Sports and other athletic activities can play an important role in the rehabilitative process of spinal cord injury patients. Beyond enhancing physical fitness and functioning, sports can benefit psychological and emotional functioning, promote quick returns to the activities of daily life and community reintegration, and reduce SCI-associated morbidities.15810 Thus, sports can be seen as a significant contributor to the overall health maintenance and health promotion of patients.

...interventions had an introspective and calming effect, helping her to adapt to her new life situation and even to alleviate some of her falling fear.

Going back to as early as 1948, sports have been a component of rehabilitation for SCI. The history of this begins with Dr. Ludwig Guttmann, who utilized sports in the rehabilitation of those sustaining SCIs in World War II. This led to the first wheelchair olympics held in 1960.5 The outstanding athletes of the subsequent Paralympic Games demonstrate the “immeasurable potential that is possible when their determination is met with social and technological efforts to promote access.5

While these athletes may not be representative of the general population of persons with SCI, participation in sports has many positive outcomes beyond just the physical and psychological. Athletic activities can enhance the values of cooperation, participation and life enjoyment 5 — key elements of community reintegration.

A sports therapist can help to integrate sports and athletic interventions into the rehabilitation process. Such interventions will necessarily need to be adapted to individual cases. A patient’s age, physical fitness before and after the injury, emotional state and personal interests, as well as the type of injury (tetraplegia vs. paraplegia, complete vs. incomplete) and the resources available are all factors that are relevant to selecting which sports are most appropriate.

In Lisa’s case, a young, extremely athletic woman suffered a climbing-related accident that resulted in paraplegia, multiple injuries and related emotional disorders. The initial rehabilitative efforts aimed at recovery from her injuries, alleviating her fear of falling and increasing her mobility (including using a wheelchair).

These early interventions were pre-requisites to the sporting activites that were to come in the subsequent Rehab Cycle. Together with her sports therapist, a range of sports were explored and the optimal interventions were selected. Given her fitness level and athletic experience, quite a number of sports were included for her to choose from. Some of them had additional social benefits — enhancing old friendships and offering an opportunitiy to develop new ones.

She would be able to play tennis, hand bike and canoe with non-injured people, most notably her boyfriend. Other more competitive sports would allow her to meet others in similar circumstances with similar interests.

In this way, sports offered an important path to community reintegration. Additionally, each of the Cycle Goals was mutually reinforcing. Fitness training improved mobility which in turn improved athletic ability — and all contributed to greater self care for the reasons described above. Non-sports related interventions (art therapy and Feldenkrais therapy in particular) also made significant contributions. Feldenkrais in particular helped to decrease Lisa’s fear of falling and increasing her body awareness.

Overall, a comprehensive rehabilitative approach that includes sports in combination with other fitness, mobility and non-athletic interventions did much to help with Lisa’s rehabilitative progress. Effects of this approach range from the physiological to the emotional/psychosocial and through broader community reintegration aspects. Lisa’s case offers an almost ideal example of integrating sports into rehabilitation.

She was physically active and fit prior to the injury and highly motivated afterwards. However, significant and unanticipated challenges remained that needed to be addressed through individual approaches to her rehabilitation. Her fear of falling was one example. Based on Lisa’s own needs, abilities and resources, the Rehab Cycle’s assessment phase promoted setting goals that were appropriate to her situation. The result was a sports-intensive cycle whose outcomes demonstrated significant gains.

Lisa's case offers an almost ideal example of integrating sports into rehabilitation.

In summary, patients stand to greatly benefit physiologically as well as psychosocially from a rehabilitative process that is able to integrate individually tailored sports and athletic interventions while also taking specific needs and abilities into consideration.