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Wheelchair Sports and Recreation:
Health and Wellness After Disability
Paul MortensenArizona Spinal Cord Injury Association
Chrystal SnyderRidgewood: Ingenious Communication StrategiesArizona Governor’s Council on Spinal and Head Injuries
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Arizona Statewide
SymposiumIn Support of
Military Families
July 15, 2010
In collaboration with
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█ Introductions█ Class objectives & expectations█ Secondary Conditions Model
(using spinal cord injury example)█ Conditions and Interventions█ Adaptive Sports and Recreation█ Resources█ Q/A█ Evaluation
Agenda
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ObjectivesBy the end of the session, the participant will be able to:
█ identify physiological systems at risk for secondary disabling conditions after paralysis
█ discuss the value of fitness and health promotion as a method for reducing risk factors of secondary disabling conditions
█ identify Arizona civilian, military, and government resources for information and health promotion support programs
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Secondary Conditions Model
Disability in America: Toward a National Agenda for Prevention
Andrew M. Pope & Alvin R. Tarlov, Editors Institute of Medicine, 1991.
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Secondary Conditions Model
Primary Disabling Condition
Environment (Social and Physical)
Lifestyle and Behavior
Biology
RIS
K F
AC
TOR
S
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Secondary Conditions Model
EVENTSe.g., infections, skin breakdown, ill-fitting equipment, poor diet,
depression, isolation, inadequate rehabilitation
PREC
IPIT
ATIN
G E
VEN
TS
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Secondary Conditions Model
Secondary Pathology
Secondary Impairment
Secondary Functional Limitation
Secondary Disability
DIS
AB
LIN
G P
RO
CES
S
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Secondary Conditions Model
QUALITY OF
LIFEINDICATORSPhysical Health
Emotional Well-being
Functional Level of Independence
Level of Mobility
Social Integration
Interpersonal Relationships
Personal Productivity
INDICATORSEconomic Status
Intellectual Functioning
Housing/Neighborhood
Subjective Perception of Health
Life Satisfaction
Job Satisfaction
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Secondary Conditions Model█ Disability is a dynamic process█ Disability is not predictable: two persons
with similar impairments may experience disability very differently.
█ Individuals with disabilities are susceptible to: ▐ chronic conditions found in the general
population
▐ conditions secondary to their primary disability.
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Common Medical Conditions After SCISE
CO
ND
ARY
CO
ND
ITIO
NS
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Common Medical Conditions After SCI█ Urinary tract problems█ Bowel management difficulties█ Pressure sores█ Deep vein thrombosis and pulmonary embolism█ Autonomic dysreflexia█ Pneumonia or other lung problems█ Spasticity█ Weight control issues█ Sexual dysfunction█ Pain█ New injuries█ Osteoporosis
SEC
ON
DA
RY C
ON
DIT
ION
S
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Chronic Health Conditions and SCI
█ Individuals with SCI are surviving longer
█ Chronic diseases are now being seen in individuals with SCI, for example:
▐Cardiovascular disease
▐Diabetes
▐Cancer
SEC
ON
DA
RY C
ON
DIT
ION
S
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Chronic Health Conditions and SCI
█ Some diseases occur earlier than expected when compared with able-bodied individuals
█ In some cases, the disease occurs more rapidly, is more aggressive, or is more advanced when diagnosed.
SEC
ON
DA
RY C
ON
DIT
ION
S
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Accelerated Aging
█ The combination of: ▐ secondary conditions and risk
factors▐ the long term effects of the
primary spinal cord injury contribute to the phenomenon of accelerated aging.
SEC
ON
DA
RY C
ON
DIT
ION
S
Health Promotion
“The purpose of health promotion is not simply to
extend life but also to improve the quality of life and to extend
active life free of disability.”Fries, 1988; Katz et al., 1983
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Source: Disability in America: Toward a National Agenda for PreventionAndrew M. Pope & Alvin R. Tarlov, Editors, Institute of Medicine, 1991.
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Interventions█ Screening for early detection and
treatment of the secondary conditions
█ Reducing the risk factors for secondary conditions
█ Education
█ Promoting self-care
█ Counseling
█ Effective Rehabilitation
INTE
RVE
NTI
ON
S
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Personal Monitoring█ SCI-related health issues requiring regular
monitoring include:▐Respiratory system
▐Urinary system
▐Gastrointestinal system
▐ Integumentary system
▐Cardiovascular system
▐Neurologic changes
INTE
RVE
NTI
ON
S
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Health Promoting Factors█Proper nutrition█Stress management█Weight control█Physical fitness█Regular monitoring of health status█Strong social support system█Elimination of substance abuse█No smoking
INTE
RVE
NTI
ON
S
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ADAPTIVESPORTS & RECREATION
Sports / Recreation Programs
for Spinal Cord Injury, TBI and PTSD
in Vietnam versus Today’s Programs
Paul Mortensen602-507-4209
www.azspinal.org
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Video PresentationsAdvancing our Abilities:
Introduction to Adaptive SportsU.S. Military Warrior Games
BG Gary CheekAirman survives life-threatening burns,
now trains for Warrior GamesTSgt Israel Del Toro
Warrior GamesSgt Randi McCartney
Arizona Resources & Activities
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Wheelchair Sports and Recreation█ Promote broader participation in the
community
█ Build a sense of community and reduce the isolating impact of disability
█ Promote health and fitness and reduce the risk of secondary conditions
█ Foster mental renewal through involvement in athletic and leisure activities
█ Enhance the quality of life for persons with spinal cord injury and their families
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PUR
POSE
S
Social & Recreational Events█ Opportunities for shared activities in wheelchair
accessible settings█ Outdoor activities that promote fitness and
offer participants access to areas of the state they may not have had the opportunity to experience
█ Sports (as audience and/or participants)█ Social networking █ Sharing of information█ Modeling of effective mobility and coping
strategies█ Fun, interesting experiences, stimulation
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PRO
GR
AM
S &
AC
TIVI
TIES
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SCI Empowerment Course
The goal of this 12-week course is to promote
optimum quality of life after spinal cord injury.
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SCI Empowerment Course
Based upon the principles of:
█ independent living
█ informed choice and self-advocacy
█health promotion
█prevention of secondary conditions after spinal cord injury
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Key Concepts▐ Acceptance and adjustment to disability as a
process
▐ Prevention rather than crisis intervention
▐ Improved quality of life and all systems of health
▐ Full consumer engagement in his/her life choices and life decisions
▐ Personal advocacy skills
▐ Education of self and others through self-advocacy
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Key Concepts▐ Information and changed attitudes can lead to
wellness and health
▐ Accessing medical care and services that works for you
▐ Identification of issues that need to be addressed continuously
▐ Health promotion and prevention of secondary conditions become “routine” habits of living
▐ Understanding the laws impacting persons with disabilities
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Wheelchair Skills TrainingThis program grew out of the findings of the Arizona Spinal Cord Injury Association that
the early training in wheelchair use that is provided during rehabilitation
is not enough to support an individual’s long-term needs.
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Wheelchair Skills Training█ The rehabilitation period is an
emotional process, where the individual is attempting to come to terms with a substantial change in his expectations for how life is now as compared to how it was planned to be.
█ More education will be needed after this adjustment period is completed—long after access to rehabilitation staff is over.
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Wheelchair Skills Training█ In rehab, the primary focus is on basic skills
needed to ensure that she can function adequately to be discharged home.
█ Later, after some adjustment to the disability has occurred, that these individuals are ready for and interested in learning a greater array of skills.
█ The desire to begin or resume athletic activities can open a world of extended mobility and physical vitality through exercise.
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Wheelchair Skills Training█ Everyone’s body changes over time; the
changes in a body after spinal cord injury may be even greater.
█ New education about using a wheelchair is essential at an older age, after weight gain or loss, after arthritis has developed, or in response to any other type of body change that impacts upon mobility in a wheelchair.
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Arizona Connections: Information & Referral
█ Local Soc/Rec Programs
█ Municipal Recreation Resources
█ College/University Adaptive Gyms
█ Healthcare & Rehab Providers
█ Durable Medical Equipment
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Arizona Spinal Cord Injury
AssociationInformation & Referral
602-507-4209888-889-2185
(toll-free)
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Arizona Spinal Cord Injury Association
At theDisability Empowerment Center
(DEC)5025 East Washington Street
Suite 110Phoenix, AZ 85034
www.azspinal.org
Disability Empowerment Center
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Arizona Activities
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www.azspinal.org/calendar.aspx
Christopher & Dana REEVE FOUNDATION
paralysis.org
National Information & Activities
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Q & A
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