Athletics for people with disabilities.

Sport for people with disabilities was pioneered by Sir Ludwig Guttman who in 1944 opened a new spinal cord injury unit at the Stoke Mandeville Hospital in Aylesbury, England. He organized the National Stoke Mandeville Games for the Paralysed in 1948 which evolved into an international competition in 19521. Subsequently, the first Paralympics were held following the Rome Olympics in 1960. By 1976 the Paralympic games included athletes with amputations, visual impairment, and those in wheelchairs. Athletes with cerebral palsy were included in the 1980 games for the first time2. The scope of sports’ participation by people with disabilities continued to grow and in the early 1970s the first winter ski competition for people with disabilities was held in Winter Park, Colorado. In 1983 the American Academy of Orthopaedic Surgeons, recognizing the positive impact of sport on children and young adults, published material on a broad spectrum of recreational as well as competitive sporting activities for people with disabilities3. Physical barriers continue to fall as the initial Spinal Cord Injury Classification has evolved into the Functional Classification System which allows trainers and physicians to classify athletes in the following categories: visual impairment, cerebral palsy, amputation, wheelchair athletes, and les autres which includes athletes with short stature, muscular dystrophy, limb deficiency, arthrogryposis, and osteogenesis imperfecta4. This system means that individuals can compete on equal terms with competitors who have similar disabilities. Medical conditions that are unique to the wheelchair athlete including thermal regulation, autonomic dysreflexia, seizures, overuse syndromes, and traumatic injuries have been well documented and, therefore, appropriately trained personnel can use this information to promote greater safety in competitions4. Innumerable studies have been made of the general health benefits of exercise and physical fitness for the non-disabled, but to date there have been few clinical studies exploring the benefits of therapeutic exercise and conditioning for people with disabilities. Preliminary studies now indicate that regular sports activities can enhance the psychological status of persons with paraplegia as well as those with quadriplegia5. In this issue, Rimmer’s report on the physical fitness of people with cerebral palsy6 is especially noteworthy. This study details what can be deduced from the known benefits of athletic activity in the general population as applied to individuals with cerebral palsy. Providing enhanced physical fitness for those with disabilities will promote greater joint flexibility, reduce osteopenia, improve vital capacity, and offset the tendency to obesity in some otherwise inactive individuals. Other positive aspects of recreational and competitive sport for people with disabilities are apparent to any health professional who has had the opportunity to witness first hand the growth in self-confidence, enhanced self-image, and allround maturity that accompanies young people participating in these activities. Today there is a wealth of organizations that provide recreational activities for children and teenagers with disabilities ranging in the US from the Cerebral Palsy Athletic Association and the National Wheelchair Basketball Association to the Dwarf Athletic Association of America. On the international scene, the popularity of the Paralympic movement reached record proportions at the recently concluded Paralympics in Sydney, Australia, in which 3824 athletes from 122 countries participated; ticket sales exceeded 1100000: a new record. I was fortunate enough to attend the final day of competition and one memorable observation was noting the enthusiasm of many disabled young persons attending the games as spectators with their parents. Although they were not able to compete they showed remarkable enthusiasm for participating as spectators. Lisa Llorens, a young track and field athlete who is autistic, won two gold medals at the games. Granted autism is not a physically limiting condition but her comment best summarized the spirit of the entire disabled movement. Questioned by a sports writer after winning her second medal she said: ‘Autism is very strange. Everyone assumes we’re a bit simple but that’s not true. My brain is simply wired up differently. I don’t see or hear the world in quite the same way as you do’7.