BOOK
Para and Adapted Sports Medicine, An Issue of Physical Medicine and Rehabilitation Clinics of North America
Yetsa A. Tuakli-Wosornu | Wayne Derman
(2018)
Additional Information
Book Details
Abstract
This issue of Physical Medicine and Rehabilitation Clinics will cover a number of important topics related to Para and Adapted Sports Medicine. The issue is under the editorial direction of Drs. Yetsa Tuakli and Wayne Derman. Topics in this issue will include: Representations of self and disability through para sport; Prosthetics in para sport; Evidence-based classification of para athletes; Autonomic nervous system in para athletes with spinal cord injury; Training and performance characteristics of para swimmers; Concussion in para athletes; Engineering and technology in wheelchair sport; The Athlete with brain injury; Social inclusion through para sport; and Para athletic identity from competition to retirement.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Para and Adapted\rSports Medicine\r | i | ||
Copyright\r | ii | ||
Contributors | iii | ||
CONSULTING EDITOR | iii | ||
EDITORS | iii | ||
AUTHORS | iii | ||
Contents | ix | ||
Foreword: Maximizing One’s Potential | ix | ||
Preface: Contemporary Medical, Scientific & Social Perspectives on Para Sport | ix | ||
Illness Among Paralympic Athletes: Epidemiology, Risk Markers, and Preventative Strategies | ix | ||
Acute and Chronic Musculoskeletal Injury in Para Sport: A Critical Review | ix | ||
Autonomic Nervous System in Paralympic Athletes with Spinal Cord Injury | ix | ||
Athletes with Brain Injury: Pathophysiologic and Medical Challenges | x | ||
Key Nutritional Strategies to Optimize Performance in Para Athletes | x | ||
Concussion in Para Sport | x | ||
Applying Scientific Principles to Enhance Paralympic Classification Now and in the Future: A Research Primer for Rehabilita ... | x | ||
Performance Characteristics of Para Swimmers: How Effective Is the Swimming Classification System? | xi | ||
Engineering and Technology in Wheelchair Sport | xi | ||
Sport-Specific Limb Prostheses in Para Sport | xi | ||
Para Sport Athletic Identity from Competition to Retirement: A Brief Review and Future Research Directions | xii | ||
The Social Empowerment of Difference: The Potential Influence of Para Sport | xii | ||
Social Inclusion Through Para Sport: A Critical Reflection on the Current State of Play | xii | ||
Paralympic Games: History and Legacy of a Global Movement | xii | ||
PHYSICAL MEDICINEANDREHABILITATION\rCLINICS OF NORTH AMERICA\r | xiii | ||
FORTHCOMING ISSUES | xiii | ||
August 2018 | xiii | ||
November 2018 | xiii | ||
February 2019 | xiii | ||
RECENT ISSUES | xiii | ||
February 2018 | xiii | ||
November 2017 | xiii | ||
August 2017 | xiii | ||
Foreword:\rMaximizing One’s Potential | xv | ||
Preface:\rContemporary Medical, Scientific & Social Perspectives on Para Sport | xvii | ||
Illness Among Paralympic Athletes | 185 | ||
Key points | 185 | ||
INTRODUCTION | 185 | ||
METHODOLOGY | 186 | ||
RISK OF ILLNESS IN PARALYMPIC ATHLETES | 187 | ||
Incidence Rate and Incidence Proportion of Illness in Paralympic Athletes Versus Olympic Athletes | 187 | ||
Incidence of Illness in Paralympic Athletes in Different Organ Systems | 187 | ||
RISK MARKERS FOR ILLNESS IN PARALYMPIC ATHLETES | 187 | ||
Extrinsic Risk Markers for Illness in Paralympic Athletes | 189 | ||
Precompetition versus competition period | 189 | ||
Sport code | 189 | ||
Other possible extrinsic risk markers for illness | 192 | ||
Intrinsic Risk Markers for Illness in Paralympic Athletes | 193 | ||
Age | 193 | ||
Sex | 193 | ||
Other possible intrinsic risk markers for illness in Paralympic athletes | 193 | ||
Impairment type | 193 | ||
Underlying unique medical conditions in Paralympic athletes | 194 | ||
PREVENTATIVE STRATEGIES TO DECREASE RISK OF ILLNESS IN PARALYMPIC ATHLETES | 198 | ||
General Preventative Strategies | 198 | ||
Specific Preventative Strategies | 198 | ||
SUMMARY | 198 | ||
ACKNOWLEDGMENTS | 201 | ||
REFERENCES | 201 | ||
Acute and Chronic Musculoskeletal Injury in Para Sport | 205 | ||
Key points | 205 | ||
INTRODUCTION | 206 | ||
METHODS | 206 | ||
RESULTS | 207 | ||
Summary of Search Results | 207 | ||
Eligible impairment categories | 207 | ||
General injury trends in summer and winter Para sports | 207 | ||
Summer Sports | 235 | ||
Athletics | 235 | ||
Football (5-a-side, 7-a-side, intellectual impairment, amputee) | 235 | ||
Swimming | 236 | ||
Sitting volleyball | 236 | ||
Para powerlifting | 236 | ||
Wheelchair fencing | 236 | ||
Para cycling | 236 | ||
Overhead summer Para sports | 236 | ||
Para sailing and rowing | 237 | ||
Winter Sports | 237 | ||
Para skiing/snowboarding | 237 | ||
Para ice hockey (formerly called IPC ice sledge hockey) | 237 | ||
DISCUSSION | 237 | ||
The Lifetime Injury Model | 237 | ||
SUMMARY | 238 | ||
REFERENCES | 238 | ||
OVID MEDLINE SEARCH STRATEGY | 243 | ||
Autonomic Nervous System in Paralympic Athletes with Spinal Cord Injury | 245 | ||
Key points | 245 | ||
INTRODUCTION | 245 | ||
ORGANIZATION OF THE AUTONOMIC NERVOUS SYSTEM | 246 | ||
CLASSIFICATION OF SPINAL CORD INJURY | 248 | ||
Neurologic Classification | 248 | ||
Evaluation of Remaining Autonomic Functions | 248 | ||
Paralympic Classification | 249 | ||
CONSEQUENCES OF SPINAL CORD INJURY | 250 | ||
Sensorimotor Dysfunction | 250 | ||
Autonomic Dysfunction | 250 | ||
Impact of autonomic dysfunction on the heart | 250 | ||
Cardiovascular disease in athletes with spinal cord injury | 251 | ||
Cardiac output in athletes with spinal cord injury | 251 | ||
Heart rate responses in athletes with spinal cord injury | 252 | ||
Resting blood pressure in athletes with spinal cord injury | 252 | ||
Orthostatic hypotension in athletes with spinal cord injury | 253 | ||
Autonomic dysreflexia in athletes with spinal cord injury | 253 | ||
Impact of blood pressure instability on performance in athletes with spinal cord injury | 254 | ||
Respiratory dysfunction in athletes with spinal cord injury | 254 | ||
Impairment of thermoregulation in athletes with spinal cord injury | 255 | ||
Neurogenic lower urinary tract dysfunction in athletes with spinal cord injury | 256 | ||
Neurogenic bowel dysfunction in athletes with spinal cord injury | 257 | ||
Enhancement of Performance During Competition | 257 | ||
SUMMARY | 258 | ||
REFERENCES | 259 | ||
Athletes with Brain Injury | 267 | ||
Key points | 267 | ||
INTRODUCTION | 267 | ||
DEFINITION AND CAUSES OF BRAIN INJURY | 268 | ||
Congenital Brain Injury | 268 | ||
Acquired Brain Injury | 268 | ||
PATHOPHYSIOLOGIC CHALLENGES OF ATHLETES WITH BRAIN INJURY | 268 | ||
Neuromuscular Control of Movement | 268 | ||
Decreased central output | 268 | ||
Movement dysfunction associated with brain injury | 268 | ||
Hypertonia | 269 | ||
Incoordination | 269 | ||
Coactivation | 269 | ||
Measurement of Muscle Irregularities in a Clinical Setting | 269 | ||
Gravitation Toward the Affected Side | 269 | ||
Athletes May Gravitate Toward Improved Function | 271 | ||
Residual Effect of Brain Injury | 271 | ||
Rehabilitation of Individuals with Hemiplegic Brain Injury | 271 | ||
PARTICIPATION IN SPORT | 271 | ||
Sports for Athletes with Brain Injury | 272 | ||
Paralympic Classification | 272 | ||
Sport Classification | 272 | ||
Performance of Athletes with Brain Injury at the Paralympic Games | 273 | ||
MEDICAL CHALLENGES OF ATHLETES WITH BRAIN INJURY | 273 | ||
Exercise-Related Medical Challenges | 273 | ||
Ankle and foot deformities | 273 | ||
Pain | 274 | ||
Fatigue | 274 | ||
Musculoskeletal injury | 274 | ||
Maximal exertion and muscle spasms | 275 | ||
Degenerative arthritis | 275 | ||
Non–exercise-related Medical Challenges | 275 | ||
Postimpairment Syndrome and the Effect of Sedentary Behavior | 275 | ||
Psychological Resilience | 277 | ||
SUMMARY | 277 | ||
REFERENCES | 277 | ||
Key Nutritional Strategies to Optimize Performance in Para Athletes | 283 | ||
Key points | 283 | ||
INTRODUCTION | 283 | ||
NUTRITION CONSIDERATIONS IN PARA ATHLETES | 284 | ||
NUTRIENTS THAT IMPACT ATHLETIC PERFORMANCE | 287 | ||
Energy | 287 | ||
Energy expenditure | 287 | ||
Feeding concerns | 287 | ||
Inadequate energy intake | 287 | ||
Carbohydrate | 288 | ||
Fueling recommendations | 289 | ||
Muscle glycogen resynthesis post exercise | 289 | ||
Gastrointestinal concerns | 289 | ||
Protein | 290 | ||
Meal plan example for a moderate training day | 290 | ||
Iron | 291 | ||
Iron testing in athletes | 291 | ||
Treatment considerations | 292 | ||
Inhibition and enhancement of iron | 292 | ||
Vitamin D and Bone Health | 293 | ||
Benefits of optimal vitamin D status in athletes | 294 | ||
Causes of vitamin D insufficiency | 294 | ||
Vitamin D testing in athletes | 294 | ||
Recommendations to optimize vitamin D status | 294 | ||
Recommendations to optimize bone health | 295 | ||
SUMMARY/DISCUSSION | 296 | ||
REFERENCES | 296 | ||
Concussion in Para Sport | 299 | ||
Key points | 299 | ||
INCIDENCE | 300 | ||
Paralympic Games Injury Surveillance | 300 | ||
Sport-Specific Studies | 303 | ||
Football 5-a-side | 303 | ||
Wheelchair basketball | 303 | ||
Para ice hockey | 304 | ||
Summary | 305 | ||
ASSESSMENT | 305 | ||
MANAGEMENT | 307 | ||
RISK REDUCTION | 307 | ||
Education | 308 | ||
Enforcement | 308 | ||
Engineering | 309 | ||
“MIND THE GAP” | 310 | ||
REFERENCES | 310 | ||
Applying Scientific Principles to Enhance Paralympic Classification Now and in the Future | 313 | ||
Key points | 313 | ||
INTRODUCTION | 314 | ||
Vision of the Paralympic Movement and Evidence-Based Classification | 314 | ||
Governance and Terminology in Para Sport | 314 | ||
Implications of Para Sport Governance for Researchers | 316 | ||
Taxonomic Evolution of Para Sport Classification | 316 | ||
Specific Aims | 320 | ||
THE CURRENT CLASSIFICATION PROCESS | 320 | ||
Taxonomic Foundations for an Evidence-Based Classification System | 320 | ||
The Athlete Classification Process | 321 | ||
USING THE SCIENTIFIC METHOD TO ENHANCE CLASSIFICATION | 323 | ||
Descriptive Versus Experimental Science | 323 | ||
Improving Extant Systems of Classification Through Science | 324 | ||
Developing New Systems of Classification | 326 | ||
THE FIRST DATA-DRIVEN PARA SPORT CLASSIFICATION STRUCTURE | 328 | ||
Translational Research: Getting Evidence-Based Systems of Classification into Practice | 329 | ||
ROLES FOR PHYSICAL MEDICINE AND REHABILITATION SPECIALISTS IN PARA SPORT CLASSIFICATION | 330 | ||
SUMMARY | 330 | ||
REFERENCES | 331 | ||
Performance Characteristics of Para Swimmers | 333 | ||
Key points | 333 | ||
INTRODUCTION | 333 | ||
METHODOLOGY | 335 | ||
RESULTS | 335 | ||
DISCUSSION | 339 | ||
SUMMARY | 345 | ||
REFERENCES | 345 | ||
Engineering and Technology in Wheelchair Sport | 347 | ||
Key points | 347 | ||
INTRODUCTION | 347 | ||
FUNDAMENTAL PRINCIPLES OF SPORTS WHEELCHAIR DESIGN | 348 | ||
Weight | 348 | ||
Stiffness and Strength | 348 | ||
Resistance | 348 | ||
Ergonomics | 348 | ||
ADVANCED DESIGN AND FABRICATION TOOLS | 349 | ||
BREAKTHROUGH SPORT WHEELCHAIRS | 350 | ||
TECHNOLOGICAL INEQUITIES | 352 | ||
APPROPRIATE WHEELCHAIR DESIGN AND USE IN RESOURCE-SCARCE ENVIRONMENTS | 353 | ||
Social Enterprise and Policy | 354 | ||
Design Features of Wheelchairs in Resource-Scarce Environments | 354 | ||
ELECTRONIC TOOLS AND TECHNOLOGIES FOR SPORT AND PHYSICAL ACTIVITY | 355 | ||
Wearable Technologies | 355 | ||
Computer-Assisted Rehabilitation Environment | 356 | ||
Resistance Training and Vibration Exercise | 358 | ||
The SmartWheel | 359 | ||
Video Game Motivation for Exercise | 362 | ||
APPLICATIONS AND WEB SITES THAT PROVIDE WORKOUT IDEAS AND INSTRUCTION | 362 | ||
Applications and Web Sites for Accessible Fitness Information and Resources | 362 | ||
Applications and Web Sites for Developing Sport-Specific Skills | 363 | ||
SUMMARY | 363 | ||
REFERENCES | 363 | ||
Sport-Specific Limb Prostheses in Para Sport | 371 | ||
Key points | 371 | ||
INTRODUCTION | 371 | ||
AMPUTATION | 372 | ||
Upper Limb Amputation | 372 | ||
Lower Limb Amputation | 372 | ||
CLASSIFICATION | 372 | ||
PROSTHETIC COMPONENTS | 373 | ||
Upper Limb Prostheses | 373 | ||
Lower Limb Prostheses | 373 | ||
Cycling prostheses | 374 | ||
Bicycle setup considerations | 375 | ||
Regulations regarding prostheses | 376 | ||
Long jump prostheses | 376 | ||
Differences in jump techniques between amputees and able-bodied athletes | 377 | ||
Running-specific prostheses | 378 | ||
Unilateral versus bilateral prostheses | 379 | ||
Transtibial versus transfemoral amputees | 380 | ||
FACTORS INFLUENCING PARTICIPATION SPORT AND PHYSICAL ACTIVITY | 380 | ||
MEDICAL FACTORS RELATED TO AMPUTEES | 381 | ||
SUMMARY | 382 | ||
REFERENCES | 382 | ||
Para Sport Athletic Identity from Competition to Retirement | 387 | ||
Key points | 387 | ||
INTRODUCTION | 387 | ||
Quantitative Research | 388 | ||
Athletic Identity Measurement Scale | 388 | ||
Correlates of athletic identity | 389 | ||
Athletic identity and Para sport participation | 389 | ||
Qualitative Research | 389 | ||
Athletic identity among persons with acquired disability | 389 | ||
Affirmative model challenges disablist attitudes | 390 | ||
Athletic identity is correlated with personal and social identities | 390 | ||
Para Sport Athletic Identity: Future Research Directions | 391 | ||
Identity development in Para athletes with congenital and acquired disabilities | 391 | ||
Narrative identity | 393 | ||
Identity implications of leaving sport | 393 | ||
SUMMARY | 394 | ||
REFERENCES | 394 | ||
The Social Empowerment of Difference | 397 | ||
Key points | 397 | ||
INTRODUCTION | 397 | ||
THE HEGEMONIC POWER OF ABLEIST NORMS | 399 | ||
WHY DIFFERENCE MUST MATTER IN PARA SPORTS | 401 | ||
THE CHALLENGE DIFFERENCE IMPOSES ON PARA SPORTS | 404 | ||
SUMMARY | 405 | ||
REFERENCES | 406 | ||
Social Inclusion Through Para sport | 409 | ||
Key points | 409 | ||
INTRODUCTION | 409 | ||
THE IMPORTANCE AND VALUE OF PARA SPORT | 410 | ||
SEPARATE AND UNEQUAL? | 411 | ||
HOW FAIR AND INCLUSIVE ARE THE PARALYMPIC GAMES? | 412 | ||
DO THE PARALYMPIC GAMES INCREASE PARTICIPATION IN PARA SPORT? | 412 | ||
DO THE PARALYMPIC GAMES PERPETUATE UNHELPFUL IMAGES AND STEREOTYPES? | 413 | ||
TENSIONS BETWEEN BIOMEDICAL AND SOCIAL MODELS OF DISABILITY | 413 | ||
WHAT ROLE WILL SPORTS MEDICINE PLAY IN THE FUTURE OF THE PARALYMPIC GAMES? | 414 | ||
SUMMARY | 414 | ||
REFERENCES | 415 | ||
Paralympic Games | 417 | ||
Key points | 417 | ||
DISABILITY SPORT | 417 | ||
PARA SPORT | 418 | ||
THE MODERN PARALYMPIC GAMES | 419 | ||
INTERNATIONAL PARALYMPIC COMMITTEE AND INTERNATIONAL OLYMPIC COMMITTEE RELATIONSHIP | 420 | ||
GAMES LEGACY | 422 | ||
REFERENCES | 424 |