Assisting Sport for Disabilities

Disability Identification Due to the Paralympics being held in London in 2012 the British public were treated to a media extravaganza. With the fantastic live coverage that was available, we not only got to witness a fantastic spectacle where competitors would compete to a very high level, we also got to see behind the scenes footage of how the athletes live with their personal disability in their day to day lives. These high profile athletes brought awareness, to the nation, of the many different types of disabilities that individuals throughout the world have to live with.

Below we will look at some of those disabilities. Physical Disabilities Mobility issues or a physical disability often affect parts and/or the whole body and restricts movement. Forms of a mobility issue or physical disability may include: Cerebral Palsy (CP) “Is the term used for a group of non-progressive disorders of movement and posture caused by abnormal development of, or damage to, motor control centres of the brain? CP is caused by events before, during, or after birth. The abnormalities of muscle control that define CP are often accompanied by other neurological and physical abnormalities”.

(medical dictionary, 2009) Quadriplegia “A lesion of the spinal cord that results in paralysis of all 4 limbs, along with the corresponding loss of sensation”. (disabled world, 2013) Paraplegia “Complete paralysis of the lower half of the body including both legs, usually caused by damage to the spinal cord” . (Dorland’s medical dictionary, 2007) Multiple sclerosis (MS) “Multiple sclerosis (MS) is a chronic autoimmune disorder affecting movement, sensation, and bodily functions. It is caused by destruction of the myelin insulation covering nerve fibres (neurons) in the central nervous system (brain and spinal cord)”.

( The American Heritage Medical Dictionary,2007) Hemiplegia “The inability to move a group of muscles on one side of the body. When hemiplegia is caused by a stroke, it often involves muscles in the face, arms and legs” . (Vega, 2008) Amputees “A person who has had one or more limbs removed by amputation”. ( Stedman’s Medical Dictionary, 20012) Muscular Dystrophy “Muscular dystrophy is the name for a group of inherited disorders in which strength and muscle bulk gradually decline” . (Gale Encyclopedia of Medicine, 2008)

Dwarfism “When caused by inadequate amounts of growth hormone (as opposed to late growth spurt or genetics), hGH deficiency results in abnormally slow growth and short stature with normal proportions” . (Gale Encyclopedia of Medicine, 2008) Sensory Disabilities Visual Loss or Impairments Visual impairments and or loss (blindness) can be caused by many factors, including disease, accidents and illnesses. Hearing Loss or Impairments Hearing impairments and or loss (deafness) can be caused by many factors, including physical damage, disease or exposure to very loud noises.

Learning Difficulties “Athletes with an intellectual impairment are limited in regards to intellectual functions and their adaptive behaviour, which is diagnosed before the age of 18 years”. (Walter, 2010) Autism Spectrum Disorder (ASD) ASD is a complex condition that is a neurological disorder that often results in development delay in the following areas: Communication. Social understanding. Behaviour, activities and interests. Asperser’s Syndrome- This falls within the spectrum of ASD. This may go unnoticed because language and cognitive development are not delayed.

Characteristics of Asperser’s Syndrome may include: Mild to severe impairments in social interaction and understanding. Restricted and repetitive activities and interests. Language and cognitive development not delayed. Deficits in communication. Down Syndrome- “Down Syndrome is a chromosomal disorder charactherized by recognizable facial and physical features, associated with mental retardation and medical issues. Historically, it was the first known chromosomal cause of mental retardation and developmental disability” (Lynn,C. 2002).

Classification Systems Each performer at the Paralympics has their disability grouped into one of five categories. Below (disabled-world, 2010) lists these five categories as: 1. Cerebral palsy. 2. Visual impairment (including blindness). 3. Wheelchair athletes. 4. Amputees. 5. Les autres (all others, for example dwarfism or multiple sclerosis). Classification systems are put in place to make competition fairer; like in the same way the handicap system is in place with golf. A lower-body amputee running against an upper-body amputee (just because they are both classed as amputees) would be unfair.

This is why each sport requires its own classification system. Each sport has different physical demands and this also dictates that they also have their own respective classification system. That classification is set by the International Federation (IF) that governs that specific sport. In order for athletes to participate in certain sport the Ifs have to “deem that their disability is severe enough to hinder their sporting performance”. (paralympic. org, 2008) To enforce that a fair and proper competitive sport is always in place sport classes have been introduced.

Each sport has their own Coded letters and numbers which categorise the severity of their disability and how it affects their sporting performance. . An impairment of the arms doesn’t affect performance in running quite as much as it would affect performance in Swimming; so within their respective sport they will be categorised differently. Athletes with totally different disabilities may find themselves competing in the same event because there disability affects their sporting performance in much the same way.

Examples being when the gold medallist Ellie Simmonds, who has dwarfism, was swimming against bronze medallist Natalie Jones who has cerebral palsy(Telegraph, 2013). Even though the two Great British swimming representatives had very different disabilities the International Federation for swimming evaluated and placed the pair in the same class. For team events like wheelchair Rugby and will find themselves playing against players from a different class; however, players with the more severe limitations will be given lower numbers. When the four player’s, on court, numbers are added they may not total more than 8 points.

If a coach choses to deploy a more mobile (and higher class number, player on to the court he will have to make sacrifices elsewhere on his team. This system ensures the game remains balanced and fair. This sport class, evaluation and grading system which looks at each individual (their condition) and their respective sport are the reason that the competitive nature of the Paralympics has remained strong. Detailed Explanation of a disability Amputation to a limb or part of a limb may happen should the individual suffer from severe pain or if their health is in danger.

It is always the last resort. Causes of amputation are: Traumatic Injury Accidents like car crashes, severe burns and sporting injuries may well happen to a normal civilian. For soldiers serving on the front line there is a serious risk of stepping on an Improvised explosive device (IED), suffering from a gunshot wound or getting hit from shrapnel. The damage caused from these traumatic injuries may not be repairable which may leave the individual with no other option than to have one or more amputations. “In the age group of 50 and younger, traumatic injury is the leading cause of amputation.

”(Clements, P. nd). Cancer To stop malignant tumors from spreading to other parts of the body it may be essential to have an amputation in order to preserve life. Disease Individuals with diabetes may suffer from Peripheral artery disease (PAD). With blood vessels hardening to such an extent that blood is getting blocked from reaching tissues at the body’s extremities. This lack of blood to the tissues eventually leads to them dying and the need for amputation. Congenital Amputation Congenital amputation is the loss of a limb or part of a limb at birth.

The cause is most often unknown; however, constricted blood flow within the womb may see bands of tissue starved of blood and subsequently lost permanently. Lower and Upper Limb Amputations Lower limb amputations can differ from the loss of a toe to the removal of the entire leg and part of the pelvis. Below is a list (provided by the Limbless Association, 2012) of the typical forms of lower limb amputations: Lower Limb Amputations Partial foot amputation – this involves the removal of one or more toes; which will affect walking and balance.

Ankle disarticulation – the amputation of the foot at the ankle, leaving a person still able to move around without the need for a prosthesis. Below knee amputations (transtibial) – an amputation of the leg below the knee that retains the use of the knee joint. Through the knee amputations – the removal of the lower leg and knee joint. The remaining stump is still able to bear weight as the whole femur is retained. Above knee amputation (transfemoral) – an amputation of the leg above the knee joint. Hip disarticulation – the removal of the entire limb up to and including the femur.

A variation leaves the upper femur and hip joint for better shape/profile when sitting. Hemipelvectomy (transpelvic) – the removal of the entire limb and the partial removal of the pelvis. Upper Limb Amputations Upper limb amputations vary from the partial loss of a finger to the removal of the entire arm and part of the shoulder. Below is a list (provided by the Limbless Association, 2012) of the typical forms of upper limb amputations: Partial hand amputation – amputations can include fingertips and parts of the fingers.

The thumb is the most common single digit loss. The loss of a thumb affects the ability to grasp and pick up objects. When other fingers are amputated, the hand can still grasp but with less precision. Metacarpal Amputation – this involves the removal of the entire hand with the wrist still intact. Wrist disarticulation – this form of amputation involves the removal of the hand and the wrist joint. Below elbow amputation (transradial) – the partial removal of the forearm below the elbow joint. Elbow disarticulation – the amputation of the forearm at the elbow.

Above elbow amputation (transhumeral) – the removal of the arm above the elbow. Shoulder disarticulation and forequarter amputation- the removal of the entire arm including the shoulder blade and collar bone. When we consider these different impairments and how they would affect sporting performance? Some amputees would be affected more than others due to the different impairments. A soldier who stands on an IED may have an amputated leg and arm and someone else may have been involved in an industrial accident and only have an amputated hand.

It would be highly unfair should these 2 compete against each other in the same event as one man’s impairment is worse than the other. Other areas of concern with amputees are: how long they have had their disability? Some may be used to their condition from birth and others for a short period of time. Do they currently still suffer Pain? Participating while in pain would seriously affect performance. Identifying these concerns should also help ensure for fairer competition.

Adapted/Specifically Designed Sports With its introduction at the Barcelona Olympic Games in 1992 Wheel chair Tennis has gradually saw an increase in the sport. Starting with just 11 tournaments in 1992 the NEC wheelchair tennis tour now boasts over 140 tournaments in over 40 different countries. Wheelchair tennis is now even part of all four Grand Slams. The rules of tennis are the same as normal tennis; however an adaptation of two bounces is allowed before the ball needs to be returned; so long as the first bounce is within the court.

The matches are decided by the best of 3 sets (first to two). Due to the physical nature of the sport, where leaning forward, backwards or to the side is sometimes essential when returning a shot, players choose to have their thighs and feet strapped to the chair to avoid falling out. They have specially designed wheelchairs help prevent them from toppling over; however there has been many occasions where over exertion and stretching has got the better of them and they have ended on the floor. Wheelchair tennis is split into 2 divisions which are:

Open Division This division is applicable to participants who have good use of their arms while serving, moving around the court and returning. This division is for players who have impairment in 2 or less limbs. This is a single sex division meaning that men can only compete against men. Quad Division For participants who have a disability in their arms, legs and trunk. Players use straps to secure the racquet to their hand. Athletes in this division can play against others with different disabilities as long as they have an impairment that affects 3 or more limbs.

This division is also a mixed sex division meaning that men and women can compete against each other. Demands When working with or coaching someone with a disability we have to think very differently to how we would normally set up a coaching session. We have to include them in everything we do and ensure we do not discriminate against them or neglect their needs. Knowing the disability beforehand and gaining basic knowledge and understanding will go a long way in making an altogether more enjoyable and successful session. Not everyone who has a disability is demanding.

They may have a minor amputation and can do most things by themselves. They may even insist on taking part with able-bodied individuals; however, there are still factors to consider: they may need to rest more frequently and if it is a contact sport the opposition have to be aware of the disability so that caution is taken when challenges are being made. It doesn’t matter if the impairment/disability is minor or major we as coaches have to place limitations and adaptations where necessary, be very flexible and always have a contingency plan in place.

Facilities People with mobility disabilities are often forgot about when facilities were being built. Wheelchair users often struggle to get into facilities because access is restricted. If they manage to get inside the facility, toilet issues are also sometimes a problem. Are there specifically designed wheelchair toilets available? If not this could represent a huge problem. Conditions As coaches we have to ensure that the conditions are right. This could be anything from the weather, to the playing surface being adequate but there are other hidden causes of concern.

Should Local builders with their heavy machinery, be working close to where a coaching session, with autistic (ASD) children, is meant to take place could be catastrophic. One of the many challenges that children with ASD suffer from is their hypersensitivity to noise (Stiegler & Davis, 2010); and the coach would have to have a contingency plan in place. Being ignorant to this noise sensitive information would place enormous strain on the health and safety of the children and it could well harm them psychologically as well. This is why it is important to know the disability as well as the conditions before we plan ahead and coach.

Health and Safety Health and safety issues when working with people with disabilities will vary greatly on the type of disability they have got. Controlling, and ensuring the safety of, a group of children with learning difficulties would be significantly more challenging than doing the same for a group of wheelchair basketball players; however, both scenarios would need to be assessed in order to meet the health and safety criteria. Individuals with learning difficulties would ideally have a one (participant) to one (helper) but that is not always possible and this would have to be looked at when deciding what the lesson content is.

If they get distracted or see anything that seems appealing, the Individuals may try to wander around the hall/coaching area and we as coaches cannot allow this! We have to ensure that there is no way of them causing injury to themselves. Take time beforehand to plan the correct location of where they are not likely to hurt themselves or be distracted. Wheelchair basketball players may be easier to communicate with (dependent on their disability) but they may feel patronised should a coach be monitoring their every move. This is when accident could happen; players getting too competitive, colliding and getting injured.

Preventative measures and the correct coaching style identified beforehand will help prevent any health and safety issues. Equipment When coaching golf, tennis or hockey to children do we ever think that they have a dangerous weapon on their hands? If we were to give a real golf stick to someone with learning or sensory disability someone may get hurt when they try to swing for the ball. Due to their skill level being low or not being able to see the surrounding areas all that well sometimes changing equipment is necessary to avoid injury.

Using softer than normal bats, clubs, racquets, balls etc. will help should someone get hit, by accident, in the face with it. Coaching and demands While coaching participants with a disability our approach should remain the same as when we are coaching able bodied participants. We have to motivate, analyse and give constructive criticism/feedback where necessary. To treat any different would be unfair: however, we have to recognise that they have very different needs and demands.

For wheelchair basketball participants we have to acknowledge that if they topple to the ground they may need assistance to get back up. We also have to realise that collisions may happens. Injuries are common, especially the higher standard of players, and because of this we may need to provide medical support that specialise in disability sport injuries. This may include doctors, nurses, physiotherapists and first aiders; these valuable members can also play a crucial role regarding the administration of medicine that needs to be taken by the participants.

We also need to recognise that wheelchairs may malfunction due to the intensity and demands of the game and because of this we may have to have mechanical experts who are able to get the players back on court again. Depending on the level of participants we may have to adapt practice skills and drills. Examples being: We may provide smaller balls, lower net height, not allow touching of wheelchairs and the delivery of fitness training to unaffected body parts i. e. weight training. We need to respect the participant’s privacy when changing, showering and needing the toilet.

Alarms (panic) should be present if help is needed and adequate locks(key card) fitted should we need entry. Paralympic athletes expect to be challenged by their coach just as able bodied athletes would. They will have short and long term goals but they will only be able to achieve them if they are coached correctly and we provide them with their respective demands. Conclusion When we take in to account the many different types of disability we have to remember not to put people in certain brackets just because they are labled or tagged with a disability.

Just like the classification and sport classes we looked at, we need to treat everyone differently and evaluate individually. Sometimes we have to take by the hand and other times we have got to give a little bit of breathing space. As coaches working with individuals/groups with disabilities is often challenging and stretches many to their maximum breaking point; however, when we see the enjoyment, benefits and improvements that so often occurs during each lesson it makes it all worthwhile. If you coach someone with a disability you can be assured that it will make you a much better coach when taking other non-disabled groups.

References 1. Amputee. (2002). The American Heritage Stedman’s Medical Dictionary. Available: http://dictionary. reference. com/browse/amputee (accessed 02/05/2013). 2. Chadband,I. (2012). London2012. http://www. telegraph. co. uk/sport/olympics/paralympic-sport/9518583/Ellie-Simmonds-wins-second-London-2012-gold-with-world-record-victory-in-the-200m-individual-medley. html. (Accessed 01/05/2013). 3. Clements,P. (NotDated). Howamputationworks. Available:http://science. howstuffworks. com/life/human-biology/amputation1. htm (Accessed 05/ 05/2013).

4. Disabled World (2007)- Disability News and Information: http://www. disabled-world. com/artman/publish/article_0082. shtml#ixzz2SEKeQgvu (Accessed 02/05/2013). 5. Dorland’s medical dictionary. (2007). Paraplegia. Available: http://medicaldictionary. thefreedictionary. com/paraplegia. (Accessed 03/05/2013). 6. GaleEncyclopediaofMedicine. (2008). Dwarfism. Available:http://medicaldictionary. thefreedictionary. com/dwarfism. (Accessed 03/05/2013). 7. Gale Encyclopedia of Medicine(2008). Musculardystrophy. Available: http://medicaldictionary.

thefreedictionary. com/muscular+dystrophy. (Accessed 03/05/2013). 8. Houghton Mifflin Company. ( 2007). The American Heritage Medical Dictionary. Multiple Sclerosis. Available: http://medical-dictionary. thefreedictionary. com/multiple+sclerosis (Accessed 03/05/2013). 9. Laymen’s guide to Paralympic Classification. (Not dated) Available: http://www. paralympic. org/sites/default/files/document/120716152047682_ClassificationGuide_2. pdf. (Accessed 01/05/2013). 10. 2012 London Summer Paralympic Games. (not dated). Available: http://www. disabled-world.

com/sports/paralympics/2012/. (Accessed 01/05/2010). 11. Lynn C. Garfunkel, M. D. , Cynthia Christy, M. D. , Jeffery Kaczorowski, M. D. (2002). Mosby’s Pediatric Clinical Advisor: Instant Diagnosis and Treatment. Missouri: Mosby, Inc. 12. Stiegler, L. , & Davis, R. (2010). Understanding sound sensitivity in individuals with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20 (10), 1–9. 13. Jose Vega M. D. , Ph. D. , (March 09, 2008) Hemiplegia. Available: http://stroke. about. com/od/glossary/g/Hemiplegia. htm. (accessed 02/05/2013)

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