pediatrics dpt semester 10

1. ADAPTIVE SPORTS AND
RECREATION
Dr. Tehreem Anis
DIRS, DU

2. EXERCISE IN PEDIATRICS:
PHYSIOLOGIC IMPACT
• Exercise programs in healthy children have resulted in quantifiable
improvements in aerobic endurance, static strength, flexibility, and
equilibrium.
• Insulin resistance is reduced in youth who are physically active, reducing
the risk of developing type 2 diabetes.
• Exercise in obese children can improve oxygen consumption and may
improve cardiopulmonary decrements, including resting heart rate.
• Exercise has positive effects on bone mineralization and formation.
• Ambulatory children with CP who participate in circuit training show
improved aerobic and anaerobic capacity, muscle strength, and health-
related quality-of-life scores

3. EXERCISE IN PEDIATRICS:
PSYCHOSOCIAL IMPACT
• Regular PA in early childhood through adolescence
fosters not only improvements in physical health, but
also psychosocial health and development
• Disabled children often view their lack of physical
competence and, second, the status among their
peers as the major barriers in social competence.
• Physical and occupational therapists often
incorporate sports and recreation into their
treatment plans.
• “To improve functioning and independence as well as
reduce or eliminate the effects of illness or disability”

4. ADAPTED SPORTS AND RECREATION
PROFESSIONALS
• Adaptive sports often run parallel to typical sport activities. However, they
allow modifications necessary for people with disabilities to participate and
many sports use a classification system that puts athletes with physical
challenges on an even playing field with each other.
• The primary purposes of treatment services are “to improve functioning
and independence as well as reduce or eliminate the effects of illness or
disability”
Recreation Professionals
• Adapted physical education teachers
• Child life specialists
• Therapeutic recreation specialists

5. PARTICIPATION IN PHYSICAL ACTIVITY
• A number of scales have been developed to measure participation in
activities
• Health Organization Health Behavior in Schoolchildren
• The Previous Day Physical Activity Recall (PDPAR) survey
• The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)
• The Craig Hospital Inventory of Environmental Factors (CHIEF)
• Children’s Assessment of Participation and Enjoyment.
• The European Child Environnent Questionnaire (ECEQ)

6. INJURY IN DISABLED ATHLETES
• Among elite athletes in the 2002 Winter Paralympics, 9% sustained sports-
related injuries.
• Sprains and fractures accounted for more than half of the injuries, with
strains and lacerations making up another 28%
• Of those seeking medical attention during competition, overall incidence is
under 5%, with nearly half related to illness rather than injury
• Knee injuries are the most frequently reported musculoskeletal injury
• Among elite wheelchair athletes, upper limb injuries and overuse
syndromes are common
• Swimmers report foot scrapes and abrasions from transfers
• Having classification systems and segregation in DA sports allows for
achievement based on ability rather than disability

7. “EVENING THE ODDS”:
CLASSIFICATION SYSTEMS
• Impaired muscle power
• Impaired passive range of movement:
• Limb deficiency:
• Leg length difference:
• Hypertonia:
• Ataxia:
• Athetosis:
• Vision impairment:
• Intellectual impairment:

8. ADAPTING RECREATION OPPORTUNITIES
• Camping
• Fishing
• Hunting
• Dance
• Martial Arts
• Scuba and Snorkeling
• Music
• Hippotherapy and Horseback Riding Therapy
• Aquatic Therapy
• Yoga/Tai Chi Chuan

9. SPORTS FOR FUN AND COMPETITION
• Archery
• Baseball
• Basketball
• Bowling
• Cycling
• Football (American)
• Hockey
• Goalball
• Quad Rugby
• Racquetball
• Road Racing
• Skiing
• Soccer
• Softball
• Swimming
• Table Tennis
• Tennis
• Track and Field

10. PEARLS AND PERILS
• Major barriers to participation for children and adolescents with disabilities
include lack of transportation, financial constraints, and physical and attitudinal
barriers. The presence of an adult assistant further distances disabled children
from their AB peers.
• Strengthening exercises in children with spasticity are not contraindicated, and
often result in improved strength, aerobic capacity, and quality of life.
• Active weight-bearing exercises such as jumping result in increased bone density,
• Use of Active video games is resulting in increased levels of PA. This technology is
also being implemented in habilitative and rehabilitative therapy programs
• Sport- and disability-specific injury patterns are being recognized among disabled
youth, leading to a new field of sports medicine for the disabled. Prescription of
appropriate training and equipment are among the tools necessary for the
pediatric rehabilitation professional.

11. References
• Pediatric Rehabilitation –
Principles and Practice. Chapter 5