Practical Management: Common Medical Problems in Disabled Athletes

Abstract

Disabled athletes face many challenges during training and competition. As the number of disabled athletes grows, sports medicine professionals must become proficient in dealing with this population. A functional classification system is used to classify disabled athletes into 1 of 6 categories: wheelchair athletes, amputees, athletes with cerebral palsy, visual impairment, intellectual impairment, and les autres. Injury patterns have been identified for certain groups, with wheelchair athletes typically sustaining upper extremity injuries, blind athletes sustaining lower extremity injuries, and cerebral palsy athletes sustaining both. Common problems affecting wheelchair athletes include autonomic dysreflexia, difficulty with thermoregulation, pressure sores, neurogenic bladder, premature osteoporosis, peripheral nerve entrapment syndromes, and upper extremity injuries. Cerebral palsy athletes often have injuries involving the knee and foot due to problems with spasticity and foot deformities. Amputee athletes sustain injuries to the stump, spine, and intact limbs, while blind athletes suffer lower extremity injuries. Intellectually disabled athletes frequently have underlying ocular and visual defects, congenital cardiac anomalies, and atlantoaxial instability that predispose them to injuries. This article reviews key information pertinent to the care of these athletes.

Aspectos das lesões esportivas em atletas com deficiência visual

“…These data were found in other references (3,7,10,11) . This result may be explained by the reason that the proprioception in blind individuals tends to be worse than in those with partial vision, affecting mainly the lower limbs and resulting in abnormal gait and biomechanics (4) . A great variety of body regions was affected (Figure 3), and structures such as biarticular muscles (in the thigh region), more unstable articulations with higher freedom level (shoulder and knee) are also the ones with higher injury frequency.…”

“…Some studies in the field of sports injuries in athletes with disabilities have been published (2)(3)(4) ; however, the majority presents methodology which joins data of different disabilities and sports modalities, making the sample heterogeneous and unspecific (5) . The specification of these data, according to the group of athletes with disability and modality practiced, may inform on the sports injuries which occur in a modality or a group of athletes with disability, aiding in the application of specific preventive strategies.…”

Sports Medicine Considerations for the Paralympic Athlete

“…Of all injuries reported at the 2012 London Paralympic games, injuries to the upper extremities were most common, with shoulder injuries being predominant among these [12]. Athletes competing in wheelchair sports are especially at increased risk for overuse injuries of the shoulder complex due to repetitive use of the upper Table is organized by major disability category, rather than IPC impairment-based classification, and thus is not inclusive of all types of impairments a Inclusive of athletes who compete with use of a sports wheelchair, to include those with upper and/or lower extremity impairment due to various etiologies b Inclusive of athletes who have also experienced traumatic brain injury, stroke, or other central neurologic injury c Five summer and three winter sports are all-inclusive of disability categories d Classification for these sports is currently still in development as these will appear first at the 2016 Summer Paralympics in Rio de Janeiro, Brazil extremities for propulsion [22]. A typical sitting position for these athletes involves posterior pelvic tilt, increased thoracic kyphosis, and forward head position, especially for athletes with SCI.…”

Lesión medular y ejercicio físico: revisión desde una perspectiva deportiva

“…También son síntomas frecuentes un dolor de cabeza palpitante, un aumento de la espasticidad, congestión nasal, visión borrosa, bradicardia, hipertensión, vasoconstricción por debajo del nivel de la lesión, arritmias, palidez y sofocos (Klenck y Gebke, 2007). Además, en ocasiones destacan otros síntomas como el enrojecimiento, manchas de la piel en la cabeza y el cuello, escalofríos sin fiebre, falta de aliento y ansiedad (Geraghty, 2001).…”