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Organizations throughout the country are offering or launching adaptive sports programs for people with disabilities who are seeking expanded access and participation in activities at recreational and professional levels. The trend poses challenges for physical therapists who provide support and guidance to help patients overcome disabilities and reach their goals.

Hundreds of U.S. veterans with disabilities gathered in Snowmass, Colo., March 25-30 for the largest adaptive winter sports event in the nation, a sign that the trend has momentum. The National Disabled Veterans Winter Sports Clinic near Aspen was held to give positive rehabilitation reinforcement for servicemembers injured or wounded in recent fighting in Iraq and Afghanistan.

"The pledge of the clinic is to motivate veterans with traumatic brain injuries, spinal cord injuries, orthopedic amputations, visual impairments, certain neurological problems and other disabilities to live life to the fullest by experiencing Miracles on a Mountainside," said Theresa Parks, spokeswoman for the event, which drew 355 participants.

Harvey Naranjo, OTA/L, adaptive sports coordinator for Soldiers Undertaking Disabled Scuba at Walter Reed National Military Medical Center in Bethesda, Md., said scuba diving is a popular activity because of its therapeutic value for injured soldiers returning from Iraq and Afghanistan.

"Once they’re in the water and safe, it equalizes the playing field as long as they have the right type of equipment and modified technique to do it safely and with a diving buddy," said Naranjo, a civilian and native New Yorker who spent seven years as a Coney Island lifeguard and did a tour on active duty in occupational therapy in the U.S. Army.

Naranjo also works with PTs and other OTs in coordinating adaptive sports therapy in such activities as skiing, kayaking, rock climbing, hunting, fishing, wheelchair basketball, judo, soccer, surfing, and even dog sledding.

If someone has an interest in a specific sport, efforts are made to adapt the activity and create a program, said Naranjo, who also teaches participants how to travel with adaptive equipment or accessories, navigate crowds, board planes and safely reach their destinations.

"Doctors are huge supporters of what we do and encourage it as part of the rehabilitation plan when patients come to the hospital," Naranjo said. "The military has totally adopted adaptive sports therapy at all its rehabilitation clinics."

Underwater therapy

The therapeutic benefits of scuba diving also are strongly touted by Cody Unser, who has been paralyzed since contracting transverse myelitis at age 12, and whose Albuquerque–based Cody Unser First Step Foundation, backed a recent study that showed some positive results during a Cayman Island dive in September 2011.

Unser, who now is 25 and in the graduate program for public health at George Washington University in Washington, D.C., motivated two physicians to put on scuba gear and investigate why she feels tingling sensations when going on deep underwater ventures. "I was experiencing weird things so I brought the doctors on board," Unser said.

The Cayman study involved a group of 10 paralyzed veterans who dove to about 60 feet to help determine whether the zero gravity undersea environment had therapeutic value for improving their physical or mental health. The tests showed unexpected positive results that has surprised researchers and gives hope of a new pathway to recovery for people with disabilities. "The study results were really outside the box and has put adaptive scuba diving on the map," Unser said.

Daniel Becker, MD, one of the two physicians on the project, said the study showed positive results from diving that lasted three to four weeks and included an average 15% drop in muscle spasticity, a 10% rise in sensitivity to light touch, a 5% increase in the ability to feel a pinprick, and in some cases body tone, sensation, and motor function improved as much as 20% to 30%. In five veterans who suffered from post-traumatic stress disorder, symptoms dropped by 80%, while for the overall group, symptoms of obsessive-compulsive disorder and depression fell 15%. In contrast, a matched group of healthy divers showed no changes on any of the array of tests.

Becker, head of Pediatric Restoration Therapy, International Center for Spinal Cord Injury at Kennedy Krieger Institute, Baltimore, is hoping to fund an expanded $250,000 scuba study. "Within 13 months, I’m quite confident we would have significant and exciting results," Becker said.

Powerful therapy

At Crested Butte in Colorado, the Adaptive Sports Center just wound up the 25th season of its winter clinic that assists people with various disabilities to ski mountain slopes safely. As the snow melts, other events are taking shape to help disabled visitors take control of a sports activity, such as adaptive biking or canoeing.

Trent Ezzell, PT, MPT, had worked with pediatric patients and at an outpatient orthopedic clinic in the Dallas/Fort Worth area when he volunteered for a summer at the Colorado center. An outdoors enthusiast, Ezzell was hooked on the adaptive sports agenda and since has raised funds for groups of disabled children from Texas to come to the Gunnison Valley region and take part in the innovative program.

"It’s amazing how happy and relieved people are to be active again," Ezzell said of patients with amputations, cerebral palsy, or other disabilities who learn how to use special ski or snowboard apparatus to glide down a wintry mountain slope or pedal specially designed bicycles across a grassy spring meadow. "For many disabled people, getting back to doing something challenging and trusting their instincts is rewarding and gives them hope. It’s powerful therapy."

Participants in the adaptive sports clinics often are accompanied by physical or occupational therapists who help them make equipment adjustments, learn movements, or do strength-building techniques, Ezzell said. "They can incorporate outdoor physical therapy with rehabilitation through activities that are safe, fun and empowering."

Ezzell, of Canadian, Texas, liked the Colorado region so much that five years ago he accepted a job at a new Physiotherapy Associates clinic in Crested Butte and moved there with his wife, KayLynne Ezzell , PT, MPT, who also works at the outpatient facility. KayLynne grew up in the Texas panhandle, is active in sports, and has lectured on physical education at the college level, emphasizing empowerment of individuals with disabilities through adaptive sports.

For the past five years, the couple, who have two young children, have raised funds to sponsor the Lone Star Freestyle Team of disabled youngsters from Texas in the winter Adaptive Sports Ski Program.

Toby Long, PT, PhD, FAPTA, associate dean for disabilities study and associate professor of pediatrics at Georgetown University, is a leading advocate of adaptive sports and assistive technologies for children and adults with disabilities and special needs.

"Research is showing that, when given a simple mobility device, young babies develop better cognitive skills than those who are not able to explore their environment on their own and are passively moved around or have their environment brought to them," Long said. "So I think that independent mobility using assistive technology is extremely important."

Long took part at a recent symposium on barriers to adaptive sports activities for the disabled that emphasized how young people who participate in the programs have higher self-esteem, better body images, more confidence and higher rates of academic success. "Furthermore, sport is where skills like teamwork, goal-setting, the pursuit of excellence in performance and other achievement-oriented behaviors necessary for success in the workplace are developed." •

John Leighty is a freelance writer.