the
International Sport Organisation for the Disabled (ISOD) was formed in 1964 and its
objective was to coordinate sport competitions for all disabled athletes.
Now the Paralympics are a major feature of all Olympic Games.
Disabled groups considered:
• Sensory: the deaf athlete
• Les Autres: disabled athletes who do not fit into any of the disability groups
above, such as muscular dystrophy, multiple sclerosis, dwarfism.
Athletes with Sensory Impairment
The Blind Athlete
• Blind athletes have a partial or complete loss of sight. Eligibility for athletic
competition is granted only to those individuals who have a visual acuity of 6/60 or
less.
• Blind athletes can compete in a wide variety of sports including baseball, bowling,
cycling, marathon, racing, track and field and wrestling. The events include
modification of some rules to facilitate participation by blind competitors.
• The only specific sports medicine problem for the blind is related to falls. Falls on the
outstretched upper limbs are not uncommon, leading to the same types of fractures
and soft tissue injuries as in the able-bodies athletes. Sprains of the knee and ankle
ligaments are also not uncommon.
∙ An increased risk of cardiovascular disease by unfavourable modification of
risk factors.
∙ Diabetes and other medical conditions associated with obesity.
∙ The development of osteoporosis and renal calculi.
The Cerebral Palsied Athlete
• Cerebral palsy is a group of disorders of impaired brain and motor function with an
onset before or at birth, or during the first years of life (Fig. 3). The condition has
multiple aeteologies and the most obvious manifestation is impaired function of the
voluntary musculature.
• Track and field and swimming are popular sports for these athletes. Participants may be ambulatory or
complete in a wheelchair depending on extent of their motor dysfunction. It should be noted that half the
cerebral palsied athletes compete in wheelchairs.
• Sport may help to prevent atrophy of the stump muscles, improve circulation of
the stump and strengthen the remaining muscles in the affected limbs.
Children’s Diseases (after O-Bar-Or)
Children, whether well or ill, can safety participate in physical fitness programmes. In fact,
training may improve physical fitness for such diseases as bronchial asthma (but beware
exercise-induced bronchospasm), cystic fibrosis (follow for signs of arterial desaturation),
diabetes mellitus (improves control) and chronic renal failure (better appetite), muscular
dystrophy, mental retardation, obesity and rheumatoid arthritis. There are physical and
mental benefits (improved self-esteem) however the exercise prescription must be specific
to the problem.
Athletes with Cognitive Disability
• Mental retardation specifies as an IQ less than 70 resulting from pathophysiologic processes affecting the
cerebrum during the developmental period.
• Mentally retarded athletes are not restricted and are able to participate in any sport
available.
• The mentally retarded, prior to systemic training, are often not as physically fit as
the general population.
• Dwarfism
• Multiple Sclerosis
• Friedrich’s ataxia
Wheelchair Athlete
• Wheelchair athletes are those disabled by spinal cord injury, cerebral palsy, lower
extremity amputation or any of the disorders included with Les Autres. The common
denominator for these disabled athletes is their mobility impairment and need of
a wheelchair for sports participation.
• Wheelchair locomotion is not an efficient means of transportation. The mechanical
efficiency of wheelchair locomotion is at best 5%, compared with a minimum of 0%
for walking or cycling at similar velocity.
• The design of sports wheelchairs is constantly evolving. Recent design
modifications are intended to improve the mechanical efficiency of the wheelchair,
facilitate a more effective wheelchair stroke and minimize the risk of upper-extremity
injuries (Fig. 4).
Wheelchair Sport Injuries
• The most common injuries incurred by wheelchair athletes are soft tissue injuries,
blisters, lacerations, abrasions and cuts (Fig. 4).
Figure 5
Region Type of Injuries Prevention
• contusion of muscle, • strengthening of the shoulder
soft tissue stabilisers
• sprains • warmup, cool down and
• capsulitis stretching procedures
• rotator cuff problems • equipment modification
• fractures • early reporting and treatment of
shoulder pain
Nontraumatic:
• bicipital tendonitis due to tendon
strain caused by overuse and
inadequate warmup.
• as above
• wearing of clothing on the upper
• lacerations and abrasions
Elbow arms
• use of tube socks on the rim
• as above
• use of padded push rims
• lacerations and abrasions
Wrist • use of gloves and padding over
the wrist and heel of the hand
• abrasions and lacerations
• use of gloves and taping
particularly of the knuckles
Hand and fingers • padded push rims and plastic
• avulsion of the nails
wheel covers
• finger injuries related to the
catching of fingers in the spokes of the • removal of sharp edges on the
wheelchair are common wheelchair
• muscular spasm related to overuse
during maintenance of trunk stability
• blistering at the top of the seat post
or the back of the wheelchair • postural correction by specific
Upper back strengthening exercises
• wearing a shirt and padding on
the back of the wheelchair
Figure 5 (Cont’d)
wheelchair seat
• intermittent lifting from the
seat
• combination of the above
preventative measures
Special Medical Problems of Wheelchair Athletes
Urinary tract complications
• Neurological control of the urinary tract is usually lot after spinal cord injury.
• Prevention of pressure sores is important in all persons with spinal cord injury. Such
measures include:
• Intermittent shifting and lifting of the buttocks fro the wheelchair’s seat relieves
pressure.
• The loss of sensory afferent inputs from the spinal cord and muscles below the level
of the lesion may limit hypothalamic responses to exercise and temperature.
• The loss of lower extremity skeletal muscle pump in disabled athletes, such as
amputees reduced venous return to the heart during exercise and further
compromises thermoregulatory responses.