ASSESSMENT AND MANAGEMENT ASSESSING AND MANAGING

AN ATHLETE WITH A DISABILITY

By Linda Mitchell MSc, MCSP

BACKGROUND Athletes participate in many different sports, come with a wide range of abilities, and present with a broad range of expectations and demands. Those with a disability are no different, although they often present with a few extra and unexpected issues.

There is a broad range of sports available to the person with a dis- ability. Some of these are modifications of able-bodied sports eg. wheelchair basketball, wheelchair tennis and judo and whilst oth- ers are specially developed for a particular group eg. boccia for those with severe cerebral palsy and goalball for those with a visu- al impairment. Many athletes with a minimal functional disability participate in sport with little or no modification eg. swimming, athletics and skiing and can sometimes participate in mainstream sport with little disadvantage.

Sport activity is undertaken at recreational or competitive levels and therefore the athlete with a disability can be susceptible to injury just as any athlete would be. Similar psychological influences apply to both able-bodied and athletes with a disability when an athlete is preparing for competition, or is denied participation because of injury. In addition, athletes with a disability are vulnerable to further factors predisposing to injury or illness. These are often the result of a combination of influences which include the use of a mobility aid, or limitations imposed by their underlying disability, and therefore athletes with a disability often present with non-traditional problems associated with participation in sport (1). For example, people with a high-level spinal cord lesion have a reduced ability to sweat and therefore their ability to keep cool in hot conditions is compromised. They are at greater risk of over-heating and heat related illnesses.

ISSUES TO ADDRESS Access to your clinic/treatment area The Disability Discrimination Act 1995 (2) has provided clear guide- lines for physical access to premises so that those with a disability are not unfairly denied access to services or goods. It is therefore worth reviewing the ease of use of your facilities to consider how a person with a visual impairment or a wheelchair user could move around inside the premises or treatment area. Could, for instance, an athlete use the reception facilities fully, or access the treatment area without obstruction? Is it possible to provide a comparable range of treatment options and use appropriate exercise equipment adequately? Might you have to adapt how you deliver interventions or make additional provisions? Conducting a risk assessment, or a

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Working with athletes with a disability can be both challenging and interesting for the therapist in sport. The principles applied in able-bodied sport are very relevant; however these must be enhanced with consideration of additional facets if optimum outcomes are to be achieved.

In some circumstances the needs of athletes with a disability are not thoroughly assessed, can be over- looked, or are not fully addressed. This may be due to a lack of awareness of the impacting issues, or a fear on the practitioner's part of potentially doing something wrong.

This article aims to shed light on the needs of the athlete with a disability and offer practical advice to help the practitioner confidently engage with this group of sportsmen and women.

review exercise, should provide valuable insight into how your treatment area can be used.

Your approach An evaluation of your personal approach and understanding of disability is usually helpful. Frequently practitioners feel awkward or uncertain when dealing with disability because it is outside familiar practice. To take away some of the anxiety, gain insight into what it must be like by doing some activities seated, or with- out vision. Be careful though, while this gives you some aware- ness, it doesn't provide the whole picture and sometimes those with a disability can be offended if you do undertake these tasks.

Practitioners also report concerns relating to the language and terminology that they should use and frequently in their attempts to be correct, become more tongue-tied! A common example is that he/she becomes afraid to use the word 'walk' with a wheelchair athlete (eg. 'let's walk to the car'), or 'see' with a visually impaired athlete (eg. 'have you seen X recently?’). While other words could be substituted, often the struggle to find the right word and make a correction leads to stilted and self-conscious conversation. As 'walk' and 'see' are used as normal phrases and colloquialisms, don't worry too much. An athlete will often help you by making a joke and it’s better to admit your errors and nervousness. An athlete will pick up your genuine intention and not usually be offended.

sportEX medicine 2007;32(Apr):6-9