Chapter 31 Outdoor Adaptive Athletes Chapter 31 Outdoor

Chapter 31 Outdoor Adaptive Athletes

Chapter 31: Outdoor Adaptive Athletes Objectives • Determine special needs of patients who are mentally challenged. • Determine special needs of patients who are physically challenged. • Demonstrate the special care needs required when treating adaptive patients. 2

Chapter 31: Outdoor Adaptive Athletes Adaptive Populations • In 1990, the ADA opened frontiers for participation. • Different terms are used; the NSP has adopted “adaptive athlete. ” • Adaptive athletes have a long and rich history in sports. • Adaptive skiing programs exist at many ski areas in Europe and the U. S. 3

Chapter 31: Outdoor Adaptive Athletes Mental Challenges • Learning disorders: ADD and/or dyslexia • Mental retardation: Down syndrome • Autism: developmental neurologic disorder • Cognitive disability from a prior brain injury • Psychological disorder: psychosis, manic-depressive (bipolar) 4

Chapter 31: Outdoor Adaptive Athletes Mentally Challenged Patients • Assessment can be challenging. • Supervising adult or caregiver can help communicate. • Use a gentle, calm, caring approach. • Determine level of communication and level or interaction. • Determine if an underlying condition is cause of behavior or if an injury is the cause. 5

Chapter 31: Outdoor Adaptive Athletes Physical Challenges • • • Amputations, ataxia, cerebral palsy Deafness, epilepsy, multiple sclerosis Muscular dystrophy, spina bifida Postpolio syndrome, stroke Spinal cord and/or brain injuries Blindness or other visual challenges 6

Chapter 31: Outdoor Adaptive Athletes Amputee Patients • Amputations can be traumatic, surgical, or a person can be born missing a limb. • Amputation at a joint is a disarticulation. • Prosthesis (artificial limb) may be worn. • Specialized equipment such as outriggers and “buckets” are often used with regular skis. 7

Chapter 31: Outdoor Adaptive Athletes Adaptive Snowsports Terms (1 of 2) • Outrigger: forearm crutch with short ski built onto the bottom • Three tracker: A skier with one ski and two outriggers • Four tracker: A skier with two skis and two outriggers 8

Chapter 31: Outdoor Adaptive Athletes Adaptive Snowsports Terms (2 of 2) • Mono-skier: A skier in a seat or “bucket” mounted to a single ski • Bi-skier: A skier in a seat or “bucket” mounted to a pair or skis. Both use outriggers. 9

Chapter 31: Outdoor Adaptive Athletes Treating Amputee Athletes • Gently remove prosthesis from an injured limb. • Extricate patient from equipment. • Traction for a femur fracture may not be possible due to distal amputation. • Outriggers can cause upper extremity injuries. • Let patient comfort guide treatment. 10

Chapter 31: Outdoor Adaptive Athletes Cerebral Palsy (CP) Patients • CP is a result of a brain injury before, during, or shortly after birth. • Three syndromes: – Spastic—constant muscle contraction – Athetoid—slow, writhing movements – Dystonic—extreme muscle rigidity • Usual fracture treatments may not work. • Again, let comfort guide treatment. 11

Chapter 31: Outdoor Adaptive Athletes Multiple Sclerosis (MS) Patients • Neurologic condition that effects stamina, balance, vision, and cranial nerves. • Disease may have periods of remission and exacerbation. • Individuals process information slower and may take longer to respond. 12

Chapter 31: Outdoor Adaptive Athletes Muscular Dystrophy (MD) Patients • • • Progressive muscle atrophy Easily fatigued Joints are hypermobile. Usually sit skiers Gentle approach to prevent further injuries 13

Chapter 31: Outdoor Adaptive Athletes Postpolio Syndrome Patients • Usually have a “wasted” or atrophied limb • The limb can have some or no function. • Be aware of pre-existing CMS dysfunction. • Protect any affected limb. 14

Chapter 31: Outdoor Adaptive Athletes Spina Bifida (SB) Patients • Mono- and bi-skiers mostly. • Spinal compromise only below congenital anomaly • SB patients may have a CSF shunt— blockage may cause mental status change. • They may also have an extreme latex allergy. Use non-latex gloves. 15

Chapter 31: Outdoor Adaptive Athletes Spinal Cord Injury Patients (1 of 2) • Quadriplegia—injury to cervical spine • Paraplegia—injury to thoracic or lumbar spine • Sit skiers (mono or bi) if injury was lower than T 5 • May exhibit autonomic dysreflexia (AD) 1. Can be a life threatening due to hypertension 2. Eliminating stimuli will usually correct 16

Chapter 31: Outdoor Adaptive Athletes Spinal Cord Injury Patients (2 of 2) • Lack normal sensation and movement below original injury site • Unknown injuries can occur easily: – Frostbite, fractures, and soft-tissue injuries such as lacerations, abrasions – Assess insensate extremities carefully. – Guard against further injury. • Upper extremity injuries occur due to outrigger use. 17

Chapter 31: Outdoor Adaptive Athletes Stroke and Brain Trauma Patients • Disability is related to the amount and site of prior injury. • Some may exhibit behavioral or psychological changes as well. • Patients may exhibit aphasia. • Watch for seizures, and treat them appropriately. 18

Chapter 31: Outdoor Adaptive Athletes Visually and Hearing Impaired Patients • Participation is increasing. • Visually impaired patients have a guide. • Remember to speak to patient while treating. • Gain the attention of the hearing impaired patient and speak directly to him or her. 19

Chapter 31: Outdoor Adaptive Athletes Other Treatment Concerns • Ostomy bags collect feces and urine. • Rescuers should avoid exerting pressure on these appliances. • Watch for blood in collection bags; this could indicate trauma. 20

Chapter 31: Outdoor Adaptive Athletes Lift Evacuation and Transport • Sit-skiers should always have a threepoint leash that can be used for evacuation. • Visually impaired skiers should be lowered before their guide. 21