CHAPTER 100 • THE DISABLED ATHLETE 587different. The goal of the Special Olympics is partici-
pation and typically involves individuals with mental
handicaps. The goal of the Paralympics is winning,
involving individuals with various physical disabili-
ties who compete nationally and internationally to
determine who the best is.- In 1924, the first international competition for athletes
with physical disabilities, the International Silent
Games, was held. The first winter Paralympic games
were held in 1976 and were hosted in Ornskoldsvik,
Sweden. - In the United States, the Committee on Sports for the
Disabled is a subcommittee of the U.S. Olympic
Committee (USOC). It recognizes seven national dis-
abled sports organizations: U.S.A. Deaf Sports
Federation, Disabled Sports U.S.A., Dwarf Athletic
Association of America, Special Olympics
International, U.S. Association for Blind Athletes, U.S.
Cerebral Palsy Athletic Association, and Wheelchair
Sports U.S.A.
DEFINITIONS/CLASSIFICATIONS
•World Health Organization (WHO)
•Impairment: Any loss or abnormality of psycho-
logic, physical, or anatomical structure or function.
- Disability: Any restriction or lack (resulting from an
impairment) of an ability to perform an activity in
the manner or within the range considered normal
for a human being. - Handicap: A disadvantage for a given individual,
resulting from an impairment or a disability that
limits or prevents the fulfillment of a role that is
normal (depending on age, sex, and social and cul-
ture factors) for that individual. - National Collegiate Athletic Association (NCAA)
•A disabled athlete is one who is confined to a
wheelchair; deaf, blind, or missing a limb; has one
of a pair of organs; or a behavioral, emotional or
psychologic disorder that substantially limits a
major life activity.
•Classification systems for disabled athletes are more
complicated than those for able-bodied athletes. These
systems are both sports and impairment specific and
are different for each organization. Every effort is
made to ensure competition exists between individuals
of similar impairments. For example an individual
with a transfemoral (above-knee) amputation, would
be at a disadvantage racing an individual with a
transtibial (below knee) amputation. Team sports, gen-
erally involve a point system, where individuals are
assigned a point value based on their impairment level.
Lower numbers are given to athletes of higher level
impairments, and fairness in competition between
teams is achieved by limiting the total amount of
points each team may have on the court at anytime. In
addition, limitations and regulations are also placed on
adaptive equipment, e.g. size and features of wheel-
chair and prosthetic device.BENEFITS OF SPORTS AND EXERCISE- Research has shown that physical fitness and sports
participation offer both physical and psychologic
health benefits to individuals of all ages, including
those with disabilities (Johnson et al, 1998; Weiss and
Beck, 1973). - These benefits include self-image, body awareness,
motor development, and mood. - Athletes with disabilities demonstrate increased exer-
cise endurance, muscle strength, cardiovascular effi-
ciency, and flexibility; improved balance; and better
motor skills compared with individuals with disabili-
ties who do not participate in athletics. - Individuals with amputations who participate in ath-
letics have improved proprioception and increased
proficiency in the use of prosthetic devices. - Disabled athletes have fewer cardiac risk factors,
higher high-density lipoprotein (HDL) cholesterol,
and are less likely to smoke cigarettes than those who
are disabled and nonactive. - Athletes with paraplegia are less likely to be hospital-
ized, have fewer pressure ulcers, and are less suscep-
tible to infections than nonactive individuals with
paraplegia.
PREPARTICIPATION ASSESSMENT- Preparticipation assessments (PPA) should be per-
formed in a systematic comprehensive fashion similar
to that performed for able-bodied athletes. - Sports medicine practitioners should not be overly
focused on the athlete’s impairment/disability, and
miss common medical issues.
•Careful evaluation of the athlete’s wheelchair, pros-
thetics, orthotics, and assistive/adaptive devices
should also be performed prior to competition. This is
usually facilitated by consultation with the individ-
ual’s Orthotist, Prosthetist, or other health care spe-
cialists with experience in this area. - Sports medicine practitioners, who are not familiar
with certain impairments, should solicit assistance
from practitioners with more experience. This often
requires a team approach. For example a physician
specializing in sports medicine may have little experi-
ence in spinal cord injuries, while a spinal cord injury
specialist may have even less experience in sports