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SPORTS MEDICINE DISABILITY SPORT
Seeing 200 athletes with a
disability transfer to and from the Far East during the Beijing Paralympics in 2008, seemingly without a hitch, belies the massive planning that went on and is a testament to the British Paralympic Association (BPA) and the staff of British Airways and Heathrow Terminal 5, who have not had much positive press in recent years. Preparation is vital in order to ensure that athletes arrive in good shape for the competition.
Getting on a plane n Are there enough members of staff to assist at the airport with luggage and equipment? There will be a requirement for extra luggage, including wheelchairs (both day-to-day and competition chairs). n Is there an ability to move around in the cabin to address issues such as going to the toilet? The ability to transfer to an aisle chair (of which there is generally only one on a flight) is not always straightforward, as not all arm rests are removable on aisle seats. n Is there a plan regarding bladder care needs? Sometimes the athlete may choose to use indwelling catheterisation for the duration of the flight. Is the athlete fluid-restricting because it is difficult to move around and he or she is trying to avoid the need to go to the toilet, thus increasing the risk of urinary tract infection?
In the host country Is there adapted transport? In Macau, there was none on the island before the build-up to the Paralympic Games in 2008. n Is the environment suitable for disabled people? Many countries lag behind in their approach to “access for all”. n Is there an acceptance of disability within the society? Acceptance is increasing, perhaps due to awareness- raising events such as the Paralympics,
but disability is still not always met with enthusiasm. n Is the infrastructure suitable for athletes with a disability? Are hospitals equipped to deal with patients with spinal injury, and do staff understand the need for issues such as pressure area care? n Are the competition or training venues accessible? Remarkably, this is not always the case.
At the hotel n Is the hotel appropriately equipped to deal with athletes with disability? Think of the needs of wheelchair users, people who have less lower limb mobility such as amputees and athletes with cerebral palsy, and visually impaired people. n Are there suitable facilities in the room to allow for space to move in a wheelchair or attend to bathroom needs? n If you are travelling with visually impaired athletes: n Is the hotel room easy to find rather than down multiple corners at the end of the corridor? n Consider signage in Braille or other low vision aids to augment the hotel signage where needed. n Carry out a sighted walk through the hotel and surroundings to identify risks. This may include high-visibility strips on steps, signage to alert of obstruction, and removing decorative plant pots from corridors. – Ensure obstructions in hotel rooms are kept to a minimum. – Ensure the support team are all
aware, willing to help and know how to guide the visually impaired people. n Adjusting to time zones when there is no light perception is a challenge, and often athletes with visual impairment find it difficult to adjust.
SUMMARY
It has been a great privilege and a lot of fun working with the Paralympic team over the past few years. The
athletes are generally in every way as competitive and dedicated as their able-bodied counterparts. There may be additional medical needs to consider, but the athletes are very resilient and take adversity in their stride, as many have had to do over the years.
References
1. International Paralympic Committee. Beijing largest TV audience in Paralympic history. Press release 9 December 2008. http://bit.ly/3wcy3
2. International Paralympic Committee. Classification code and international standards. 2007 International Paralympic Committee
3. Ferrara MS, Peterson CL. Injuries to athletes with disabilities: identifying injury patterns. Sports Medicine 2000;30:137– 143
4. Ferrara MS, Buckley WE. Athletes with disabilities injury registry. Adapted Physical Activity Quarterly 1996;13:50–60 5. McKinley W. Functional outcomes per level of spinal cord injury. e-Medicine. http://bit.ly/cJhXH 6. Bycroft J, Shergill IS, Choong EAL, Arya N, Shah PJ. Autonomic dysreflexia: a medical emergency. Journal of Postgraduate Medicine 2005;81:232–235 7. Karlsson AK. Autonomic dysreflexia. Spinal Cord 1999;37:383–391 8. Spinal Injuries Association. Guide to bladder management after spinal cord injury. Spinal Injuries Association http://bit.ly/ReqSe 9. Price MJ. Thermoregulation during exercise in individuals with spinal cord injuries. Sports Medicine 2006;36:863– 879
10. Thorogood C, Alexander MA. Cerebral palsy. http://bit.ly/fVMTg 11. Klenck C, Gebke K. Practical management: common medical problems in disabled athletes. Clinical Journal of Sport Medicine 2007;17:55–60 12. IBSA medical classification International Blind Sports Federation. http://bit.ly/2GI6u
THE AUTHOR
Dr Stuart Miller is a specialist in sport and exercise medicine. He is chief medical officer for Paralympics GB, a sports
physician in the English Institute of Sport, and clinical director of sport and exercise medicine at Bath University. He also works in the Bristol area, both in the NHS and privately.
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