Sports for Athletes with Physical Disabilities PDF

Topic 10 Sports for Athletes with Physical Disabilities SRLP 4035 Sport and Recreation for Persons with Physical and Intellectual Disabilities SPORT ASSOCIATIONS FOR PERSONS WITH DISABILITIES IN HONG KONG ❑China Hong Kong Paralympic Committee (HKPC) ❑Sports Association f...

Topic 10 Sports for Athletes with Physical Disabilities SRLP 4035 Sport and Recreation for Persons with Physical and Intellectual Disabilities SPORT ASSOCIATIONS FOR PERSONS WITH DISABILITIES IN HONG KONG ❑China Hong Kong Paralympic Committee (HKPC) ❑Sports Association for the Physically Disabled of Hong Kong, China (HKSAPD) ❑Hong Kong Sports Association for the Persons with Intellectual Disability (HKSAPID) ❑Special Olympics Hong Kong (SOHK) ❑Hong Kong, China Sports Association of the Deaf (HKCSAD) ❑Hong Kong Blind Sports Federation (HKBSF) ❑Riding for the Disabled Association Ltd. (RDA) ❑Hong Kong China Rowing Association (Adaptive Rowing) ❑Hong Kong Wheelchair Dance Sport Association (HKWDSA) ❑Hong Kong PHAB Martial Art Association (HKPHABMA) Describing People with Disabilities The most commonly cited definitions are those provided by the World Health Organization Impairment = Any loss or abnormality of body part or function (e.g. leg amputated, hearing loss) Disability =Any restriction or lack of ability to perform an activity within the range considered normal for a human being due to impairment (e.g. Need crutches, hearing aid) Handicap = A disadvantage in filling a role in life relative to a peer group (e.g. does not go out to do things) Describing People with Disabilities Person before Characteristics Persons with …. Athletes with …. - Amputation - Spinal Cord Injuries - Cerebral Palsy - Vision Impaired - Les Autres Amputation & Limb Loss ◼ Amputee: the loss of an entire limb or a limb segment Possible Causes: Congenital ❑ failure of the fetus to properly developed ❑ missing a middle segment of a limb (phocomelia) ❑ no normal structure of missing a segment ❑ accounts for 60% of all amputations in children ❑ upper-limb deficiencies occur 1.6 times more than lower-limb Acquired ❑ trauma, diabetes, cancer, vascular disease or others ❑ males > female in trauma ❑ infection ❑ severe burn Functional Classification ❑The site and level of limb absence ❑A functional point of view ❑International Wheelchair and Amputee Sports Federation (IWAS) classification: *A1 = Bilateral above knee (AK) *A2 = Unilateral AK *A3 = Bilateral below knee (BK) *A4 = Unilateral BK *A5 = Bilateral above elbow (AE) *A6 = Unilateral AE *A7 = Bilateral below the elbow (BE) Peter Hull (MBE)– UK 3 gold medals in 92 Paralympics *A8 = Unilateral BE *A9 = Combination of amputations (upper and lower limbs)  Sport Classification Example: Athletics Classification “T” for Track/Jumps and "F" for Field Class Examples T/F42 ❑ Single/double above or through knee amputation. Other conditions that result in similar functional limitations. Competes as an ambulant athlete T/F43 ❑ Double below knee amputation. Other conditions that result in similar functional limitations. Competes as an ambulant athlete T/F44 ❑ Single below knee amputation. Ambulant with moderately reduced function in one or both lower limbs. T/F45 ❑ Double above or through elbow amputation. Other conditions that result in similar functional limitations. Likely to be a track athlete only T/F46 ❑ Single through or above elbow amputation. Other conditions that result in similar functional limitations. Full function in both lower limbs. ❑ Double above or through wrist amputees are eligible to compete as T46 in 100m to marathon. T/F47 ❑ Single or double through wrist amputation or similar, events up to 400m https://www.paralympic.org/athletics/classification Amputee Competitions ❑ T42, T43, T44 athletes must wear prosthesis in running events. “Not artificially enhance body length or performance” “Prevent the lead to an unrealistic enhancement of stride length” ❑ In other competitions, the wearing of prosthesis is optional ❑ Other sports have their own rules and regulations in wearing prosthesis  Amputee Competitions 掃描 0010 ❑Amputees are eligible to compete in events with wheelchair ❑If they have an amputation of the lower extremity and require the use of a wheelchair Spinal Cord Injuries Possible Causes: Injury or Diseases Incidence  In between 250,000 and 500,000 people suffer from spinal cord injuries each year Automobile accidents / Road traffic crashes (37%)  Falls (28%)  Violence (21%)  Athletic injuries (6%)  Others (8%)  Spinal Cord Injuries Possible Causes: injury or diseases 1. Poliomyelitis (Polio) A viral infection that affect the motor cells in the spinal cord Vaccine has been used and no much new case for the past twenty years 2. Spina Bifida Congenital birth defect The posterior arch of one or more vertebrae fails to develop properly, leaving an opening in the spinal column Can be detected prior to birth (16th to 18th weeks)  Spinal Cord Injuries Diagram of the three types of spina bifida Myelomeningocele Meningocele Occulta 脊髓膜膨出 脊膜囊 隱性脊柱分裂 The covering of the spinal cord, The covering of the spinal cord Defect of the cerebrospinal fluid, and part of and cerebrospinal fluid protrude posterior arch of the the spinal cord protrude through through the opening and form a vertebra, but nothing the opening and form a visible sac visible sac on the back protrudes through on the back the opening Spinal Cord Injuries Orthotic device Plastic Hip-knee-ankle-foot Knee-ankle-foot Ankle-foot Ankle-foot orthotics orthotics orthotics orthotics  Spinal Cord Injuries Normal Milestones Without Aids Visual field Hands-free Exploration Hands-free Sit and stand important sitting standing mobility Milestones With Aids Child Safety Sitting Stand Caster cart Standing brace Parapodium Orthotic device help children with spina bifida attain normal developmental postures  Spinal Cord Injuries Resulting in: Quadriplegia (Cervical Injury) Paraplegia (Injuries other than Cervical) ** The American Medical Association (1990) recommended** -A neck injury should be suspected if a head injury has occurred -Never move a victim with a suspected neck injury without trained medical assistance unless the victim is in imminent danger of death -Any movement of the head can result in paralysis or death Picture retrieved from: https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890#dialogId3802994 Classification Medical classification - Based on the segment of the spinal cord that is impaired Sport classification - Based on athletes’ abilities in order to match similarly able athletes for competition Spinal Column and Cord  Tactile area are associated with each spinal segment Connections are broken between the brain and the segment of the cord that has been injured, as well as all segments below the injury. American Spinal Injury Association: International Standards for Neurological Classification of Spinal Cord Injury, (2008) Functional Sport Classification Classification for Sports International Wheelchair Basketball Federation (IWBF) At least a “minimal disability” to be eligible to play in IWBF sanctioned tournaments Athletes are classified according to points Disability Level Points Moderate to Severe 1 1.5 2 2.5 3 Mild 3.5 4 4.5 A team can comprise players in any combination of classes Total point value does not exceed 14 Cerebral Palsy (腦麻痺症) Cerebral: brain Palsy: disordered movement or posture Cerebral Palsy: a group of permanent disabling symptoms resulting from damage to the motor control areas of the brain Severe: Total inability to control bodily movement Mild: Only a slight speech impairment Abnormal reflex development → many other impairment: seizures, speech and language disorders, sensory impairments  Cerebral Palsy Caused by : 1) Congenital : Failure of brain to develop properly 2) Acquired causes: Injury to brain before, during, after birth (within the first two years) Incidence: ❑ Estimated 800,000 children and adults in USA ❑ Only 10% of the cases are acquired, mostly caused by some form of head trauma  Classification Topographical Classification System (Anatomical site) 1) Monoplegia – Any one limb involved 2) Diplegia – Major involvement of both lower limbs and minor involvement of both upper limbs 3) Hemiplegia – One complete side of the body 4) Paraplegia – Involvement of both lower limbs only 5) Triplegia – Any three limbs involved 6) Quadriplegia – Total body involvement (all 4 limbs, head, neck, and trunk) Medical Classification ◼ Neuromotor Classification System 1) Muscle Spasticity  From damage to motor area of the cerebrum  Increased by muscle tone (hypertonicity)  Strong muscle contraction which is associated with hyperactive stretch reflex Medical Classification ◼ Neuromotor Classification System 1) Muscle Spasticity  Exhibiting scissoring gait  Have problem with balance and locomotor activities  Limited range of motion  Have difficulty in running, jumping, and throwing properly Person exhibiting spastic cerebral palsy Medical Classification ◼ Neuromotor Classification System 2) Athetosis (Dyskinetic CP)  Damages of basal ganglia  Overflow of motor impulses to the muscles  Slow, writhing movements that are uncoordinated and involuntary  Muscle tone fluctuate  Severe difficulty in head control, drawn back & position in one side Medical Classification ◼ Neuromotor Classification System 2) Athetosis (Dyskinetic CP)  Facial grimacing  Difficulty eating, drinking, and speaking  Difficulty performing movement that require accuracy  A lordotic standing posture is common  Exhibit aphasia Medical Classification Neuromotor Classification System 3) Ataxia - Damage of cerebellum - Disturbance of balance and coordination - Usually not diagnosed until the child attempts to walk - A wide-based gait is typically exhibited - People who are able to ambulate will frequently fall - Have difficulty with basic motor skills and patterns, such as running, jumping and skipping ** Most people have mixed types ** General Consideration ◼ CP cannot be treated by rather managed  Alleviating symptoms caused by damage to the brain  Helping the person achieve maximum potential in growth and development Functional motor skills should be developed and attained reducing musculoskeletal impairments to improve functional and quality of life enabling children to function optimally given their existing impairments preventing or limiting development of secondary implications altering the natural course of the disorder promoting wellness and fitness over the life span  Classification Functional classification system - Individual placed into ONE of EIGHT ability classes according to the severity of the disability - Commonly used in the field of education * Class 1 to 4 : Non-ambulatory * Class 5 to 8 : Ambulatory  Functional Classification for Sports Class Description Locomotion Object Control 1 ◼ Severe spasticity or ◼ Motorized ◼ Only thumb athetosis wheelchair opposition and ◼ And poor functional range ◼ Assistance for one finger of motion and strength in mobility possible all extremities ◼ Can grasp only ◼ Poor to nonexistent trunk beanbag control 2 ◼ Severe to moderate ◼ Propel ◼ Can manipulate spasticity wheelchair on and throw a ball level surfaces ◼ Athetoid quadriplegic and slight inclines ◼ Poor functional strength in ◼ May able to all extremities ambulate short ◼ Poor trunk control distances with assistance  Functional Classification for Sports Class Description Locomotion Object Control 3 ◼ Moderate quadriplegic ◼ Can propel ◼ Normal grasp of wheelchair round objects but ◼ Triplegic independently but release is slow ◼ Severe hemiplegia ◼ Limited extension ◼ May walk a short ◼ Fair to normal strength in in follow through one extremity distance with with dominant assistance or arm assistive devices 4 ◼ Moderate to severe ◼ Assistivedevices ◼ Normal grasp is diplegic used for distances seen in all sports ◼ Normal follow ◼ Good functional strength ◼ Wheelchair is through is evident and minimal control usually used for pushing a problems in upper sport wheelchair or extremities and torso throwing  Functional Classification for Sports Class Description Locomotion Object Control 5 ◼ Moderate to severe diplegic ◼ No wheelchair ◼ Minimal control or hemiplegic problems in ◼ Might or might ◼ Moderate to severe upper limbs not use assistive involvement in one or both devices ◼ Normal legs opposition and ◼ Good functional strength grasp seen in ◼ Good balance when assistive all sport devices are used 6 ◼ Moderate to severe ◼ Ambulates without ◼ Spastic-athetoid quadriplegic aids grasp-release can ◼ Fluctuating muscle tone ◼ Function can vary be significantly producing involuntary ◼ Running gait can affected when movements in trunk and both show better throwing sets of extremities mechanics than ◼ Spasticity or athetosis when walking present (upper-limb)  Functional Classification for Sports Class Description Locomotion Object Control 7 ◼ Moderate to minimal ◼ Walks and runs without ◼ Minimal control spastic hemiplegic assistive device problems with ◼ Good functional ability ◼ Has marked grasp and on non-affected side asymmetrical action release in ◼ Obvious Achilles dominant hand tendon shortening ◼ Minimal limitation when standing seen in dominant throwing arm 8 ◼ Minimal hemiplegic, ◼ Runs and jumps freely ◼ Minimal in- monoplegic, diplegic or with little to no limp coordination of quadriplegic ◼ Gait demonstrates hands ◼ Might have minimal minimal or no coordination problems asymmetry when ◼ Good balance walking or running ◼ Slight loss of coordination in one leg  Vision Impaired ◼ Causes: Congenital, acquired, aging Classification of Visual Impairments  Photo retrieved from: Vision impaired athletes dazzle with athleticism (theconversation.com) Vision Impaired ◼ Classification for sport B1= No light perception or inability to recognize a shape. B2= Visual acuity not exceeding 1/30th after correction or visual field not exceeding 5°. B3= Visual acuity not exceeding 1/10th after correction or visual field not exceeding 20°. Athlete with Visual Impairment USA Olympic Team Marla Runyan Lost most of her vision at the age of nine In 2000, she became the first legally blind athlete to win a place on the U.S. Olympic team She finished eighth in the women’s 1500m  Sports For Persons With Visual Impairment Games and Sports 5-a-side Football Goal Ball Judo Sports For Persons With Visual Impairment Other Sports:  Athletics  Archery  Alpine Skiing  Nordic skiing  Powerlifting  Swimming  Tandem Cycling  Bowling  Shooting Les Autres ▪For athletes do not fall into other categories ▪Athletes performed at the National Cerebral Palsy Games in 1981,1983, and 1985 along with CP athletes ▪Included in Paralympic Games since 1988 Seoul ▪Classes are divided into wheelchair and ambulatory sections Les Autres Muscular Dystrophy (肌肉失調)  Muscle cells within the belly of the muscles degenerate and are replaced by adipose and connective tissue. *Duchenne Muscular Dystrophy (DMD)  Genetic disease (Inherited in an X-linked recessive pattern)  Lack of protein called distrophin  Muscles cells eventually die Photo retrieved from: Muscular Dystrophy Duchene - Philadelphia Holistic Clinic (philaholisticclinic.com) X-linked recessive inheritance Les Autres Duchenne Muscular Dystrophy (DMD) X-linked Recessive Pattern ◼ Females will typically be carriers for the disease while males will be affected ◼ 1 in 4000 new born U.S. National Library of Medicine  Les Autres Juvenile Rheumatoid Arthritis (幼年型風濕性關節炎)  Joints inflamed which affect joint movement  Between age 1-3 and before 16 Osteogenesis Imperfecta (Brittle bone)(玻璃骨)  An inherited condition in which bones are imperfectly formed  An unknown cause produces a defect of collagen fibers  Les Autres Arthrogryposis (關節攣縮症)  Multiple congenital contractures (stiff joints) & weak muscles  Fatty and connective tissue is presented in joints Multiple Sclerosis (多種硬化症)  Slowly progressive neurological disorder (20 – 40 years old)  Muscles become weaker regardless of the amount of exercise or activity  Associated with cerebral palsy sports Multiple Sclerosis (多種硬化症) Normal Spinal Neuron Diseased Spinal Neuron Normal nerve fiber Affected nerve fiber Normal skeletal muscle Wasted skeletal muscle Comparison of Normal and Diseased Spinal Neurons A neurological disease  Les Autres 1 ▪ AMYOTROPHIC LATERAL SCLEROSIS (ALS) 5584221.jpg ◼ Often referred to as "Lou Gehrig's Disease" ◼ A progressive neurodegenerative disease ◼ "Lateral" identifies the areas in a person's spinal cord area where portions of the nerve cells that signal and control the muscles are located ◼ As this area degenerates it leads to scarring or hardening ("sclerosis") in the region ◼ The muscles begin to atrophy and weaken and the person eventually loses the ability to use Stephen Hawking these muscles Famous physicist with ALS  Les Autres Dwarfism (侏儒) Dwarfism are shorter than 98% of all other people Prefer to be called: “little people” Causes: - Failure of cartilage to form into bone as the person grow - Pituitary irregularity More than 80% of all infants born with dwarfism are born to average size parents  Les Autres Dwarfism Proportionate ❑All proportionate body parts ❑Very short (average shorter than 4 feet) Disproportionate ❑Achondroplasis: 1 in 26,000 infants (USA) ❑Short arms and legs with a normal torso and a large head ❑Average height for adult is about 4 feet (122cm) ❑May involve spinal and bone deformities ❑Muscle weakness, pain, and loss of sensation might occur Dwarfism-Participation in Sports - No formal organization until 1985 - Dwarf Athletic Association of America (DAAA) - basketball, boccia, powerlifting swimming, skiing, table tennis, volleyball, badminton, soccer, and equestrian * World Dwarf Games in 1993  Dwarfism-Participation in Sports * Individual with disproportionate: Equal or shorter than 152cm (5 feet) * Individual with proportionate: Equal or shorter than 147cm (4 feet, 10 inches) UK%20V%20USA * Five divisions for participation: - Youth: age 7 – 15 - Open: age 16 – 39 - Master: over age 39 - Future: younger than age 7 (non-competitive) Dwarfism-Participation in Sports In Paralympics - Les Autres Class - Different classification system among sports: Swimming: Class S6 * Male: 137cm or shorter * Female: 130cm or shorter Field : Class F40 – F41 * Javelin, short put, discuss * No track event Power Lifting: * Disproportionate * 145cm or shorter ANY QUESTIONS???