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European sports network for rehabilitation of persons nwith disabilitiesES reSpSPOrrT GUUiDdELIinESE European ReSport Guidelines For implementation Of ReSport Activities reSpSPOrrT GUUiDdELIinESE

Maribor 2019

European sports network for rehabilitation of persons with disabilities EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES

European sports network for rehabilitation of persons with disabilities

ConTEnTS

ReSport Guidelines 1. INTRODUCTION 9

European ReSport Guidelines for implementation of ReSport Activities FOREWORD 11 PARTNERS IN THE EU PROJECT ERASMUS + SPORT “EUROPEAN SPORTS Jasna Vešligaj Damiš, Yoana Filipic, Vladimir Jaćević, Ladislav Mesarič, Zvonka Novak, Valentina NETWORK FOR REHABILITATION OF PERSONS WITH DISABILITIES – RESPORT” 17 Bolšec, Danijela Majcenovič Cipot, Zsuzsanna Kovács, Zsuzsana Antal, Dr Mohammed Mammad, Mireille AUTHORS OF RESPORT GUIDELINES 18 Boucher, Nihat Yıldız, Mehmet Afşin Güven, Gökhan Bahçecik, Melik Bingöl, Eduardo Borges Pereira, 1.1. TERMINOLOGY IN THE GUIDELINES 22 Raúl Candido, Carlota Cunha, Michele Lepori, Alessandro Munarini, Silvia Noci, Paolo Zarzana, Ilona 1.2. ADAPTED PHYSICAL ACTIVITY 24 Koval Grubišić, Michael Lamont, Fiona Mc Cabe, Treasa Rice. 1.3. DECLARATION ON THE SPECIFIC CHARACTERISTICS OF 26 SPORT AND ITS SOCIAL FUNCTION IN EUROPE (NICE 2000) Editor and foreword: Jasna Vešligaj Damiš Proof reading: Brain Injury Matters 2. THE ROLE OF ORGANIZATIONS IN THE PROCESS OF INCLUSION 29 Technical editor, design and illustrations: Marko Damiš Dtp: Marko Damiš & Kostja Bras 2.1. EXCLUSION, SEGREGATION, INTEGRATION AND INCLUSION 30 2.2. EFFECTIVE IMPLEMENTATION OF INCLUSION FOR VOLUNTEERS 32 Publisher: Center Naprej, Maribor 2.3. RAISING AWARENESS OF INCLUSION 35 centre for persons with acquired brain injury 2.4. THE ROLE OF RESPORT PROJECT PARTNERS ORGANIZATIONS IN THE PROCESS OF INCLUSION 37 2.4.1. THE ROLE OF CENTER NAPREJ IN THE PROCESS OF COMMUNITY INCLUSION OF 37 Maribor 2019 www.resport.si PERSONS WITH ACQUIRED BRAIN INJURY 1st edition - 125 copies 2.4.2. CENTRO SPORTIVO ITALIANO 41 2.4.3. RIJEKA DISABILITY SPORTS ASSOCIATION - THE ROLE OF ORGANIZATION 42 Guidelines were published with the support of the Erasmus+ programme of the European Union. IN THE PROCESS OF INCLUSION 2.4.4. THE ROLE OF FPDD IN THE PROCESS OF INCLUSION 44 The authors take sole responsibility for the content. The copyright is owned by partners and authors 2.4.5. THE ROLE OF BRAIN INJURY MATTERS IN THE PROCESS OF COMMUNITY 44 in the project. Copying and reproduction without written permission is prohibited and is punishable INCLUSION OF PERSONS WITH ACQUIRED BRAIN INJURY under the Copyright Act. 2.4.6. KEÇIÖREN MUNICIPALITY AND ITS ROLE IN THE PROCESS OF INCLUSION 45 2.4.7. THE ROLE OF HUMAN PROFESS NON-PROFIT LTD. IN THE 46 PROCESS OF INCLUSION OF PEOPLE WITH DISABILITIES CIP - Kataložni zapis o publikaciji 2.4.8. THE ROLE OF CIF FRANCE IN THE PROCESS OF INCLUSION 47 Narodna in univerzitetna knjižnica, Ljubljana

796.034-056 3. DISABILITY AND HEALTH 49

RESPORT guidelines : European Resport guidelines 3.1. DEFINITIONS OF DISABILITY 50 for implementation of Resport activities / [Jasna 3.2. CLASSIFICATION OF DISABILITY 52 Vešligaj Damiš ... [et al.] ; editor and foreword Jasna Vešligaj Damiš ; illustrations Marko Damiš]. - 3.3. HEALTH CONCERNS 55 1st ed. - Maribor : Center Naprej, 2019 3.3.1. THE HEALTH OF PEOPLE WITH DISABILITIES 55 3.3.2. MENTAL HEALTH 56 ISBN 978-961-290-436-4 3.3.3. DISABILITY AND OBESITY 58 1. Vešligaj Damiš, Jasna COBISS.SI-ID 301584896 3.3.4. HARMFUL HABITS 59 3.3.5. 21ST CENTURY - VIDEO GAMES OR TRADITIONAL SPORT DISCIPLINES 62 3.3.6. DOPING IN THE SPORT FOR PERSONS WITH DISABILITY 65

4. BENEFITS OF PHYSICAL ACTIVITY 69

4.1. BENEFITS FOR THE PSYCHOLOGICAL AND SOCIAL FUNCTIONING 70 4.2. SPORTS AND PHYSICAL ACTIVITY AS REHABILITATION 76 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES

5. PLANNING AN ADAPTIVE PHYSICAL ACTIVITY 87

5.1. HOW TO PLAN ADAPTIVE PHYSICAL ACTIVITY 88 5.2. COMPETITION IN SPORTS 93 5.3. RISKS IN ADAPTED PHYSICAL ACTIVITY 98 5.4. THE ROLE OF ADAPTED PHYSICAL ACTIVITY EDUCATION 104 5.4.1. CHANGING TRADITIONAL ATTITUDES, BELIEFS AND ASSUMPTIONS 104 5.4.2. BUILDING SAFE RELATIONSHIPS 106 5.4.3. PSYCHOLOGICAL PREPARATION OF ATHLETES WITH DISABILITIES AND CHALLENGES WE FACE 108 5.4.4. PHYSICAL ACTIVITY RECOMMENDATIONS 116 5.4.5. CHALLENGES FOR FACILITATORS AND SERVICE USERS 118 5.4.6. EQUIPMENT AND TECHNOLOGY 120

6. APPLICATION OF ADAPTED PHYSICAL ACTIVITY PROGRAMMES 125

6.1. SWIMMING 126 6.2. NORDIC WALKING AND GYMSTICK - GNW PROGRAM 129 6.3. STAND UP PADDLE BOARDING (SUP) AS A NEW FORM 134 OF REHABILITATION OF INDIVIDUALS WITH ACQUIRED BRAIN INJURY (ABI) 6.4. SLACKLINING OR WALKING ON FLAT WEBBING 141 6.5. CROSSBOCCIA 146 6.6. SKIING 150 6.7. FOOTGOLF 155 6.8. SNOWSHOEING 158 6.9. NETBALL 162 6.10. SPORT ORIENTATION 165 6.11. TABLE TENNIS 169 6.12. CHEERLEADING 172

7. EVALUATION OF SPORT PROGRAMMES 177

7.1. THE PURPOSE OF MONITORING AND EVALUATING SPORTS PROGRAMMES 179 7.2. THE SPORT FOR DEVELOPMENT COLLATION OUTCOMES MODEL 182 7.3. SPECIFIC OUTCOME MEASURES 186

8. LONGEVITY AND QUALITY OF LIFE 191

8.1. REGULAR PHYSICAL ACTIVITY 195 8.2. COMMUNITY ACTIVE LIVING PROGRAMMES 199 inTRo DUc tIon EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 11

ForewOrD

Sport represents a great part of human interest and life. His- torically sport activities and other similar activities have attracted huge interest since ancient times. Current evidence can be traced back to 30,000 years as examples of paintings in caves originating from prehistoric periods.

Sport activities in the form of rehabilitation originate from the Greek, Roman, and Chinese empires. Then they already knew that physical activity was an excellent media for rehabilitation, since they also dealt with the physical, mental, emotional, social and spiritual elements of a person.

The basic goal of physical activity is to optimize the psycho- somatic condition of the individual, make effective use of the leisure time, preventive health care procedures and improve health, well-being and recovery.

Sport is an area of human activity, which is important for all citizens of the European Union with an exceptional potential for unifying people. It concerns everyone, regardless of age, social status, disability, race or gender. However, we face the fact that people with disabilities are physically less active than their peers, and consequently 38% are overweight (53% more than people without disability). Physical inactivity is the fourth most common risk factor for premature mortality. At the same time, we must be aware that every sixth person in the Eu- ropean Union suffers from a mild or severe form of disability, which means approximately 80 million individuals. Many European countries are aware of this problem and act accordingly.

Sports activities represent an effective method for rehabilitation of persons with disabilities. Taking part in sporting activities helps people with disabilities to achieve greater quality of life and greater social inclusion. For this purpose, they need to be able to participate in sports events and appropriate sports programs, where they can engage equally and access sports and recreational areas. Sports activities must also become an integral part of the rehabilitation of people with disabilities, regardless of the type or level of their disability, age and level of physical fitness.

These facts are the reason that 8 partners from 8 European countries gathered within the framework of the Erasmus + Sport with a project entitled “European sports network for rehabilitation of persons with disabilities “ReSport”, connecting many organizations, professionals, people with disabilities and their relatives, volunteers and all who have a common goal of 11 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 12 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 13

equal opportunities. We decided to follow this goal and join in need to increase the chances of including people with disabil- the preparation of comprehensive sports solutions in the field ities in various sports and recreational programs. “Re Sport” of physical activities with rehabilitation effects for persons Guidelines are designed to promote awareness of the importance with disabilities. Therefore, after a long planning process and of the physical activity of people with disabilities, to trans- discussion, we created and published European ReSport Guide- fer knowledge at European level and to inspire as many of them lines for the implementation of “ReSport Activities”. as possible to be active in their life.

As project partners we are aware of the importance of ensur- Sport and recreation have many other positive outcomes, and ing equal access and equal opportunities for all and promoting one of these is certainly connecting people with and without healthy physical activity for all, especially for people with disabilities. It is an excellent opportunity for integration, disabilities. It is believed that patterns of physical activi- overcoming prejudices and creating a tolerant society. And the ty are fundamental to lifelong physical activity and health in authors of the ReSport Guidelines hope that it will serve this the future and that they represent an important part of every purpose! individual’s life.

The Guidelines is a result of the team work of the interdisciplinary team of all partners in the project. The members of the working group have made an enormous contribution in terms of time, effort, knowledge and experience in shaping the guide- JASNA VEŠLIGAJ DAMIŠ lines, and this is why we are extremely grateful to the whole PROJECT MANAGER team.

The Guidelines contain a number of directions and examples of good practice that will help all readers - employees, therapists, trainers, people with disabilities, their relatives and interested members of society - in deciding and preparing programs of adaptive and integrated sports activities for people with disabilities. Following the guidelines allow us to take appropriate actions and monitor users in various adapted sports activities, timely identification and prevent possible complications, and thus carry out sports and recreational programs smoothly.

According to the data of international and national health and sports organizations, physical activity is very important factor in maintaining health. Indeed, persons with disabilities, representing almost 15% of the world’s population, rarely participate in sport and physical activity.

At the same time, we understand that, like everyone else, they have to fight more and more for their rights, and always look for optimal solutions for rightful development. Based on the Convention on the Rights of Persons with Disabilities adopted in 2006, the signatory countries of the Convention committed to ensure appropriate conditions for the development of sports for persons with disabilities, especially with regards to sports facilities, financing, school system and education, both at state level and in the local community, and introduce appropriate actions to enable persons with disabilities, as well as others, to participate in recreational, leisure and sporting activities.

Nevertheless, we still notice that there are too few existing programs and organizations that allow them to exercise properly. It is of utmost importance that we encourage and raise awareness both among state and experts at all levels about the EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 15

Photo: Center Naprej, Expert meeting, March 2017, Planica Slovenija EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 16 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 17

Partners in the EU project Erasmus + Sport “European sports network for rehabilitation of persons with disabilities – ReSport”.

FR HU SI HR IT PT TR

SI - PARTNER 1 – coordinator and lead partner UK - PARTNER 5 CENTER NAPREJ Maribor Brain Injury Matters Slovenia United Kingdom

IT - PARTNER 2 TR - PARTNER 6 CSI - Centro sportivo Italiano Keçiören Municipality Italy Turkey

HR - PARTNER 3 HU - PARTNER 7 Rijeka Disability Sport Center Association Human Profess Közhasznú Nonprofit Kft Croatia Hungary

PT - PARTNER 4 FR - PARTNER 8 Federação Portuguesa de Desporto para pessoas CIF France com Deficiência France Portugal

Figure 1: Partners in the EU project Erasmus + Sport “European sports network for rehabilitation of persons with disabilities – ReSport”. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 18 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 19

AUThors oF Re- SPOrt guIDelINes

Valentina Bolšec, MA Psychology currently works at Center Zsuzsana Antal, she is a certified adult training manager - Naprej providing long-term psychological rehabilitation of teacher. She has 20 years experience in the field of social persons with acquired brain injury (ABI). Her work is based and labour market rehabilitation of disadvantaged groups and on providing emotional and psychological support for people people living with a brain injury. In her job, she primarily with disability. She also focuses on providing cognitive re- deals with the development of international training mate- (ABI). He facilitates a number of adapted sports programs. habilitation and encouragement of motivation and achievement rials. She used to work in the framework of a Slovenian-Hun- His professional interests include assessment and treatment of goals for individuals with ABI. garian project on the development of sport opportunities for of individuals with cerebral palsy, stroke and brain injury disabled people. Working together with a medical and dive and other allied neurological conditions, and incorporating master team, she took part in the adaptation of the method various techniques in the process of treatment. of diving, so that it can become a sport that is available Jasna Vešligaj Damiš, MA Psychology and licensed psychodrama for disabled people. She took part in the development of the psychotherapist with extensive experience as Director of ABI training manual, as well as the preparation of the Study Center Naprej providing long-term rehabilitation of persons entitled Long-term rehabilitation of people living with an with acquired brain injury (ABI). She has completed the acquired brain injury. course of dr. Sarah McKay in neuroscience and brain health: The Neuroscience Academy Certificate of Completion in Applied Neuroscience and Brain Health. She is also the project manager of ReSport project. Leader of several rehabilitation Danijela Majcenovič Cipot, B.A. Sociology, as sociolo- sports summer and winter events for people with ABI. She gist passed professional examinations on a field of public offers psychological preparation for professional athletes administration and welfare. She worked on various fields (Law Ladislav Mesarič, MSc Physical education, Sport and Kinesio- at international and world competitions in athletics - Ath- enforcement, Military, Social Welfare, Long-term unemploye- therapy, Olympic coach in athletics, strength and condition- letics Club Slovenska Bistrica, Jitai Maribor. She developed ment). She is currently working as group facilitator providing coach of Taekwondo federation of Slovenia. He has more a number of training programs for long-term ABI caregivers. ing long-term rehabilitation of persons with acquired brain than thirty years of experience coaching and training numer- She is also an expert in management and co-ordination of EU injury (ABI). She is also Head of unit in Murska Sobota. She ous successful sportsmen, representatives of various sports. projects, national projects, realization of good practices, participated in many international and national conferences Dr Mohammed Mammad, Born on 11/07/1965 in Oran –Algeria, With his primary sport - athletics he has been coaching networking with schools, companies and institutions and as attendee and also author of papers and gave preventive Dentist surgeon since 1988, French License 200, Magister of three Olympic athletes. He is an external collaborator of dissemination of the project products and outcomes. workshops to various target groups. She has experience with French, option: Sciences of the Literary Texts 2008, Doc- Center Naprej in the preparation and evaluation of adapted various projects on national and international level. torate of French, option: Sciences of Literary Texts, Jury sports programs for persons with acquired brain injury. in 2019, Training in Mediation and Conflict Management from 2012 to 2014 in Algeria, France and Germany, Head of the IEC (Information - Education - Communication) unit at the Hai El Ghoualem Public Health Establishment in Oran, Training in Montpellier for one month in 2001 on “Teaching French as a Foreign Language”, 4 internships (2 in Lyon and 2 in Oran) for the development of the university manual on oral methodology in 2010, 2017 Social Action Program CIF France in Bourges Saint Florent sur Cher, 2018 Training ANPAA (ad- Yoana Filipic, MA Psychology and DBT skills coach currently dictology) Bourges. Dr. Mammad takes part in a weekly radio works at Center Naprej providing long-term psychological Zsuzsanna Kovács, she is 32 years old. She graduated at show “Tips on Health”, Trainer, communicator and trainer Zvonka Novak, MA Social Work, licensed mediator and paedi- rehabilitation of persons with acquired brain injury (ABI). the Faculty of Economics of West Hungarian University. Her of trainers. He joined the CIF France team as an expert for atric nurse. She is currently employed as Head of unit at She has facilitated and provided support in the process of thesis focuses on equal chances and disadvantaged social actions around people with disabilities. Center Naprej in Maribor providing long-term rehabilitation crisis intervention of persons with disabilities and persons groups. She lives with a locomotory disability; she has been of persons with acquired brain injury (ABI). She has worked with psychiatric disorders. Her professional interests are swimming and cycling since childhood. She has always been as a paediatric nurse at Intensive therapy in Paediatrics focused in the area of counseling, goal setting and motiva- striving to help her fellow sufferes as much as she can. Unit of University Medical Centre Maribor. She has got vast tion of persons with disabilities and exploring challenges She is aware of the opportunities provided by local sport experience in the field of social welfare, managing dislo- facilitators of adapted physical activity programs face. associations. She knows the system of national para sport cated units, leadership in numerous camps and other group organizations, she is informed about the regularly orga- activities for people with intellectual disabilities. Zvonka nized programs and events, and she continuously follows the has incorporated MATP (motor activity training program) in changes. Along with her job, she completed a course entitled different activities for people with severe disorders and „Enforcement of equal treatment and development of social she has participated in Special Olympics with them. She has awareness”, organized by Equal Treatment Authority. Cur- participated in the project Happy Farm (Leonardo da Vinci) rently she has been working for Human Profess Public Benefit Mireille BOUCHER, Born April 11, 1951 Bourges, Retired and Grundtvig (Socrates). Nonprofit Ltd. Her task is, among others, to organize sport social worker director. Training: specialized educator. activity of disabled people. President CIF France, CIF International Association international of social workers. Deputy Mayor school affairs and early childhood in Saint Florent sur Cher Vice President of Vladimir Jaćević, BA Physiotherapy is certified for Bobath the Local Mission (Insertion 16-25 years people) Competence problem-solving neuro-developmental approach and Cyriax in the field of social action and integration. Trainer for method. He currently works at Center Naprej providing long- fosters families. Expert on insertion, animation of collec- term rehabilitation of persons with acquired brain injury tive actions for people with disabilities. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 20 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 21

• 2 years work experience as Personal Trainer at Health water pilates, bike and treadmill. Specializing in water Club Solinca Vasco da Gama. sports for infants and disabled people, she has worked in • Goalball National Referee. this sector since 1992. She collaborates with local health • Coach of Boccia in the Cerebral Palsy Association of authorities and schools for inclusion and self-development Lisbon. projects for disabled people, through physical activity in • Participation as National Technical Official at the Boccia the water. He currently manages the AcquaInsieme project World Cup 2011 organized by the Cerebral Palsy Interna- with the Centro Toscana Toscana which involves around 25 tional Sports & Recreation Association (CRISRA). children from 20 months to 15 years.

Nihat Yıldız, Deputy Mayor of Keçiören Municipality. He is Melik Bingöl, manager and head of IT Department. He is a responsible for Sports and Youth Department of Municipality computer engineer. He has many experience with various and Sports Centres. He temporarily serves as rapporteur in projects (project partner and manager of EMPATHY Project, various commissions established by the Ministry of Interior Parental Training in Families of Children with Disabilities in the budget and accounting systems of the municipalities, and of DEVOMDA project - Development Of Vocational Suitabil- State Tender and Public Procurement Legislation, Personnel ity for Disabled Adults, project coordinator of Developing Legislation, Public Financial Management System and Public Skills of Young Disabled People DESYODIP, LLP –Leonardo Audit. He is lecturer in seminars and training programmes – TOI. He has got experience in preparation of Training organized by the Ministry of Interior, Turkish Municipal- Modules for Disabled, Preparing Technical Handbook, Country Michele Lepori, CSI ReSport project handler. He has twen- Paolo Zarzana, CSI national trainer, CT of Italian Nation- ities Union, Konya Municipal Union, Aegean Municipalities Analysis Reports, Expert Platforms, Dissemination of Proj- ty years of experience in the field of sports associations al amputee soccer team. He works at the CSI of Modena with Union, Marmara and Boğazlar Municipalities Union, Black ects and Mobility Tools. and in organizing events in the field of sport for disabled the role of Vice President, responsible for school projects Sea and Mediterranean Municipalities Associations, TODAİE, people. For 10 years he has been a provincial councilor and and activities for disabled athletes. In addition, he is a Governorships, municipalities, foundations and universities. a member of the Paralympic commission of the Lombardy re- councilor of the Municipality of Formigine (Mo). Graduated He is member, founder or manager in various non-governmental gion of CSI, where he obtained the qualification of Paralym- in Educational Sciences, he is the Vice CT of the Italian organizations. pic coach. Thanks to the experience he has acquired, he has Soccer Amputation Team, which he has been following since also obtained a CONI high-level diploma. 2012. With this team he participated in a European and 2 world championship. He currently works with the CSI in the Technical School.

Eduardo Borges Pereira, Sports Manager. • National Technical Director of FPDD since 2017. • Board of Directors Chairman and Sports Director at the municipal town hall company “Palmela Desporto, EM” (Sport Mehmet Afşin Güven, computer engineer and biologist. He Palmela) for five years – 2011 to 2016. has got experience in EU Projects, preparation of Technical • Portuguese Sports Institute Vice-President of the Board Alessandro Munarini, CSI referente nazionale attività Handbook, testing reports and evaluation. He is an expert between 2003 and 2005. disabili. He obtained his magistral diploma, and for 15 in EU Projects for disabled people, developing skills of • Sports Coordinator at the municipal town hall of Palmela, years worked as a social worker in a cooperative, providing Ilona Koval Grubišić, Ph.D., associate professor, master of young disabled people, development of vocational suitabil- from 1996 to 2011 (except from 2003 to 2005). assistance and support to disabled people. In the 90’s he physiotherapy ity for disabled adults and parental training in families obtained the requalification on the job, acquiring the qual- of children with disabilities. He has got experience in ification of professional educator. After a break in which he Michael Lamont, BSc Psychology has recently moved on from web site design and management, software design, testing, carried out various jobs (building trade and agriculture) he his role as Associate Psychologist with Brain Injury Matters data analysis and management. He is a professional computer returned, from 2015, to work as a professional educator in (NI). Michael coordinated the Youth Matters Programme pro- programmer. a cooperative, always in relationship with disabled people, viding 1:1 and group based support services to young people both minors and adults. In terms of volunteering, it has (13-25 years) across Northern Ireland, who have experience given rise to and developed a sports club in the municipali- of an acquired brain injury. Michael provided psychologic ty of Reggio Emilia; he was president of this sports company input based on the individuals needs of the young people for 30 years. Also at the level of the Sports Center, he involved in the programme. performed, always free of charge, various tasks: provincial Raúl Candido, Sports Technician at FPDD Portugal since 1999. councilor, head of training, regional councilor and gener- Fiona Mc Cabe, Brain Injury Matters Ireland. • Adapted Sport Coach. al manager of the committee. He is currently President and • Work in the technical area of Disability Sports since general manager of the Reggio Emilia committee, national 1991. representative of the Sports Center for disabled persons and • Technical support to several Paralympic Missions at professional educators (part-time) in a cooperative with Gökhan Bahçecik, manager and head of Department of Youth Portugal team. disabled people. and Sports. He worked on several European Union Leonardo Da Vinci Action Programmes related to local municipalities. He participated in various seminars, meetings, symposiums and training programmes regarding Turkish politics and local government.

Treasa Rice, Community Engagement Officer, Brain Injury Matters. Treasa Rice, BSc Environmental Health, MSc Health Promotion currently works at Brain Injuri Matters (NI) coor- dinating youth and adult services for persons with acquired brain injury within their local community. She has facil- CUNHA, Carlota, Sports Technician at FPDD Portugal since 2015 Silvia Noci, CSI National Technical Commission for disabled itated support groups, sports interventions and one to one • 2 years work experience as physical teacher for disabled people. She is a federal swimming technician. He is the sessions within her role as community engagement officer. people at Ginásio Clube Português. director of the CO.G.IS swimming facility and coordinator • Technical Officials Coordinator in Paralympic Games Rio 2016. of the swimming school. Swimming instructor, water fitness, • Boccia International Referee. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 22 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 23

1.1. TerMinoLOGY in the gUIDeLiNES

AUTHOR: JASNA VEŠLIGAJ DAMIŠ

Key words: handicapped, disability, disabled person

For the purpose of these guidelines we used the tion is a problem experienced by an individual Disability Handicap terms person with disability and athlete with in involvement in life situations. Disability is disability. Athletes with disability are peo- thus not just a health problem. It is a complex Meaning Disability means the inabil- Handicap means the difficulty experienced ple with a disability who engage in sports and phenomenon, reflecting the interaction between ity of a person to perform by a person in performing his/her tasks. are able to compete in sports at elite levels. features of a person’s body and features of the his/her routine actions. They can also practice almost any sports and society in which he or she lives.” — World Health sometimes need adapted equipment (Ferrara & Organization, Disabilities. Writing these Guide- Core Disability is being completely Handicap is a partial disability. difference unable to perform a function. Peterson, 2000). As we realize that the language lines we have followed the description of WHO used is very important in terms of attitudes and as this is the definition we support and think is Applicability Disability is mostly as- Handicap could also mean a disadvan- beliefs we chose to emphasise the person rath- the most appropriate and politically correct. It sociated with the medi- tage imposed in a professional sport. er than the disability placing the word person gives a vast and correct perception of the topic cal condition of not being able to perform a task. first. and issues explored. Variants Disabilities of various Handicap related to medical condi- We also present a table differentiating the kinds such as physical, sen- tions such as being physically, mental- terms disabled and handicapped person. We did Reference sory, intellectual, men- ly handicapped et al., and handicap in tal, emotional, etc. terms of sports such as golf handicap, not decide to use the term handicapped for the chess handicap, tennis handicap, etc. reasons stated in the table on the right page. Ferrara M.S. & Peterson C.L. (2000). Injuries to athletes with disabilities: identifying injury patterns. Sports Medi- Diplomatic More acceptable as com- Regarded as being offensive to peo- cine; 30(2):137-43. A disability is an impairment that may be cogni- accuracy pared to ‘handicap’. ple suffering from conditions of impairment or disability. tive, developmental, intellectual, mental, phys- Tanaka, H. & Seals, D. (2003). Invited Review: Dynamic ical, sensory, or some combination of these. It exercise performance in Masters athletes: insight into the effects of primary human aging on physiological functional substantially affects a person’s life activities capacity. J Appl Physiol.; 95(5): 2152–2162. pmid: 14555676 and may be present from birth or occur during a person’s lifetime (Tanaka & Seals, 2003). https://en.wikipedia.org/wiki/Disability “Disabilities”. World Health Organization. Retrieved 6.5.2018 We refer to disability as normal part of human life and experience that can occur. However http://www.differencebetween.info/difference-between-disabil- there are many definitions and different ways of ity-and-handicap. Retrieved 18.9.2018 describing the term. We have chosen the World Health Organization (2018) definition: “Disabil- ity is an umbrella term, covering impairments, activity limitations, and participation restrictions. Impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing Table 1: Difference between Disability and Handicap (http://www.differencebetween.info/difference-between-disabili- a task or action; while a participation restric- ty-and-handicap, 18.9.2018) EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 24 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 25

erasmus/multilateral_actions_2008/eras_emhe_142271_eusapa.pdf Retrieved on 12.3.2018

Mälkiä, E. Puolanne, M. & Palosuo, M. (1991). Special Ex- ercise 1: Appropriate Exercise basics. Jyväskylä. Gummerus Kirjapaino Oy.

Mälkiä, E. & Rintala, P. (2002). New Special Movement. Exer- 1.2. cise facilitation for special groups Tampere. Tammer-paino Oy.

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Reid, G. (2003). Defining Adapted Physical Activity. In R.D. AcTIvity Steadward, G.D. Wheeler, & E.J. Watkinson (Eds.), Adapted Physical Activity (pp. 11-25).

AUTHORS: YOANA FILIPIC, JASNA VEŠLIGAJ DAMIŠ

Key words: adapted physical activity, EUSAPA, EUFAPA

Adapted physical activity (APA) is an extremely ation, competition and recreational activities; broad concept. Therefore, we cannot give a sin- sport in all its dimensions (Ninor & Partyka, gle exclusive definition. Opinions and views in 2007, Mälkiä, 2002). this area are quite different. Greg Reid (2003) believes that the main problem lies in the word EUSAPA - European Standards in Adapted Physical “adapted”. Most of us have some ideas about what Activities is a project that strives to devel- physical activity means, however the word adapt- op and research adapted physical activity at a ed is sometimes problematic. So, an immediate European level. It defines three areas of adapted response is often: “It’s physical activity for physical activity - 1 - adapted physical edu- people with special needs.” The APA description cation, 2 - adapted sports and recreation, and in terms of activity for people with disabili- 3 - adapted physical activities in rehabilita- ties gives us a perspective, but this is by no tion. The Finnish expert Mälkiä shares a similar means a complete definition or more precisely a opinion and states that apart from the implemen- limited view of this concept (Reid, 2003). The tation of adapted physical activity in sport, development of APA for people with disabilities recreation and education, it is also important has gone through various stages of implementa- in rehabilitation of persons with disabili- tion and overcoming difficulties, due to dif- ties or people with chronic diseases. Physical ferences in understanding in various paradigms activity is crucial part of all areas of life - philosophical, kinesiological, psychological, - health, knowledge, social inclusion, educa- and social. EUFAPA (European Federation of tion and rehabilitation. Adaptation of physical Adapted Physical Activity) defines APA as a cross activity may also involve technical adjustments, disciplinary field of knowledge and research such as using technical adaptation, adapting directed towards identification and solution of sports equipment and structural changes. For individual differences in physical activity. It example in adapting rules and instructions of is a service delivery profession and an academ- the game or in developing training, which means ic field of study that supports an approach that adapting professional approaches and methods and promotes acceptance of differences among indi- methods of exercise and teaching (Mälkiä, 1991). viduals, advocates improving access to an active lifestyle and sport activities and encourages innovation and cooperative service delivery and References empowering systems (EUFAPA, 2018). The purpose of adapted physical activity is to promote human EUFAPA - European Federation of Adapted Physical Activity, health, independence, quality of life and social http://www.eufapa.eu/index.php/apa.pdf, Retrieved 2.2.2018 inclusion. APA is an area of interdisciplinary expertise, which includes: rehabilitation and EUSAPA -European Standards in Adapted Physical Activities. therapy; physical education and sport; recre- http://eacea.ec.europa.eu/LLp/project_reports/documents/ EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 26 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 27

economic and social role of volunteers, with the women, in order that their vocational integra- support, where necessary, of the Community in tion is not jeopardized because of their sport- the framework of its powers in this area. ing careers, to their psychological balance and family ties and to their health, in particular the prevention of doping. It appreciates the 1.3. contribution of associations and organizations 1.3.1. Role of sports federations which minister to these requirements in their training work and thus make a valuable contribu- DeclaratIOn on The European Council stresses its support for tion socially. the independence of sports organizations and their right to organize themselves through ap- the spECIfic Char- propriate associative structures. It recognizes that, with due regard for national and Community 1.3.3. Economic context of legislation and on the basis of a democratic sport and solidarity acteriStics of and transparent method of operation, it is the task of sporting organizations to organize and sP•Ort aNd its s•O- promote their particular sports, particularly The sale of television broadcasting rights is as regards the specific sporting rules applica- one of the greatest sources of income today for ble and the make-up of national teams, in a way certain sports. The European Council thinks that Cial FUnCTion in which they think best reflects their objectives. moves to encourage the mutualisation of part of the revenue from such sales, at the appropriate It notes that sports federations have a central levels, are beneficial to the principle of soli- EurOPe (NICE 2000) role in ensuring the essential solidarity be- darity between all levels and areas of sport. tween the various levels of sporting practice, from recreational to top-level sport, which co-exist there; they provide the possibility of Reference AUTHORS : ZSUZSANNA KOVÁCS, ZSUZSANNA ANTAL access to sports for the public at large, human and financial support for amateur sports, promo- European Council – Nice, 7-10 DECEMBER 2000, Declaration on Key words: declaration, sport for all, protection of young sportsmen and – women, tion of equal access to every level of sporting the specific characteristics of sport and its social function in Europe, of which account should be taken in implementing solidarity activity for men and women alike, youth train- common policies. Retrieved from: ing, health protection and measures to combat doping, acts of violence and racist or xenopho- http://www.europarl.europa.eu/summits/nice2_en.htm?textMod- e=on, 2018.02.08 bic occurrences. Draft declaration on the specific characteristics of sport and its social function in Europe, of which account should be Introduction Sport is a human activity resting on fundamental These social functions entail special responsi- taken in implementing common policies. Retrieved from: social, educational and cultural values. It is bilities for federations and provide the basis http://data.consilium.europa.eu/doc/document/ST-13948-2000- The European Council has noted the report on a factor making for integration, involvement in for the recognition of their competence in orga- INIT/en/pdf, 2018.02.08) sport submitted to it by the European Commis- social life, tolerance, acceptance of differenc- nizing competitions. sion in Helsinki in December 1999 with a view es and playing by the rules. Incorporating the specific characteristics of sport and its social functions into the implementation of common policies. to safeguarding current sports structures and While taking account of developments in the Retrieved from: maintaining the social function of sport within Sporting activity should be accessible to every world of sport, federations must continue to be http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=LEGIS- the European Union. man and woman, with due regard for individual a key feature of a form of organization provid- SUM:l35007, 2018.02.08 aspirations and abilities, throughout the whole ing a guarantee of sporting cohesion and partic- The European Council hopes in particular that gamut of organized or individual competitive or ipatory democracy. the cohesion and ties of solidarity binding the recreational sports. practice of sports at every level, fair competition and both the moral and material interests For the physically or mentally disabled, the and the physical integrity of those involved in practice of physical and sporting activities 1.3.2. Protection of young the practice of sport, especially minors, may be provides a particularly favourable opening for sportsmen and women preserved. the development of individual talent, rehabilitation, social integration and solidarity and, Sport for all - ANNEX IV (Declaration, 2018) as such, should be encouraged. The European Council underlines the benefits - DECLARATION ON THE SPECIFIC CHARACTERISTICS of sport for young people and urges the need OF SPORT AND ITS SOCIAL FUNCTION IN EUROPE, OF The Member States encourage voluntary services for special heed to be taken, in particular by WHICH ACCOUNT SHOULD BE TAKEN IN IMPLEMENTING in sport, by means of measures providing ap- sporting organizations, to the education and COMMON POLICIES propriate protection for and acknowledging the vocational training of top young sportsmen and The Role 2. of Or gani zati•Ons in the ProcESs of InCl UsiOn

Learning outcomes:

• Familiarise readers with the differ- raise awareness to promote inclusion. ence between exclusion, segregation, • The benefits of volunteering for generat- integration and inclusion and the devel- ing equal opportunities for participation. opment of the concepts in the society. • Familiarise readers with the role of each • Effective implementation of in- partner country in the process of inclusion. clusion for volunteers. • Familiarise reader with the differ- • An understanding of how organizations can ent approaches and ways of implementing inclusive programmes. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 30 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 31

2.1. ExCLusI•ON, seGre- gatIon, INtegRati•On anD inclUSIOn

AUTHORS: JASNA VEŠLIGAJ DAMIŠ, YOANA FILIPIC

Key words: inclusion, integration, segregation, exclusion, disability, education, employment EXCLUSION SEGREGATION

The Committee of United Nations highlights the that best corresponds to their requirements and importance of recognizing the differences be- preferences (Convention on the Rights of Persons tween exclusion, segregation, integration and with Disabilities, 2016). inclusion. Some authors also see the process of inclusion Exclusion happens when people with disability as combining different important concepts: are directly or indirectly prevented from access to education, work, and community activities. 1. “Presence - participating in differ- Social exclusion is defined as the inability to ent settings where people without dis- participate in the economic, cultural and so- abilities can engage. These could be cial life of society. It is the denial of civil, classrooms, work related meetings, neigh- political rights of citizens. bourhoods, and community events.

2. Choice – gaining different experiences they Segregation is a type of organization where can learn and make conclusions from, choosing people with disabilities live in separate envi- and taking part in activities they prefer. ronments designed or used to respond to a particular or various impairment. They are divided 3. Competence - being recognized for from others and people without disabilities. strengths, contributing, having opportunities to learn more. INTEGRATION INCLUSION Integration is a form of placing persons with 4. Respect and Valued Roles - being seen as a disabilities in already existing educational and person - as well as a person with a disabil- employment institutions, considering that people ity, being valued by others, not being seen with disabilities can adjust to the standardized Reference: as out of the norm or as a “curiosity.” requirements of such institutions. 5. Participation - engaging with others, hav- Convention on the Rights of Persons with Disabilities (2016), Inclusion is an organization of systemic re- ing a wide variety of relationships be- United Nations. Committee on the Rights of Persons with Dis- abilities. General comment No.4. forming and applying changes and adaptations ing known and knowing others, being part in content, teaching and employment methods, of the event--not just an observer. Illinois Department of Human Services. (2011). Community approaches, structures and strategies in edu- Inclusion. 6. Belonging - a very strong feeling that a cation, work-force, community living in order person feels when they are valued by oth- to overcome barriers with a vision serving to ers, when others call just to talk or invite provide all people with disability with an equi- Figure 2: differences between exclusion, segregation, integration and inclusion (Source: http://www.sanmarcoargentano-polis. him or her to go to a party or “hang out” table and participatory living and environment it/ARCHIVIO/02.COMMENTI/2017/L’inclusione.htm at the mall.” (Community Inclusion, 2011) EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 32 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 33

Volunteering in sport has an impact on clubs, the presence of volunteers in clubs and groups members and players, the community, and volun- enables them to function successfully and to teers themselves. Sport England notes that the exist at all. Volunteers keep clubs and groups community sport sector “can make increasingly going, and provide good quality services for vital contributions to the health of the nation, members and users. The opportunities that they community regeneration and cohesion, community provide enable people to have fun, make friends, 2.2. safety and educational attainment” (Taylor et improve fitness and health, and develop confidence al., 2003). and skills. Volunteers themselves benefit from a Effective im- sense of satisfaction and the social aspects of their volunteering. plemeNTAtion Of 2.2.2. Characteristics inclusIOn fOR of volunteering 2.2.4. Implementing inclusion as a volunteer Ibsen (1992) defined volunteering by five central VOLunteers characteristics: Youth Sport Trust – Lead your gen- • Voluntary activities eration – An Inclusive Future The activities are undertaken free- AUTHOR: TREASA RICE ly without physical force, legal coer- The Youth Sport Trust (2013) developed train- cion or financial pressure, and “retiring” ing courses for volunteers who work with people Key words: inclusion, volunteers, Raising Awareness, Barriers from voluntary work does not threat- with disabilities or additional support needs in en the livelihood of volunteers. their local communities.

• Which are unpaid or paid with a symbolic They use the STEP Model, developed by Black and amount Stevenson (2011). This can be used to change the Volunteers may only receive reimburse- Introduction inclusion and for activating health-enhancing way an activity is delivered so it can be made ment of costs connected to the voluntary physical activity (European Paralympic Commit- in one or more STEP areas (Space, Task, Equip- work and symbolic fees for their work. There are around 11 million disabled people in tee, 2015). ment, People). the UK. Only two in ten disabled people in En- • The voluntary activities must be carried out gland are currently active. A lack of knowledge for other people than the family and awareness of opportunities that are avail- This distinguishes voluntary work from STEP Model (Black & Stevenson, 2011) able to disabled people is a major factor in the 2.2.1. Impact of volunteering ordinary domestic activities and the in- lack of disabled people participating in sports formal care for family members. Space examples: (The Association of Paediatric Chartered Physio- The Department for Social Development (2012) • For the benefit of other people therapists, 2014). highlighted that volunteering is at the heart of • Increase or decrease the size The value that the work done by the vol- a vibrant society where people can contribute to of the playing area. unteers has for other people is a con- Sport Scotland (2001) outlined that some people social change giving their time. Volunteers are stitutive element of volunteering. • Use zoning. e.g. where children are were simply unaware of the existence of facil- central in delivering the many things we take for matched by ability and therefore have ities or activities that could cater for the granted such as youth activities, sports clubs, • And have a formal character (organized or more opportunity to participate. needs of an individuals with a disability. They faith based activities, arts festivals, etc. agreed) had no knowledge of sports (at any level) that Volunteering can take place in a voluntary was available and that they felt they would be In 2002 research for Sport England identified 5.7 organization, but it can also be performed Task examples: able to take part in. As such, they were pre- million sport volunteers and the National Survey outside of the voluntary organizations as • Break down complex skills into small- vented from even considering taking in sport. of Volunteering estimated a similar number in long as it is “agreed’ upon between the er component parts if this helps Sport, as an option, had no profile in the con- 1997 (Taylor et al., 2003; Davis Smith, 1998). person(s) doing the voluntary work and the to develop skills more easily. text of their life (Sport Scotland, 2001). The Active People Survey conducted by Sport En- person(s) benefiting from it. Ordinary helpful- gland in 2005-06 suggested a lower figure – more ness of a spontaneous and informal character • Ensure there is adequate opportunity for Women are generally less inclined than men to do than 2.7 million (Sport England, 2006). is, however not considered volunteering. players to practice skills or components sport, and ethnic minorities, people with dis- individually or with a partner before in- abilities and other socially vulnerable groups Sport England’s 2002 National Population Survey cluding in a small-sided team game. are also under represented (EU,2014). estimated that volunteers contribute 1.2 billion 2.2.3. Benefits of Volunteering hours each year to sport, with a value of over For people with a disability sport can play a £14 billion and equivalent to 720,000 additional Gaskin (2008) highlighted that volunteers are key role; both as regards its value for social full-time paid workers (Taylor et al., 2003). the lifeblood of sport in local communities; EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 34 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 35

Equipment examples:

• In ball games, increase or decrease the size of the ball to suit the ability of the participants, or on the kind of skill being practised. 2.3. • The use of bell or rattle balls can assist the inclusion of some players. rAIsiNg AwAre- People examples: NEsS of IncLUsioN Match players of similar ability in small-sided or close marking activities.

• Balance team numbers to the over- AUTHOR: TREASA RICE all ability of the group. Key words: inclusion, volunteers, Raising Awareness, Barriers Youth Sport Trust (2013) provides some top tips for volunteers to ensure they are implementing inclusive practice: 2.3.1. Inclusion in sport embarrassment, thus depriving them of access to • Focus on the participant is able to do – don’t their local communities and facilities. worry about the detail of their impairment. The European Paralympic Committee (2015) refers Take the time to get to know what the partic- to inclusion as a sense of belonging, which in- Conroy (2007) goes on the say that sport is an ipant can do and plan activities around this. cludes respecting feelings, being valued for who excellent arena to raise awareness. Sport also you are, and a level of supportive energy and provides spectators the opportunity to break • Ask – don’t be afraid to ask the individual commitment from others. their stereotypical beliefs about those with what works best for them and involve them in disabilities because the spectators frequently the planning stage of the activity/session. The concept of inclusion is particularly im- are surprised by those with disabilities exceed- • Sometimes things don’t work – don’t be wor- portant in the sport realm, because in adapting ing their expectations (Conroy, 2007). ried if something doesn’t work – not ev- sport it is important to gain as much knowledge erything you have planned will work. Keep from those that are directly playing it as they communication open with participants during are able to comment on their own capabilities as the session and adapt when necessary. well as providing great insight into any adapta- 2.3.3. Raising Awareness tions or limitations etc. (Conroy, 2007). • Use appropriate language – aim to always There is still a great lack of awareness and give short, clear instructions and pro- Within a sport atmosphere persons with disabil- knowledge around the abilities of individuals vide a demonstration where possible. ities are presented with a space that they can with disabilities. By raising awareness you can develop skills such as teamwork, respect, commu- provide people with information about the per- nication and confidence which are all skills that sonal backgrounds of those with disabilities, are important in everyday living (U.N Task Force subsequently helping to overcome attitudinal Report, 2003). Sport can also represent a form barriers (The European Paralympic Committee, of low-cost physiotherapy in that it allows in- 2015). By creating a barrier-free environment dividuals to work on mobility, balance, strength for everybody you can ensure that persons with etc. (Roy, 2006). any type of disability are able to have access to all activities (The European Paralympic Com- mittee, 2015).

2.3.2. Barriers to inclusion England Athletics raise awareness by ensuring that all their employees receive up to date Conroy (2007) highlighted that there are major training on Equality, Diversity and Inclusion, difficulties in getting those with disabilities as well as providing information for clubs, to take part in sport, due to several reasons coaches, officials and members to help them tack- including discriminatory attitudes of family le inequality and discrimination in athletics members who view those with disabilities as an (England Athletics, 2018). EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 36 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 37

Major events, such as the International Day of courage anyone who wants to help those affected Disabled Persons and European Week of Sport, by a brain injury to get involved.” can provide great opportunities for raising awareness, from national to local level, about the need for inclusive recreation and sporting Reference: activities. These events often attract posi- 2.4. tive media attention, which can raise awareness Association of Paediatric Chartered Physiotherapists. (2014). across a wide audience (Khasnabis et al., 2010). Disability Sport. Retrieved from: http://apcp.csp.org.uk/ publications/disability-sport-0 The ROle of Re- Black, K., & Stevenson, P. (2011). The inclusion club.

Case Studies Conroy, E. C. (2007). Aiming for Inclusive Sport: the Legal and Practical Implications of the United Nation’s Disability Sp•Ort Project Alana, 25 Convention for Sport, Recreation and Leisure for People with Disabilities. The Entertainment and Sports Law Journal, 5(1), Wellbeing Programme Volunteer 4. ParTNers •OrgAni- England Athletics. (2018). Equality, Diversity and Inclusion. In 2012, Alana experienced a neurotoxic reaction Retrieved from: https://www.englandathletics.org/about-en- to medication and had to leave university. She gland-athletics/equality--inclusion, Retrieved 3.9.2018. zaTi•ONS in the made a good recovery but through her experience EU. (2014). Special Eurobarameter 412. Sport and Physical she learnt how isolating an illness can be, es- activity. Brussels: TNS Opinion and Social. pecially as brain injury has many symptoms that ProcesS of In- European Paralympic Committee. (2015). A Toolkit for Disabil- are not visible to others and therefore wanted ity – and Para – Sports. Retrieved from: http://be-inclusive. to volunteer with brain injury survivors to help eu/wp-content/uploads/2016/06/BeInclusive_Handbook.pdf, others. 3.9.2018. cluSIOn Gaskin, K. (2008). A Winning Team? The Impact of Volunteers Through her volunteer role, Alana has developed in Sport. London: The Institute for Volunteering Research and skills such as being flexible, creative, and pa- Volunteering England. tient, having an encouraging attitude and being Isben, B. (1992). Frivilligt arbejde I idraetsforeninger a good communicator. Alana assists the project [Voluntary work in sports clubs]. Copenhegan: DHL. officer with setting up arts workshops, having Khasnabis, C., Heinicke Motsch, K., & Achu K. (2010). Com- 2.4.1. The Role of Center Naprej conversations with services users, helping them munity-Based Rehabilitation: CBR Guidelines. Geneva: World Health Organization; 2010. in the Process of Community Inclusion to complete the arts activities, helping them with their lunch and cleaning and tidying up Roy, E. (2006). The Development of the Human Rights of Indi- of Persons with Acquired Brain Injury after the workshop. Alana also helps service viduals with Disabilities in Sport at the United Nations and Beyond. International Council of Sport Science and Physical users with physical activity programs in the Education 48. AUTHOR: JASNA VEŠLIGAJ DAMIŠ gym; making sure they are completing the cor- Sport Scotland. (2001). Sport and People with a Disability: rect movements; helping them with their balance; Key words: Center Naprej, inclusion in sports, acquired brain injury, Aiming at Social Inclusion. Research Report No.77. Sport encouraging them to take part and assisting them rehabilitation Scotland. when they need help with specific exercises. The Department for Social Development. (2011). Join In, Get Involved: Build a Better Future. The Volunteering Strategy “Brain Injury Matters is a great place where for Northern Ireland. The Department of Social Development. NAPREJ, Centre for Persons with Acquired Brain with counselling and support. The rehabilitation people with different brain injuries and from Injury is a non-profit organization from Slove- programmes take place at two different units in Taylor, P., Nichols, G., Holmes, K., James, M., Gratton, C., different backgrounds can meet together to have nia. Our field of expertise is long-term psycho- Maribor and Murska Sobota. Garrett, R., Kokolakakis, T., Mulder, C., & King, L. (2003). fun, learn new skills, and make friends. I love Sports Volunteering in England. London: Sports England. social and health rehabilitation after acquired getting to know the service users and see them brain injury. All the services and programmes Our service users are people who have experi- United Nations Inter-Agency Task Force for Sport Development enjoy themselves and grow in confidence.” and Peace. (2003). Sport for Development and Peace: Towards that we deliver (occupational therapy, physio- enced severe brain injury, have a disability Achieving the Millennium Goals’ United Nations. therapy, psychological, social and health care, status, and need different type of assistance

“I hope to become an Occupational Therapist. Youth Sport Trust. (2013). Lead your generation. An Inclusive employment under special conditions) are de- for daily living. Through volunteering I gained experience of Future. Inclusive Futures. Volunteer Toolkit. Retrieved from: signed to increase active participation of users working with people with brain injuries and have https://www.youthsporttrust.org/sites/yst/files/resources/doc- in society and to raise the quality of their observed how the well-being program can improve uments/IF%20Toolkit%20-%20volunteers%20FINAL.pdf, Retrieved lives as well as the lives of their families. An 2.4.1.1. Center Naprej as 3.9.2018. their quality of life.” important field of our work are various preven- an inclusive institution tive, counselling, and educational programmes “Volunteering is a great way to help improve the taegeted at special groups and the general pub- Center Naprej holds an important role through quality of life of people with brain injuries, lic. Besides our users we devote special care to its work and implementation of services, the to meet new people and learn new skills. Brain their families – we include them in all phases role of integrating people with acquired brain Injury Matters is a great cause and I would en- of the rehabilitation process, providing them injury (hereinafter referred to as ABI) in the EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 38 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 39 local and wider social environment. Definite- important to think about professional and ethi- 1. lack of awareness of inclusion amongst people around the world. The idea that they must “pro- ly, this is a very sensitive area, since we cal responsibilities, responsibility for ensur- without disabilities and how to properly vide a system of inclusive education at all are talking about the people who are the most ing equal opportunities for all, which we have engage people with disabilities in groups; levels” is also a central objective of the UN vulnerable and threatened part of humanity in signed as a country with numerous conventions Convention on the Rights of Persons with Dis- 2. lack of opportunities and sports programs; the provision of declared rights, because they and wrote in the Constitution of the Republic of abilities. These questions about the principles themselves most often cannot defend and demand Slovenia. To achieve this, a proper professional 3. lack of training programs for profession- of inclusion are especially important in our their own rights. and legal basis that allows it must be adopted. als and providers of assistance in the field work, when we support our service users in their There are many arguments in the professional of sports for persons with disabilities; return back to community. Since most of our users need help of another literature that confirm this hypothesis, but un- 4. limited access to some facili- person, it is important who and what are the fortunately in practice it often turns out to be ties due to physical obstacles; organizations who provide this assistance. It is different (Bužan, 2011). 2.4.1.4. Sports programs in Cen- important to support employees with appropriate 5. limited information, access to pro- ter Naprej - inclusive and adapt- counselling, professional help, education and Persons with disabilities are an important grams, facilities, assistants, ed physical activities training, supervision and intervision. Appro- social subsystem, representing a significant etc. (DePauw and Gavron, 2005) priate learning and technical tools are also proportion of the total population: about 10% When integrating people with ABI into sports essential. worldwide, about 15% in the EU, in Slovenia Sport and recreation can be a great medium that programs, we are focused on two important as- numbers are similar (Kresal Šoltes, 2006). The supports an active lifestyle and the development pects: the aspect of integration in general and Center Naprej as an inclusive institution: Convention on the Rights of Persons with Dis- of healthy relationships between people with the real value of sports activities. Sports must abilities, which was ratified by the Republic of disabilities and people without disabilities, represent a way of social inclusion. Sports • emphasises/encourages partici- Slovenia in 2008, has contributed significantly as they offer many opportunities for communica- activities are introduced as a training content pation, not competition, to the recognition of their rights. This has tion and rich social experience. Adapted sports where, unlike educational activities, individ- supported the greater realization of the objec- activities carried out in the community promote ual choice of sports activities can be made on • searches for solutions that are beneficial tives of the Action Programme for Persons with and facilitate the full participation of people a large scale, ranging from separate activities to all, considering their impairments, Disabilities 2014–2021 and the European Disabil- with disabilities in the real life. intended for people with disabilities to modi- • prepares for relationships and ity Strategy 2010-2020: A Renewed Commitment to fied or adapted activities that are intended for life in the community, a Barrier-Free Europe at the national and local Although sport activities can vary greatly (e.g. everyone. However, it should be emphasized that level in the everyday life of people with dis- skiing, stand-up paddle boarding, horseback each approach is equally important and valid, • establishes new relationships, con- abilities in the Republic of Slovenia. riding, biking, climbing, etc.), success depends and there is no need to discredit the separate nects an individual with others, not only on the characteristics of an individ- structures and to praise the role of the persons • enhances respect and under- People with disabilities have the same needs as ual with disabilities, but also on the skills with disabilities involved. standing of one another, all other people. In order to meet these, it is and knowledge of professionals, assistants and necessary to support them, help them recognize volunteers who collaborate with them. These We focus our attention on the importance of the • it is directed towards the needs of the their needs, and even demand them. Every indi- individuals spontaneously become partners in processes and mechanisms of integration that individual – satisfying what is possi- vidual needs to be paid attention to his special communication as a result of a shared activity. happen in the area of sports, and on the ques- ble within or outside the institution. features (Bužan, 2011). The Convention on the tions what happens or could happen to ABI survi- Rights of Persons with Disabilities (http:// Thus, through active sports and recreational ex- vors when they enter sports settings. Involving 2.4.1.2. The regulation of inte- www.mddsz.gov.si) in its Article 30 regulates periences we encourage communication and social disabled athletes in sports in the community gration of persons with disabil- this area of rights - the right to participate relationships. Groups cooperate to be success- helps overcoming prejudice, stereotypes and ities as a mirror of society in cultural life, recreation, leisure activities ful and make the most of the experience of all fears. The latters tends to occur most often and sports. interested parties. Sports should not be the ex- as a result of lack of information about the The regulation of the integration of persons clusive right of a particular social group, but life of people with disabilities, their needs with disabilities in the community is undoubt- Individuals with disabilities can experience a an opportunity for everyone to develop oneself and abilities. This is why this often leads to edly a mirror of the society as a whole (Šte- number of challenges in the process of inclusion through movement and mental activity according social isolation of children, adolescents and fančič, 2002) and a society that wants to enable in the community. They also often face isolation to their abilities. (Mihorko, 2014) adults with disabilities. people with disabilities to have better oppor- due to a narrowed social network, despite the tunities for development and that wish to accept fact that nowadays the whole developed world Sport can be perceived as concept defined by the The mechanisms of integration through sports them as equal members of the community must, to accepts the idea and the paradigm of inclusion. President of UNESCO as “all forms of physical allow them to socialize, meet and communicate the greatest possible extent create suitable activity that contribute to physical fitness, in social settings. Sports activities can be environment for their social integration and mental well-being and social interaction, such adapted for each individual according to his inclusion. 2.4.1.3. What does “inclu- as playing, recreation, organized or competi- abilities and capabilities and to the greatest sion in sports” mean? tive sports and indigenous sports and games” (UN possible extent; they are adapted for people Joining the European Union, Slovenia has commit- Inter -Agency Task Force, 2003). with disabilities. Appropriate sports activi- ted to following democratic values on equal op- Often, in our work enabling our users (ABI sur- ties can be found for each individual, whether portunities and independent life of persons with vivors) to participate in sports, we encounter Over the past few decades, UNESCO has devoted for recreational, rehabilitation or competitive special needs. The country is responsible for various obstacles, such as: many efforts to implementing the principle of purposes. ensuring equal opportunities. It is especially inclusion at all levels in education systems EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 40 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 41

We include people with ABI in sports activities. proved balance and coordination, etc. But sports zije ter vloge defektologov in specializiranih institucij. UN Inter-Agency Task Force on Sport for Development and Peace. Survivors may be: can offer much more. People who engage in sports Društvo defektologov Slovenije. (2003), Why Sport? Paris: UNESCO. Retrieved from http://www. un.org/wcm/content/site/sport/home/sport on 20.6.2018 also benefit from a number of psychological 1. physically impaired, benefits, such as improved self-esteem, self-discipline and self-confidence, and confidence in 2. blind or visually impaired, their abilities and capabilities. We also notice 3. deaf, hard of hearing, an improved anger management and the ability to 2.4.2. Centro Sportivo Italiano deal with stressful situations more effectively 4. cognitively-impaired, than those ABI survivors who are less active. AUTHORS : CENTRO SPORTIVO ITALIANO-WELFARE AND SOCIAL PROMOTION OFFICE 5. speech-impaired, They are more cooperative and interactive with others. They have more opportunities to gain a Key words: Centro Sportivo Italiano, non-profit association, voluntary work, promot- 6. individuals with mental health and/ sense of responsibility towards themselves and ing sport, educating through sports or neurological disorders, others. Sport provides them with something to 7. individuals with emotional and/ looking forward to. or behavioural problems, After suffering a brain injury, individuals may 8. multiple impairments – combined impairments. find it difficult to cope in ordinary situations Introduction accredited institution for the formation of and activities of daily living, so they experi- school staff. It has stipulated an understanding Examples of sports programs that we perform for ence many losses in their new lives. Therefore CSI - Centro Sportivo Italiano is a non-profit protocol for the organization and promotion of rehabilitation, recreational or / and competi- it is very important that we help them find some- association, based on voluntary work, promot- sensitization and information actions devoted to tive purposes in the Center Naprej: thing they cannot only cope with but also enjoy. ing sport as a moment of education, growth, students, teachers and parents on the value of Sport can give them a reason to live. social engagement and aggregation, prompted by sports practice as well as formation, updating 1. rehabilitation exercise with or with- the Christian vision of man and history at the pathways and meeting occasions for teachers and out accessories, fitness; Therefore, we can state that sport is a platform service of the people and the territory. Among parents. It has an understanding protocol with for acquiring knowledge and life skills as well the most ancient sports promoting associations the Ministry of Justice to promote reinsertion 2. water sports: rehabilitation swim- as an opportunity for social inclusion. in our country, CSI meets the demand of a sport and social inclusion activities devoted to young ming, swimming using Halliwick con- that is not only numerical, but also qualified on people moving around in the external penal area. cept, water games, stand up paddle the professional, human and social level. Young It is an institution accredited by the Nation- boarding, rowing, snorkelling; people always make up our main reference point, al Office for Civil Service to manage projects 3. ball games (small, big, sound): football, Reference even if the promoted sports activities are de- of voluntary civil service. It is a member of basketball, netball, foot golf, tennis, voted to any age bracket. the National Court of Laical Aggregation (Cnal) table tennis, volleyball, crossboccia, Bužan V. (2011). Uvod, Usposabljanje strokovnih delavcev za it represents Italy internationally within the bowling, boccia, badminton, speedminton; uspešno vključevanje otrok in mladostnikov s posebnimi po- Fédération Internationale Catholique d’Educa- trebami v vzgojo in izobraževanje v letih 2008, 2009, 2010 in 2.4.2.1. CSI mission and vision tion Physique et Sportive (Ficep), gathering 4. walking, Nordic walking, hiking, 2011, Skupnost organizacij za usposabljanje oseb s posebnimi the catholic sports associations from Austria, slack line, orienteering, running; potrebami v Republiki Sloveniji, Ljubljana Educating through sports is the mission of CSI. Belgium, Czech Republic, France, Germany, Italy, DePauw, K. P., and S. J. Gavron (2005). Disability and Sport. 5. winter sports: alpine skiing, snow Champaign, IL: Human Kinetics. This is consolidated in the procedure and con- Holland, Poland, Slovak Republic, Switzerland at shoeing, sledding, skiing; science of the association on all levels. Sport present, besides some sports groups from Mada- Konvencija o pravicah invalidov, Retrieved from http://www. facilitated by CSI can also be a preventative gascar and the former Yugoslavia. 6. sports with animals: rehabilitation horse- mddsz.gov.si/fileadmin/mddsz.gov.si/pageuploads/dokumenti__ pdf/konvencija_o_pravicah_invalidov.pdf, 8.6.2018 instrument for particular social pathologies back riding, rehabilitation fishing; such as loneliness, fears, dreads, doubts, devi- It is a member of the Permanent Forum in the Kresal Šoltes,K., Novak, M., Kresal,B., Kalčič, M., Zaviršek, 7. dancing, cheer leading. D., Invalidi med socialnim varstvom in trgom dela (ekspertiza ance of young people. Third Sector and has signed cooperation conven- – pravni in mednarodni vidik), Ministrstvo za delo, družino tions with the Italian Parents Association, with If we are committed to work promoting the health in socialne zadeve, Ljubljana, 2006, Retrieved from http:// CSI is a sports promoting institution spread all the Childline, etc. www.mddsz.gov.si/fileadmin/mddsz.gov.si/pageuploads/dokumen- of our users, we need to think about ways to ti__pdf/invalidi_soc_varstvo_trg_dela.pdf, 10.6.2018 over the national territory acknowledged by the increase their physical activity considering Italian Olympic Committee (CONI). It is recog- Mihorko, B., Štrumbej, B., Čander, J., Cimerman Sitar, M. their individual differences. Consequently this nized by the Italian Episcopal Conference as a THE NUMBERS OF CSI (2014). Smernice za šport in rekreacijo invalidov Operativni could be an important contribution to achieving program Slovenija-Avstrija 2007-2013, Maribor Christian inspired association. It is recognized a healthier lifestyle. Participation in sport by the Interior Department as a national insti- • 1.152.000 Athletes Stevenson, P. (2009). “The Pedagogy of Inclusive Youth Sport: can significantly improve their health, well-be- tution with charitable aims. It is registered in Working towards Real Solutions.” In Disability and Youth • 13.000 Sports clubs ing and quality of life. Sport, edited by H. Fitzgerald, 119–131. London: Routledge. the national register of Social Promotion Asso-

Štefančič, Z. (2002). Vizija preobrazbe specializiranih in- ciations, recognized by the Ministry of Work and • 42.000 Teams When adding sports programs into rehabilitation, stitucij – zavodov za vzgojo in izobraževanje oseb z zmerno, Social Policies. • 100 sports disciplines we are aware that for people with ABI sports may težjo in težko in najtežjo motnjo v duševnem razvoju. V: impact physical condition in different ways - Destovnik (ur). Osebe s posebnimi potrebami v procesu inklu- CSI is recognized by the Department of Educa- • 8.000 Tournaments per year good blood circulation, stronger muscles, im- tion, University and Scientific Research as an EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 42 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 43

• 300.000 Competitions per year • 135.000 Trainers, animators, ref- trainers, adapted facilities where people with erees, judges and executives Sports games for children with difficulties disabilities can have easy access, organize • 139 Territorial gatherings seminars, promotion of available sports activ- • 12.000.000 Yearly hours of free en- • 21 Regional gatherings The Rijeka sports games for children with dis- ities, organize promotional tournaments, and gagement and voluntary work abilities – launched in 2009, have transcended tour of various institutions. The inclusion in their initial form and expanded so that now they sports and recreation depends primarily on the include a new Educational-Sport program for active participation of people with disabilities children and young people. GAMES are held for and their primary environment (family, friends) 2.4.3. Rijeka Disability Sports Association - the the 8th time in a row, and the Rijeka Sports As- where they cease to be passive observers and be- role of organization in the process of inclusion sociation for Persons with Disabilities took an gin to actively participate in the creation and active part in the project. This year’s program upgrading of the system of their service. consisted of a series of games involving chil- AUTHOR: ILONA KOVAL GRUBIŠIĆ, dren with developmental difficulties as well as By conducting sports and recreational activities their friends without any difficulties in devel- of people with disabilities, as well as accompa- Key words: sports association, sports clubs for persons with disabilities, inclu- opment, and in this way, through the program “My nying media coverage, the perception in society sion, adaptive physical culture, adaptive sports, Paralympics sport. Friend and Me”, inclusion through sports was of people with disabilities as passive social presented. entities will also change.

The growth of disability is a world trend. In disabilities in the Rijeka area, regardless of The goal of Rijeka’s sports games is to enable By actively engaging in sports, people with total there are about 650 million officially reg- age, gender, socio-economic status or type of children with developmental difficulties to have disabilities will also gain new skills and in istered disabled people in the world. According disability. the best effect of physical activity, improving doing so, will challenge community to respond to the World Health Organization, people with self-confidence, positive perception, improving with new, different expectations, which will disabilities make up about 10% of the world’s The aim of the Association is to create a net- sensory abilities, developing self-reliance and in turn start the unstoppable process of social population. Despite the success of medicine, work of sports clubs for persons with disabil- helping in the group, socializing and joys, and evolution. their number is slowly but steadily growing, ities in the Rijeka area, which will provide a acceptance in the community. especially among children and adolescents. For wide range of sports for people with disabil- The employment program of city sports instruc- comparison: in the US - 54 million disabled, or ities, as well as engagement and training of tors for the sport of people with disabilities 19%, in China - 60 million, or 5%. Until recent- skilled professionals to work with people with Inclusion of new people with dis- will enable the creation of a special data bank ly, the problems of this fairly large group of disabilities. Such a bid will encourage and at- abilities and new coaches in sport of one portion of the population with disabil- people were ignored, and yet, as a result of the tract many people with disabilities, and espe- of people with disabilities ities, which will bring about new public in- gradual humanization of society, the Universal cially youth with disabilities to sports. terest, and in particular the inclusion of a Declaration of Human Rights, the World Program The success of any sports club in the long run greater number of young people with disabilities of Action concerning Disabled Persons and the is based on the ability of the club to keep in sport. United Nations Standard Rules on the Implemen- 2.4.3.1. Basic programs current members and to attract new ones. At- tation of Equal Opportunities for Persons with of the association tracting new members to clubs has proved to be The program also includes ongoing openness to Disabilities were adopted. In many countries, the biggest problem of some member clubs of the the health system, its members and their ideas, legislative acts have been adopted that reflect Promotion of sports for per- Association. and cooperation with the families of people with the problems of disabled people. From year to sons with disabilities disabilities that, due to the many experiences year, the number of children with developmen- The key to recruiting new members - the op- they have had, need to be actively involved in tal disorders increases. The number of children The level of knowledge regarding the sport of tion to include new people with disabilities the system. Since sport has a particular place with developmental disabilities and poor health people with disabilities is very low in our in sporting activities is to “reach” the right in the social hierarchy, it is logical to choose reaches 85% of the total number of new-borns. society. Reasons for this are numerous, but the people, especially the parents of young people this activity as the primary means of sensitiz- Only some of these children will later become main cause is poor media coverage (below 2% of with disabilities. Therefore, the Association ing our public, because of its social, public, the object of correctional work, but the number total media coverage). In 2011 and 2012, the regularly carries out workshops on the sport of medical and emotional reasons. of children who need such work is quite large. Association made the project “Paralympics School people with disabilities and actively promotes According to foreign statistics, it is 9-11% of Day”, in cooperation with the HPO, which proved sports for persons with disabilities in schools the total child population (Sunagatova, 2012, to be extremely successful. The Association is health organizations, hospitals and healthcare References Dyachenko, Rzyankina, Solokhina, 2010) actively participating in the media promotion institutions. of all sports and sports competitions for per- Sunagatova LV, Marchenkova UA Influence of adaptive sports on sons with disabilities in the area of Rijeka, in As is common knowledge in our society, very social adaptation of invalids // Young scientist. - 2012. - № 12. - P. 603-607. - URL https://moluch.ru/archive/47/5856/. Working with children with developmental cooperation with all relevant media. The Associ- few people with disabilities are involved in Retrieved 15.10.2018. disabilities in sports clubs (guidelines) ation communicates with the public through the active sports and recreation, which is very website. important in rehabilitation as well as social- Dyachenko, VG, Rzyankina MF, Solokhina LV A guide to social paediatrics. Under. Ed. V.G. Dyachenko / V.G. Dyachenko, M.F. The Rijeka Sports Association for Persons with ization in society. In order to include people Rzyankina, L.V. Solokhin - Khabarovsk: Publishing house of Disabilities provides equal opportunities for with disabilities in sports and recreation, it the Far-Eastern State Medical University, 2010, - 124 p. sports and recreation for all persons with is necessary to organize effectively: clubs, EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 44 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 45

the onset of secondary problems as a result of participation and maximising a person’s quality 2.4.4. The Role of FPDD in the Process of Inclusion the initial injury or illness. Our programmes of life. This is a key principle underlying the aim to help individuals achieve self-identified work of Brain Injury Matters. The principle of AUTHOR: EDUARDO BORGES PEREIRA goals, promote age appropriate independence, inclusion is reflected in our organisational vi- maximise social and educational engagement, sion of a society where those with brain injury Key words: sport development; inclusion of people with disabilities through sport; promote psychological adjustment post-ABI and can live a full and meaningful life. It also is disability areas. improve overall well-being. central to our three core organizational values:

Services offering social, sports, exercise and Rights & Responsibilities Where everyone is FPDD – Portuguese Federation for Disability of involvement required by each one, in their recreational activity, skills development, actively involved in creating solutions, encour- Sports has 30 years of contribution for develop- community. counselling, information and support are now aged & supported to take responsibility ment of sport in Portugal, especially for people recognised as an essential element in the range with disabilities. Our organization develops many projects in of services required to support people with ABI Innovation Where we will not be satisfied with partnership with other organizations, focusing and their carers. They can influence recovery the status quo and continually strive to deliver FPDD and his four associates (there were five un- on disabled people, especially children and and outcomes, in that they support and promote the best evidence-based services til 2017) – the National Associations for sports youngsters, and on training of professionals the long-term adjustment and seek to help the are specialized for disability area: blind, and teachers. We support the organization and family unit manage stress, establish meaningful Respect for All Where we will treat everyone, cerebral palsy, deaf, intellectual and motor participation in international competitions by activities, positive relationships and a valued people affected by ABI, their families, staff impairment. They have had a major contribution some national teams, such as Boccia and Goal- lifestyle. and stakeholders with equal respect and honesty, to bring more people with disabilities to sport, ball. This is a continuous process of inclusion listening and paying attention to feedback about having “sport for all” as the main mission and through sport and physical activities with very our services competition sports, national teams and high per- good results in Portugal. 2.4.5.2. Brain Injury Matters NI formance as second goal. as an inclusive organisation References: Our mission is to provide to all persons, in- References: Inclusion of people with disabilities in society dependently of their functional capacity, means involving them in every aspect of social www.braininjurymatters.org.uk opportunities of sport practice and physical http://fpdd.org/ activity through life, according with the level 2.4.6. Keçiören Municipality and its 2.4.5. The Role of Brain Injury Matters role in the process of inclusion in the Process of Community Inclusion of AUTHOR: KEÇIÖREN MUNICIPALITY Persons with Acquired Brain Injury Key words: Keçiören, Keçiören Municipality AUTHOR: FIONA MC CABE Keçiören Municipality is the biggest district in • Provide municipal police, fire depart- Key words: Brain Injury Matters NI, inclusion, acquired brain injury, Turkey by area and population density. Keçiören ment, ambulance, emergency assistance rehabilitation Municipality is a local government unit which • Forestation, parks and recreation areas uses its authorities to improve the economic, social and cultural status of its residents in a • Cultural activities, education, tour- way that encourages them to participate in the ism and publicity, sports activities 2.4.5.1. Brain Injury Matters A considerable number of people with ABI will management of the district. • Social services and care for dis- NI; organisational overview have executive functioning impairments and ex- abled and other disadvantaged people perience a greatly reduced capacity to problem The services provided by Keçiören Belediyesi to Brain Injury Matters (NI) is a non-profit or- solve, plan, organise and make decisions etc. the residents are: • Protective services for children and women ganisation aiming to help rebuild the lives of This can have a major impact on their ability to children and adults living with Acquired brain manage everyday living, educational, employment • Development and construction of pub- Keçiören dates back to 1983 when it became a injury (ABI) to enable them to reach their full and inter-personal situations which many people lic facilities and infrastructures separate municipal constituency. It comprises 51 potential in family and community life in North- take for granted. Precincts and covers the area of 190 square km. • Develop geographical and city man- ern Ireland. Our purpose is to support people It is situated about 13 km from the city centre agement information systems living with brain injury, help develop the Brain Injury Matters (NI) delivers age-appro- with altitude of 1075 m above sea level. It is skills and confidence to optimise their function- priate, needs-led support services designed to • Provide recycling and environmental cleaning the largest Municipality in Ankara with over ing and access a positive quality of life. minimize the impact of acquired brain injury on 900,000 residents. the person and their wider network and reduce EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 46 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 47

• Participation Our Values: • Ecological Awareness 2.4.8. The role of CIF France in • Transparency • Honesty the process of inclusion • Accessibility • Innovative Approach • Productivity AUTHOR: DR MOHAMMED MAMMAD, MIREILLE BOUCHER

Key words: people with disabilities 2.4.7. The role of Human Profess Non-profit Ltd. in the process of inclusion of people with disabilities CIF France contributes to the integration of people with disabilities, which are excluded from social interactions, with its continuously AUTHOR: ZSUZSANNA KOVÁCS organized programs in France for professionals and volunteers from different countries, Keywords: Human Profess, inclusion, disabled people who work on the social field and socio-cultural animation.

Human Profess Non-profit Ltd. is offering – among with disabilities (job opportunity, training CIF France organizes multicultural international other things – project management and labour opportunity, mentor support) in the interest of programs in coordination with other branches in market services, training for NGOs, governments their successful rehabilitation. 25 countries around the world. and for-profit companies in Hungary. Activities of the company also include services that pre- The long-term goal of Human Proffes is to assist CIF France continues its integration actions serve, improve and assist the living and health in the employment of workers with disabilities with its local, regional, national and inter- conditions of workers with disabilities. and to provide them with an occupation suitable national partners. Through its expertise, CIF to their education, existing skills and health France has participated in several European Human Profess is an accredited employer where conditions. The company’s further goals involve programs. they provide work for 24 workers with disabil- contributing to the improvement of their adap- ities: from simple, easily acquirable, semi- tion skills, to ensure their permanent employ- As part of the ReSport project, they contribute skilled work through project administrators to ment, and to motivate and support their entry to the integration by mobilizing local partners trainer tasks. into the open labour market. They also provide with or without disabilities. They have devel- regular sport activities for colleagues with oped partnerships by integrating people with Their experts have many years of experience disabilities. Posts are regularly available on disabilities with people without disabilities. in the fields of rehabilitation, labour market their Facebook-site. They continuously share services, adult education, and international articles and videos that are related to people The vision and fundamental goal of CIF France is practices. Professional experience and knowledge living with various diseases and impairments. inclusion and in pursuit of this goal they have provides a safe base for the organisation to be made several visits to specialized centres for able to offer long-term assistance for people the disabled. In order to carry out this project with disabilities regarding their rehabilita- well, they thought it would be better to include tion employment. Methods and practices employed young people and people with disabilities, they in international projects are also incorporated also had the idea of giving them training in into the improvement process of employees. They communication and speaking to convey a message. provide a complex service to their employees Inclusion was not just a theory but the action of a whole group who saw this project as a step to continuous working together and developing new actions. Dis 3. aBil iTy and hEaLTh

Learning Outcomes:

• to outline different definitions of disability of obesity and preventing obesity

• to highlight the importance of focusing on • to highlight the impact of harm- functional abilities and not on disability ful habits for people with disability and how to deal with them • familiarising readers with general information about what disability is and • to get to know advantages and disadvantag- certain types of disabilities es of video games, the usefulness of video games for people with disabilities • information on the specialties in the mental health of people with disabilities • to highlight the problem of doping of people with disability • familiarising readers with the risk EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 50 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 51

cal point of view and vice versa. In a medical context a person is seen in the light of his/her boundaries deriving from their disability and does not consider individuality. And there is always personal view of the usage of the right term – some people prefer the term handicapped 3.1. for this relates to their ability to work, other prefer term person with disability or person DefinItions •Of with special needs. This always differs from how a person sees and defines him/herself.

DisabILiTy All classification and categorisation of disability have special aspects on the person they refer to. Thus they are all imperfect and incom- plete, because they do not emphasize a person AUTHOR: DANIJELA MAJCENOVIČ CIPOT as an individual, but tend to point out only certain aspects. In the light of adapted physi- Keywords: Disability, models, interpretation cal activities the most useful classification is based on functional level – what a person can do without or with different levels of assistance. Disability is a concept that has during the as disabled in one context and not another, such Nowadays it is customary to describe the person years and different cultures been described from that she or he receives therapies for serious first and then state the disability – ex. child various perspectives. Although the authors of impairments but does not qualify for certain with learning disability, person with multiple these perspectives use the same term, the mean- disability-related benefits provided by his or sclerosis…. what gives emphasis on the indi- ing differs. This caused various interpretations her employer or by the government” (Altman, vidual and doesn’t point out their disability. of the term, what is not good from the person 2011:98). In her research of different models But still we must recognize that categorizing attached point of view – if these different and concepts Altman produced a table, in which gives us fundamental knowledge about general interpretations cause deprivation of rights in she summarized the differences in understanding characteristics of disability types and there- one field, a person with disability is quickly of the term disability, that are most commonly fore it is useful in planning adaptive activi- in a subordinate position. “The lack of consis- used. ties. It can provide a wider framework because tency is most dramatic when a person is defined it is essential to be aware of the fundamental characteristics of conditions as described in traditional disability classification and then Model Disability (A) Disability (B) Disability (C) Disability (D) Disability (E) take into account the unique characteristics Social model ICIDH-1 model Nagi model Verbrugge and IOM-1 and IOM- (physiological and psychological) and functional Jette model 2 models abilities of a person with disability. Definition Limit or loss of In the context of Pattern of Disability is The expression opportunities health experience, behaviour that experiencing of a physical or to take part any restriction evolves in situa- difficulty doing mental limita- Reference in community or lack (re- tions of long-term activities in any tion in a social life because of sulting from an or continued domain of life context-the gap physical and impairment) of impairments that due to a health or between a person’s Altman, B. M. (2001). Disability Definitions, social barriers ability to perform are associated physical problem capabilities and Models, Classification Schemes, and Applications. an activity in with functional the demands of Published in: Albrecht, G.L., Seelman K., Bury the manner or limitations the environment within the range M. (ed.), Handbook of Disability Studies (97- considered normal 122). Thousand Oaks – London – New Delhi: Sage for a human being Publications Inc.

Squair, L., Groeneveld, H.J. (2003): Disability Table 2: Variety of Meanings Given the Term Disability in Five Theoretical Models (Altman, B. M.: Disability Definitions, Definitions. Published in: R. D. Steadward, G. Models, Classification Schemes, and Applications. 2001). D. Wheeler and E. J. Watkinson (ed.), Adapted Physical Activity (45-64). Canada: The Univerity of Alberta Press Use of these contexts differs from one public groups granting them special rights, what can sphere to another. Where rights and benefits of cause differences and unequal treatment and special groups is in sight, legal and adminis- therefore inequalities between them. Social trative spheres tend to categorise disabled in definitions are usually not considered a medi- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 52 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 53

thritis, asthma, amputation, amyotrophic lateral Learning Disabilities sclerosis (ALS), arthrogryposis, brain injury, cerebral palsy (spastic CP, athetoid CP, ataxic We talk about learning disabilities when one or CP), congenital hip dislocation, cystic fibrosis, more of the basic psychological processes in- diabetes mellitus, epilepsy, Friedreich’s atax- volving understanding or using spoken or writ- ia, Guillain-Barre syndrome, hemophilia, multi- ten language exist. Individuals with a learning 3.2. ple sclerosis, muscular dystrophy, osteogenesis disability may have difficulty with input of imperfecta, osteomyelitis, osteoporosis, paral- information to the brain, organizing and under- CLaSsiFIcaTIon ysis, Parkinson’s diesase, polyomyelitis, spina standing information, storing information in bifida, spinal cord injury, Tourette syndrome and memory, communicating through language or motor tuberculosis (Squair and Groeneveld, 2003). output. Learning disabilities can be broken down oF DisabILIty into attention deficiency-hyperactivity disorder Recommendations: it is important that we adapt (ADHD) and developmental coordination disorder activities to individual abilities and needs (DCD) (Squair and Groeneveld, 2003). of the person and to take into account all the AUTHOR: VALENTINA BOLŠEC barriers which may occur. We need to ensure the Recommendations: when planning physical activity safety and protection for persons, especially for people with learning disabilities, we must Keywords: disability, mental illness, physical disabilities, sensory disabilities, when they have problems maintaining balance. take into account the difficulties of learning learning disabilities, developmental disabilities, recommendations cognitive information and some motor coordination difficulties. For individuals with ADHD, who Sensory Disabilities have very little patience, it is very important, People differ from each other according to their disorders that cause impairment are: mood dis- that we set an environment with few distrac- physical, sensory, and other abilities. Also, orders (depression, bipolar disorder), anxiety, We get to know the world around us through our tions. The activity should be consistent and the types of disability are different, covering phobia, panic disorder, obsessive compulsive senses, which enable us to collect and under- structured (Squair and Groeneveld, 2003). all long-term physical, mental and sensory im- disorder, schizophrenia, eating disorders, per- stand information and connect with people and pairments and mental disorders that disable the sonality disorders, multiple personality disor- our surroundings. As much as 95% of all envi- person in order to function fully and partici- ders, etc. (Squair and Groeneveld, 2003). ronmental information is obtained through hear- Developmental Disabilities pate in society. Persons with disabilities are ing and sight, therefore, the failure of these classified in categories of disability according Recommendations: persons with mental disorders senses greatly affects the way a person collects Developmental disability is defined as severe, to impairments and other indicators. Since peo- may often have difficulty participating in phys- information about the environment (Types of chronic disability attributable to mental and/or ple differ from each other, we must never equate ical activity due to feelings of worthlessness, sensory disabilities, 2019). It is not necessary physical impairments that are likely to continue two people with the same disability category; helplessness and/or hopelessness. Individuals for a person to completely lose hearing or sight indefinitely; resulting in substantial functional each person functions in his/her own way and at may need prompting or motivational tips to to be regarded as a disabled person with sensory limitations in three or more major life activity his/her best (Squair and Groeneveld, 2003). From attend a program or activity. It is also recom- deficits. Sensory deficits include a partial or areas: self-care, receptive or expressive lan- the perspective of its etiology and basic under- mended that they are accompanied by a friend/ complete loss of hearing, vision, or a combina- guage, learning, self-direction, capacity for standing, we can place disability in the follow- carer/support worker and transported to the tion of both. Squair and Groeneveld (2003) claim independent living and economic self-sufficiency ing classification: activity location. They need to feel comfort- that hearing loss can be divided into three and requiring care, treatment or other services able and safe in the environment (Squair and categories: conductive, sensory-neural and mixed of lifelong or extended duration. (Larson et Groeneveld, 2003). hearing loss. Visual impairments can be caused al., 2001, p. 231-232). Squair and Groeneveld Mental disorders by albinism, cataracts, glaucoma, retinal blas- (2003) divide developmental disabilities into: toma and rubella. Asperger’s disorder, autism, Alzheimer’s dis- Mental disorder is a medical condition that Physical Disabilities ease/dementia/senility, Down’s syndrome, fetal includes changes in thinking, emotions and Recommendations: individuals, who have a vi- alcohol syndrome (FS), fetal alcohol effects behaviour or a combination of all and is asso- Physical disability can cause problems in vari- sual disability, may need orientation of the (FAE) and intellectual disability. ciated with distress or difficulties in the field ous areas such as neuromuscular, cardiovascular, area where the activity is taking place. For of social life, work, and family. It can occur orthopaedic and pulmonary areas, and limit a partially sighted, colour contrasts might be Recommendations: for persons with developmen- anytime and anywhere, regardless of age, gender, person’s movement, swallowing, breathing and/or appropriate. We can provide auditory cues, where tal disabilities directions and instructions financial and social status, race, ethnicity, re- speech (Nkabinde, Obiakor, Offor & Smith, 2010). descriptive language is used. Individual can should be clear, brief, concise, with appropri- ligion, sexual orientation or cultural identity. People with physical disabilities tend to rely be also guided or moved by another person. For ate vocabulary and simple language that suits It can occur in different intensities and can on devices such as wheelchairs, crutches, walk- persons with hearing disability it is important the level of understanding. It is recommended even cause a person to require hospital treating frames, rods or artificial limbs. Disability that instructions are given face to face. Also that in order to ascertain participant’s lev- ment (Parekh, 2018). Mental disorders are often can be congenital or acquired, which is devel- visible signals and demonstrations should be el of understanding the facilitator should get the cause of stigma due to a lack of knowledge oped after birth and is not hereditary, degen- used (Squair and Groeneveld, 2003). the participants to repeat the instructions and awareness amongst the public. Patients are erative, or induced by birth trauma (O’Reilly or demonstrate them. Also the use of pictures, afraid to seek help due to shame, which can, of et al., 2015). In the category of physical videos, other visual aids, games and repetitions course, cause the situation to worsen. Mental disability, we include conditions such as ar- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 54 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 55 are very effective. Instructions can be broken into sequential steps for successful learning. The use of a buddy system is also recommended (Squair and Groeneveld, 2003).

References: 3.3.

Larson, S. A., Lakin, K. C., Anderson, L., Kwak Lee, N., hEaLth COnCerns Lee, J. H., & Anderson, D. (2001). Prevalence of mental retardation and developmental disabilities: estimates from the 1994/1995 National Health Interview Survey Disability Supplements. American Journal on Mental Retardation, 106(3), 231-252

Nkabinde, Z. P., Obiakor, F. E., Offor, M. T., & Smith, D. J. (2010). Educating Children with Physical Disabilities 3.3.1. The health of people with disabilities O’Reilly, M. F., Sammarco, N., Kuhn, M., Gevarter, C., Watkins, L., Gonzales, H. K.,... & Lang, R. (2015). Inborn AUTHOR: JASNA VEŠLIGAJ-DAMIŠ and Acquired Brain and Physical Disabilities. In Clinical and Organizational Applications of Applied Behavior Analysis (pp. Key words: health condition, disability 179-193). Academic Press

Parekh, R. (2018). What Is Mental Illness? Retrieved 20.5.2019 from https://www.psychiatry.org/patients-families/ what-is-mental-illness An individual’s health status is crucial for (“WHO: Disability and health”, 2019). experiencing a better quality of life, indepen- Squair, L., Groeneveld, H. J. (2003). Disability Definitions. dence and full participation in society. The In the case of persons with disabilities, a In R. D. Steadward, G. D. Wheeler and E. J. Watkinson (ed.), Adapted Physical Activity (11-25). Canada: The Univerity of central mission of public health is to improve number of health problems can be detected due to Alberta Press the health of all inhabitants. It can be ob- secondary health conditions that overlap with

Types of sensory disabilities, 2019. Retrieved 21.5.2019 served that, compared to the general population, their primary disability as they are very sus- from https://www.hwns.com.au/about-us/about-disability/ individuals with disabilities often have worse ceptible to them. For example, in people with a types-of-disabilities/types-of-sensory-disabilities/ health and higher levels of chronic illnesses, spinal cord injury or cerebral palsy, a number such as diabetes, obesity and depression. At the of secondary health conditions such as osteo- same time, we can see that persons with disabil- porosis, osteoarthritis, increased spasticity, ities are less involved in organized preven- depression, etc. can be detected, and at the tive health activities and often develop a less same time lower balance, muscular strength, en- healthy lifestyle. (Kasser, Lytle, 2013) durance, mobility and general fitness are common. All this can significantly affect their daily Over a billion people are estimated to live activities and the quality of life. with some form of disability. This corresponds to about 15% of the world’s population. Between With a good health plan, people with disabili- 110 million (2.2%) and 190 million (3.8%) people ties can improve their health and functionality. 15 years and older have significant difficulties A person, who has suffered a spinal cord injury in functioning. Furthermore, the rates of dis- and takes good care of his health, eats well, ability are increasing in part due to ageing exercises physically and mentally, goes on reg- populations and an increase in chronic health ular medical examinations, prevents ulcers and conditions (“WHO: Disability and health”, 2019). maintains appropriate body weight, will certainly maintain good health. In cases were he/she Disability is extremely diverse. While some does not adopt a healthy lifestyle, health will health conditions associated with disability more than likely deteriorate and “unhealthy” result in poor health and extensive health care habits will be adopted, like smoking, alcohol needs, others do not. However all people with and drug consumption, which may have additional disabilities have the same general health care unwanted consequences. needs as everyone else, and therefore need access to mainstream health care services. Article Because of all that, people with disabilities 25 of the UN Convention on the Rights of Persons often have more needs for health services, with Disabilities (CRPD) reinforces the right of but are also limited in access to them due to persons with disabilities to attain the highest disability (architectural barriers, necessary standard of health care, without discrimination escorts, communication barriers etc). EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 56 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 57

In some groups of people with disabilities we on their quality of life compared with others. emote, interact with each other, earn a living social and economic factors that may accompany can observe that ageing process begins earlier It is therefore necessary to provide them with and enjoy life. On this basis, the promotion, disability (Morris 2004). Causal link between than in the rest of the population. For example equal opportunities, conditions and access to protection and restoration of mental health can impairment and depression also often rests on some people with developmental disabilities show health services. be regarded as a vital concern of individuals, the assumption that acquisition of impairment signs of premature ageing in their 40s and 50s communities and societies throughout the world is an experience of traumatic loss. Person with (“WHO: Disability and health”, 2019). (“WHO: Mental health: strengthening our re- disability has to go through various stages of References sponse”, 2018). grieving before becoming psychologically whole In addition to early ageing, some people with again (Siller, 1969, p. 292 in Morris, 2004). disabilities also notice a higher rate of pre- Coppus, A.M.W. (2013) People with intellectual disability: mature death or lower life expectancy, what is what do we know about adulthood and life expectancy? Develop- 3.3.2.1. Determinants of mental health Sometimes disability can also be benefit-finding mental Disabilities Reviews, 18, 6 – 16 also connected to their general health condi- and post-traumatic growth. Many individuals tion. Overall, the life expectancy of people Emerson, E., Baines, S., Allerton, L., Welch, V. (2012) Multiple social, psychological, and biological believe that their disabilities have helped them with mental disorders is increasing (Coppus, Health Inequalities and People with Learning Disabilities in factors determine the level of mental health to find meaning or take a more adaptive perspec- the UK: 2012, Lancaster: Improving Health and Lives 2013), but their health is still worse than in of a person at any point of time. For example, tive to life. These individuals reported they the general population (Emerson et al, 2012), Heslop, P. Blair, P. Fleming, P., Hoghton, M., Marriott, A., persistent socio-economic pressures are recog- appreciate personal worth regardless of appear- Russ, L. (2013) Confidential Inquiry into Premature Deaths and their life expectancy is still lower than of People with Learning Disabilities, Bristol: Norah Fry nized risks to mental health for individuals and ance or ability, they value time spent in family the life expectancy of their peers without Research Centre, University of Bristol communities. The clearest evidence is associated activities and they became more thoughtful and disability (Heslop et al., 2013; Hosking et al., with indicators of poverty, including low levels understanding. Persons who have developed great- Hosking, F.J., Carey, I.M., Shah, S., Harris, T., DeWilde, 2016). S., Beighton, C., Cook, D.G. (2016) Mortality among adults of education. er acceptance of disability will value their with intellectual disability in England: comparisons with the selfhood and maintain positive beliefs about In the case of individuals with disabilities general population, American Journal of Public Health, d.o.i. Poor mental health is also associated with rapid themselves (Wright 1983, Taylor 1983 in Elliot, 10.2105/AJPH.2016.303240 that belong to specific racial, ethnic and other social change, stressful work conditions, gen- Kurylo and Rivera, 2002). groups, who have a higher degree of disability Kasser, S.L., Lytle R.K., 2013, Inclusive physical activity: der discrimination, social exclusion, unhealthy Promoting Health for Lifetime, 2nd ed., Human Kinetics (8-9). and a lower level of participation in the health lifestyle, risks of violence, physical ill- Individuals with a disability who have effec- care system, we see even more health problems. Konvencija o pravicah invalidov (2003). Uradni list RS, št. health and human rights violations (“WHO: Mental tive social-problem-solving skills and who have In these groups risky behaviour, such as physi- 37 (10. 4. 2008) Pridobljeno s http://www.mddsz.gov.si/ health: strengthening our response”, 2018). positive orientations toward solving problems fileadmin/mddsz.gov.si/pageuploads/dokumenti__pdf/konvenci- cal inactivity and obesity are even greater. ja_o_pravicah_invalidov.pdf, 2018.02.08. are more assertive, more psychosocially mo- There are also specific psychological and per- bile, more accepting of their disability, and WHO: Disability and health, 2019: Retrieved from: https:// It is important that we are aware that the www.who.int/news-room/fact-sheets/detail/disabili- sonality factors that make people vulnerable less depressed than their counterparts who lack health of people with disabilities is equal- ty-and-health, 2019.01.21. to mental disorders. Lastly, there are some these skills (Elliott, Godshall, Herrick, Witty, ly important and has equal decisive influence biological causes of mental disorders including & Spruell, 1991 in Elliot, Kurylo and Rivera, genetic factors which contribute to imbalances 2002). It is also very important for persons in chemicals in the brain (“WHO: Mental health: with disabilities that they are goal-oriented. strengthening our response”, 2018). Higher goal orientation is definitely associated 3.3.2. Mental Health with lower levels of depression, greater acceptance of disability and increased life satisfac- AUTHORS: ILONA KOVAL GRUBIŠIĆ, VALENTINA BOLŠEC 3.3.2.2. Disability and Mental Health tion. We must also not forget the importance of social support which is crucial for people with Key words: mental health, mental disorders, mental disabilities, mental health and Disability undoubtedly presents a dimension that disability. disability increases risk for negative outcomes in mental health and stress. Results of studies provide evidence of a linkage between disability and References Mental health is more than the absence of mental and social well-being and not merely the absence risk for impairments in mental health. Nearly disorders. Mental health is an integral part of disease or infirmity.” An important implica- 4 of 10 individuals with disability have faced WHO: Mental health: strengthening our response, 2018: of health; indeed, there is no health without tion of this definition is that mental health is problems in mental health, which is almost dou- https://www.who.int/news-room/fact-sheets/detail/men- mental health. Mental health is determined by a more than just the absence of mental disorders ble the rate observed for non-disabled. There is tal-health-strengthening-our-response range of socio-economic, biological and envi- or disabilities (“WHO: Mental health: strength- also higher risk for men than for women and for retrieved 12.2.2019 11:48 ronmental factors. Cost-effective public health ening our response”, 2018). the young than for the old (Turner, Lloyd and Elliott, T. R., Kurylo, M., & Rivera, P. (2002). Positive and inter sectoral strategies and interventions Taylor, 2006). growth following acquired physical disability. Handbook of exist to promote, protect and restore mental Mental health is a state of well-being in which positive psychology, 687-699. health (“WHO: Mental health: strengthening our an individual realizes his or her own abilities, Significant research has highlited that depres- Morris, J. (2004). People with physical impairments and men- response”, 2018). can cope with the normal stresses of life, can sion is commonly associated with impairment tal health support needs: A critical review of the literature. Joseph Rowntree Foundation. work productively and is able to make a contri- or disability. Increased rates of depression Mental health is an integral and essential com- bution to his or her community. Mental health amongst people with disability are often a Turner, R. J., Lloyd, D. A., and Taylor, J. (2006). Physical ponent of health. The WHO constitution states: and well-being are fundamental to our collec- consequence of experience of impairment and disability and mental health: An epidemiology of psychiatric and substance disorders. Rehabilitation Psychology, 51(3), 214. “Health is a state of complete physical, mental tive and individual ability as humans to think, functional limitations in the coexistence of EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 58 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 59

This can be achieved by creating an appropriate References 3.3.3. Disability and Obesity support environment and informing people. Ells, L. J., Lang, R., Shield, J. P., Wilkinson, J. R., AUTHORS: LADISLAV MESARIČ, ILONA KOVAL GRUBIŠIĆ Each individual can take care for himself by: Lidstone, J. S., Coulton, S. and Summerbell, C. D. (2006), Obesity and disability – a short review. Obesity Reviews, 7: 341-345. Keywords: obesity, sports activities, healthy food, body mass index (BMI). • limit the intake of foods contain- ing high saturated fat and sugar, Liou, T., Pi-Sunyer, F. X. and Laferrere, B. (2005), Physical Disability and Obesity. Nutrition Reviews, 63: 321-331. • limit the intake of alcoholic beverages, Obesity is one of the world’s greatest health spent calories. At the global level, there has Lobstein, T., Baur, L., Uauy, R. (2004): Obesity in children and young people: a crisis in public health. Obes Rev.,5 Suppl problems. Since 1975, the number of obese peo- been an increase in the intake of energy (rich • increases the consumption of vege- 1:4-104. ple in the world has almost tripled. In 2016, foods that are high in fat and sugar); reducing tables, legumes, nuts and fruit Mesarič, L. (2017): Adaptirano fizičko vežbanje za osobe sa there were more than 1.9 billion adults with physical activity due to the increasingly sed- • is regularly physical active (60 minutes per traumatskom povredom mozga (master rad). Fakultet za sport i overweight. Of these, more than 650 million were entary nature of many forms of work, changing day for children and 150 minutes for adults). turizam, Novi Sad obese (WHO, 2018). Research shows that obesity modes of transport and increasing urbanization. Sackett, D., Rosenberg W.M., Gray, J.A., Haynes, R.B., Rich- among people with disabilities is significant- ardson, W.S. (1996) Evidence based medicine: What it is and ly higher than for the rest of the population The genesis of obesity in people with physical Sports activities can greatly improve motor what it isn’t. BMJ. 13; 312(7023): 71-2.

(Liou, 2005). For people with physical disabil- disability is unclear. There are several risk skills, improve quality of life and represent Swinburn, B., Gill, T., Kumanyika, S. (2005): Obesity pre- ities, obesity is twice as distracting. It is factors as they are: type of injury, severity prevention against obesity. In order to reduce vention: a proposed framework for translating evidence into associated with potential chronic diseases and, and duration of injury or illness and sex and weight, it is necessary to take into account action. Obes Rev., 6 (1): 23-33. in linkage with existing limits, prevents or age. More than 50% of youngsters with muscular nutrition laws (Mesarič, 2017). WHO Helth Topics, Obesity. Prevzeto 21. decembra 2018 s stra- aggravates active participation in sports and dystrophy are obese. As with a healthy popula- ni: http://www.who.int/topics/obesity/en social activities (Liou, 2005). tion, obesity is more susceptible to women than men. Physical inactivity and consequently mus- Obesity is a medical condition in which an cular atrophy are very characteristic for people excess of body fat has accumulated to such an with disabilities (Liou et al., 2005). 3.3.4. Harmful habits extent that it could have a negative effect on health (Sackett et al., 1996). Obesity (elevated BMI) is one of the major risk AUTHORS: DANIJELA MAJCENOVIČ CIPOT, ILONA KOVAL GRUBIŠIĆ factors for diseases such as: According to the WHO definitions, adults are Keywords: harmful habits and disability, drugs, nicotine, alcohol, prevention considered as obese if their body mass index • Cardiovascular diseases (especially car- (BMI - is defined as the body mass divided by diovascular disease and stroke) the square of the body height, and is universal- Harmful habits of a person are actions that • binge eating; • Diabetes ly expressed in units of kg/m2) exceeds 30 kg / automatically repeat a large number of times • the habit of picking your skin or gnaw- m2. For weight gain, it is considered if the in- • Musculoskeletal disorders (especially os- and can harm the health of a person or those ing your nails; flicking the joints. dex is greater than 25 (Swinburn et al., 2005). teoarthritis - degenerative joint disease) around him/her. If he/she cannot force themselves to stop doing certain actions that may • Some types of cancer (including endo- BMI is the most useful measure of overweight and harm the health in the future, then gradually The main causes of bad habits metrium, breast, ovary, prostate, liv- obesity at the population level, since it is the it becomes a habit, which is quite difficult to er, gall bladder, kidneys and colon). same for both sexes and for all ages of adults. get rid of. What are bad habits? The influence Most often, the causes of development of bad However, it should be treated with caution be- of bad habits on the life and health of a person habits in humans are: cause it may not correspond to the same degree One of the leading causes of disability is the can be different. Some of them (alcoholism, drug of obesity in different individuals. weakening of the muscular skeletal system caused addiction) are considered by modern medicine • social coherence: if in the social group to by overweight. In this case, this is a vicious as a disease. Others are classified as unneces- which a person belongs is considered a norm, In children, age should be taken into account circle. The sedentary lifestyle causes obesi- sary actions caused by imbalance of the nervous this or that behaviour pattern, for example, when determining overweight and obesity (Lob- ty and obesity aggravates disability. The role system. Below the main bad habits of modern man smoking, then most likely he will also fol- steinin sod, 2004). Research has shown that BMI of physical inactivity in the development of are listed: low it to prove his belonging to this group, also may not be the best method for some people obesity is significantly higher in persons with hence the fashion for bad habits arises; with disabilities. BMI can underestimate the disabilities. There is plenty of evidence to • smoking; • disorder in life and alienation; amount of fat in people with spinal cord in- show that obesity can aggravate the state of • drug addiction; juries that have less muscle mass. Different disability and that many disorders accompanying • pleasure is one of the main reasons why measurement methods should be used for these disability cause a risk of obesity. (Ells et • alcoholism; the influence of bad habits is so great, it individuals, or the BMI value that determines al., 2006) is constant enjoyment that leads to peo- • game dependence; obesity should be lower (Liou et al., 2005). ple becoming alcoholics or drug addicts; Illness associated with excessive weight and • shopaholism; • idleness, inability to correct- The cause of obesity and overweight is most obesity can be avoided. The choice of healthy • internet and television dependency; ly dispose of free time; often the energy imbalance between consumed and food and regular physical activity is essential. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 60 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 61

• curiosity; Smoking is especially common in people with • the strongest degradation of the in- of dependence, the willpower of a person and mental health difficulties. Around 33% of people dividual (ASSIST, 2010). individual characteristics of the organism. But • avoiding stress. with mental health difficulties, such as schizo- the most important is the person’s desire to phrenia, and approximately 70% of patients in Substance abuse (drugs, alcohol) is also a start a new life without bad habits, being with Harmful habits and their im- psychiatric inpatient units, smoke. People with problem for people with physical, cognitive, or or without disability. As we mentioned so many pact on human health a mental health difficulty die 10-20 years ear- psychological disabilities. There is very little times before, people with disabilities are even lier, on average, than people in the general research data to indicate frequency, however, in more vulnerable when it comes to fighting a bad All bad habits can have a direct or indirect population, and smoking is the single biggest 2011 the United States Department of Health and habit or addiction. effect on human health. The most severe conse- factor contributing to this difference. Further- Human Services Office on Disability reported that quences are the habits of using drugs, nicotine more, smoking exacerbates poverty and social nearly 75 million people in the United States They face: and alcohol, which quickly develop into addic- stigma of people with a mental health difficulty have some form of disability. In addition, tion and can lead to the development of a number (UH, 2016). nearly 5 million adults have both a disability 1. Attitudinal barriers; of complications, even to death. and a co-occurring substance use disorder. Based 2. Communication barriers; Alcoholism is nothing more than a drug depen- on these figures, about 7 percent of people with As we stated in previous articles, people with dence of the body, in which a person feels a disabilities struggles with substance abuse 3. Discriminatory practices and procedures; disabilities experience poorer health than those painful craving for alcohol. With this disease (Alcohol.org, 2018). 4. Architectural barriers. in the general population with delays in access develops not only the mental dependence, but to diagnosis, investigations and treatment. also the physical dependence of a person on al- Other research showed that people with disabil- Consequently they are particularly vulnerable cohol (WHO, 2010, 2014). With alcoholism, severe ities use drugs and alcohol at least as often Therefore it is of the utmost importance that we to the harmful impact of bad habits on their damage to the internal organs (especially the as the general population and perhaps even more have competent trained professionals that will health, and also on their financial and social liver) and degradation of personality occurs. often; however, they have less access to treat- understand functional limitations and help over- well-being. Despite this, indulging in bad hab- The systematic use of alcohol leads to the fol- ment, even though treatment outcomes are similar come these barriers regarding the specific types its among people with disabilities has received lowing consequences: to those in the general population (Alcohol.org, of disabilities require specific adjustments to little research attention therefore there is 2018). Alcohol is one of the most common sub- the treatment program (deaf, blind, with cog- little known facts about this behaviour. • The immune defence of the body decreas- stances of abuse among people with disabilities nitive deficits, etc.). All treatment should es thus the person is often unwell; because of its availability, social acceptance, be inclusive, not only for people from diverse Next, we will examine in more detail some of and central nervous system depressant effects. racial and ethnic groups, but also for people • Gradual destruction of the liver occurs; these harmful habits and their effect on human Use of other types of substances depends on type with disabilities. Inclusive programs need to health. • Increases the glucose level in the blood of disability. be accessible to those who want to participate thus leading to increased risk of Diabetes; and in some cases adapted to address the needs Tobacco smoking. Risks from smoking include: The risk factors associated with the development and expectations of the target population and • Among alcoholics, the mortality rate is of a substance use disorder among people with adjusted to suit the needs of the individual higher due to accidents, suicides, poi- • The risk of developing cancer and re- disabilities include: included in the treatment. soning with low-quality alcohol; spiratory system pathologie; • Loss of memory (ASSIST, 2010). • Unemployment and low income • Calcium is washed out from the body, the Prevention of bad habits skin of the face grows old, fingers be- • Chronic pain and other chronic physical issues Drug addiction is perhaps the most powerful and come yellow, the teeth become damaged, the dangerous bad habit that has long been rec- • Mental illness, which is always a risk fac- Unfortunately, till now the prevention of bad structure of hair and nails is destroyed; ognised as a disease. Addiction is the depen- tor for developing a substance use disorder habits amongst people with disabilities has • The work of the gastrointesti- dence of a person on the use of narcotic drugs. not been given adequate attention. Due to the • Easier access to prescription medications nal tract worsens, the develop- The disease has several phases of the course and architectural barriers they face, prevention ment of peptic ulcer is possible; staged syndromes. The harm that drugs do to the • Less access to education campaigns don’t reach them or they are excluded human body is great. The following are the most because they are dependent on the help of an- • Vessels become brittle and • Social isolation serious consequences of drug addiction: other person or cannot get to the program. In weak, lose elasticity; • Physical abuse and sexual abuse some cases they don’t understand the topics or • Supply of the brain with oxygen dete- • a significant reduction in life expectancy; they don’t have adequate support or understand- • Enabling behaviours by caregiv- riorates, hypertension develops. ing environment to exercise changes in life. • an increased risk of contracting dangerous and ers (Alcohol.org, 2018). They face financial deficit and therefore cannot often incurable diseases (HIV, hepatitis); The percentage of adults who smoke cigarettes is afford to live healthier. But most of all they higher among people with disabilities than peo- • high mortality among drug addicts from acci- How to deal with bad habits of already face stress by struggling with disabil- ple without disabilities. For example, in 2014, dents, suicides, overdoses and drug poisoning; people with disabilities ity and therefore have additional psychological cigarette smoking was significantly higher among problems, which make harder for them to face and • rapid ageing of the body; those who reported having any disability (more What are the methods and ways to combat bad fight bad habits. than 1 in 5 were smokers) compared to those who • development of mental and so- habits, and which one is the most effective? reported having no disability (about 1 in 6 were matic abnormalities; There is no unambiguous answer to this question. smokers) (CDC, 2017). Everything depends on many factors - the degree EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 62 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 63

References from: https://www.who.int/dietphysicalactivity/publications/ Cognitive development team or in direct competition. Social and pro- recsmarketing/en/, accessed 31 March 2017. social activities are an intrinsic part of the Alcohol.org, 2018. Treating an Alcoholic Who Is Differently WHO. Global status report on alcohol and health 2014. Research into action games shows enhanced mental gaming experience with gamers rapidly learning Abled. Retrieved from: https://www.alcohol.org/disabled/, Retrieved from: https://apps.who.int/iris/bitstream/ rotation abilities, faster and more accurate social skills that could generalize to social accessed 2019 02 16, 23:37. handle/10665/112736/9789240692763_eng.pdf;jsession- id=B1AD972DD48280A38DD796C57AB86FF7?sequence=1, accessed 31 attention allocation, higher spatial resolution relationships in the real world. ASSIST: The Alcohol, Smoking and Substance Involvement March 2017. in visual processing. Meta-analysis studies Screening Test. Manual for use in primary care. Geneva, 2010. showed that spatial skills can be learned in a The vast majority of reviewed studies revealed Retrieved from: (http://www.who.int/substance_abuse/publica- WHO. European Food and Nutrition Action Plan 2015-2020. tions/assist/en/, accessed 31 March 2017. Regional Committee for Europe, 64th session; Copenhagen, relatively brief time by playing video games and positive health outcomes for older adults asso- Denmark, 15-18 September 2014. Retrived from: http://www. that the results are often comparable to train- ciated with digital video game play, especially CDC, 2017. How to Help People with Disabilities Quit Smoking. euro.who.int/__data/assets/pdf_file/0008/253727/64wd14e_Food- ing in formal courses designed to enhance those related to mental and physical health benefits. Centers for Disease Control and Prevention. Retrieved from: NutAP_140426.pdf, accessed 31 March 2017. https://www.cdc.gov/features/disability-quit-smoking/index. same skills. Cognitive advantages from video Significant mental health positive outcomes, html, accessed 2019 02 16, 23:05. WHO. HEARTS Technical package for cardiovascular disease games also appear to produce greater neural such as cognitive improvement, were reported in management in primary health care: healthy-lifestyle counsel- processing and efficiency, improve attention multiple digital video game interventions, which UH, 2016. Smoking and People with an Intellectual Disabili- ling; Geneva. Retrieved from: https://www.who.int/cardiovas- ty. University of Hertfordshire. Retrieved from: http://www. cular_diseases/hearts/Hearts_package.pdf, accessed 31 March functioning and help with pattern recognition. used measures such as working memory, focused intellectualdisability.info/physical-health/articles/smok- 2017. 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Retrieved strategy_english_web.pdf, accessed 31 March 2017. research results seem promising (Granic et al., most frequently reported significant health out- 2016). come among digital game interventions for older adults were mental health outcome factors (Hall et al., 2016). 3.3.5. 21st Century - Video Games Emotion or Traditional Sport Disciplines Video games have been used as a form of physio- Most gamers play video games for enjoyment and therapy or occupational therapy in many differ- to help improve their mood. Along with distract- ent groups of people. Such games focus attention AUTHORS: LADISLAV MESARIČ ing them from real-world problems (a special away from potential discomfort and, unlike more concern for young people looking for escape from traditional therapeutic activities; they do not Keywords: video games, benefits, bad sides, health, physical activity bullying or other negative life situations), rely on passive movements and sometimes painful succeeding in video games can lead to positive manipulation of the limbs. Therapeutic benefits feelings, reduced anxiety, and becoming more have also been reported for a variety of adult relaxed. populations including wheelchair users with spinal cord injuries, people with severe burns, and Introduction In our perception, video games still have some- people with muscular dystrophy (Griffiths, 2005). thing bad. Against this backdrop of nearly ubiq- Motivation Nowadays, video gaming is a highly popular and uitous play, the popular press regularly pulses Video games have many positive effects and are prevalent entertainment option; its use is no out urgent warnings against the perils of addic- By setting specific tasks and allowing people to appropriate for people with disabilities. Howev- longer limited to children and adolescents. tion to these games and their inevitable link to work through obstacles to achieve those tasks, er, consideration should be given to suitability Demographic data on video gaming shows that the violence and aggression, especially in children video games can help boost self-esteem and of some games for special groups of people. In mean age of video game players is 31 years old and adolescents (Granic et al., 2016). help people to learn the value of persistence. addition to the above mentioned positive sides, and has been on the rise in recent decades. It By providing immediate feedback as video game video games also have many negative sides. is a common activity among young adults (Palaus Video games are changing and the approach has players solve problems and achieve greater et al., 2016). changed. The more balanced perspective, consid- expertise, players can learn to see themselves ers not only the possible negative effects but as having skills and intelligence they might not 3.3.5.2. The bad sides of video game New research from innovation charity Nesta re- also the benefits of playing these games. otherwise realize they possess. Gaming helps veals that those who play video games are better people realize that intelligence can increase Muscle pain, Obesity, Sleep Deprivation educated, no less wealthy and more likely than with time and effort rather than being fixed. non-games players to participate actively in 3.3.5.1. The Benefits of Play- Though the activity level needed to play Wii or culture. The findings also turn the gamer stereo- ing Video Games Xbox Kinect are a step in the right direction, type on its head, with women more likely to play Social activity a majority of video games still involve sitting than men do and the average gamer being aged 43. According to meta study (Granic et al., 2016) in front of a screen, often with poor posture. However, among those that play, females do so video games provide people with compelling so- Perhaps more than ever before, video games have Excessive screen game playing leads to increased less often than men do. (Nesta, 2017) Gaming is cial, cognitive, and emotional experiences and become an intensely social activity. Instead levels of muscle stiffness, especially in the broad and complex. A ‘typical’ gamer may not ex- can potentially boost mental health and well-be- of the stereotypical gaming nerd who uses video shoulders, which can be caused by poor posture. ist. Based on the written, we can conclude that ing. Authors find the following benefits: games to shun social contact, over 70 percent of Sedentary lifestyles and bad diets are directly video games are not just for young people. gamers play with friends, whether as part of a linked to obesity. Playing too many video games EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 64 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 65 has been associated with changes in physical edge, based on the support of applied practice appearance. Increased gaming can cause sleep and human rights (Aleksandrović et al., 2016). 3.3.6. Doping in the sport for deprivation and gamers can develop black rings persons with disability in the skin under the eyes (Tazawa & Okada, Video games can be used for special purposes, 2001). taking into account advantages and disadvantag- es, but they cannot replace traditional sports AUTHOR: LADISLAV MESARIČ According to a report in Paediatrics, seven out activities. We need to adapt physical activities of 10 children are vitamin D deficient. Vitamin so people with disabilities can participate and Key words: doping, technodoping, bosting, self-harm D, of course, is commonly absorbed from expo- gain benefits. sure to sunlight. Unfortunately, being holed up in front of video games console does not afford Man was made to move. This is a biological fact Most athletes who take part in adapted sports 3.3.6.2. Increasing of blood the same exposure to sunlight as being outside that no video game can substitute. But even from activities compete ethically and use the ap- pressure (Bosting) (Misra et.all 2008). video games we will have more if we play them in proved methods to improve sports performance. good physical condition. Improving the results is achieved through train- Another form of “cheating” is encountered in Negative aspects include the risk of video game ing that takes into account scientific knowledge some athletes with spinal cord injuries who want addiction (although the prevalence of true ad- in the field of sports training. People, like in to increase their blood pressure and thereby diction, rather than excessive use, is very low) References all areas of life, as well as in adapted sports, improve their performance. Due to the nature and increased aggressiveness. There have been are looking for shortcuts to succeed. The rea- of the spinal cord injury, some athletes do numerous reports of other adverse medical and Bakhshi, H. (2017). New research proves cultural val- sons for this are recognition and publicity (in not feel the parts of their body. If the body psycho-social effects. For instance, the risk of ue of video gaming. (https://www.nesta.org.uk/news/ particular, the Olympic Games), financial benefits is damaged in areas where there is no sense, new-research-proves-cultural-value-of-video-gaming/) epileptic seizures whilst playing video games in from sponsors and state grants, and the human a physiological response, known as autonomic photosensitive individuals with epilepsy is well Brown, A. (2017) Younger men play video games, but so do a desire to be better than others, albeit in an dyslexia, is triggered. In order to speed up established (Griffiths 2005). diverse group of other Americans. (http://www.pewresearch. illegal way. this response, some athletes deliberately harm org/fact-tank/2017/09/11/younger-men-play-video-games-but-so- do-a-diverse-group-of-other-americans/) themselves. Self-harm is, for example, fracture, There are many known cases of doping. In par- causing pressure due to very tight clothing, Granic, I., Lobel, A., & Engels, R. C. M. E. (2014). The 3.3.5.3. Answer to the main question benefits of playing video games.American Psychologist, 69(1), allel with the development of methods for the overload of the bladder or in male sport - too 66-78. detection of doping in sport, even in the ear- tight clothing in the area of pelvis. These are In accordance with the text above, video games ly 1980s, doping controls were also conducted very extreme behaviours, but they point to what Griffiths, M. (2005). Video games and health: Video gaming is have a lot of space in our field of operation. safe for most players and can be useful in health care. BMJ : in competitions for persons with disabilities all para athletes are willing to do to reach the However, we have to answer the main question: British Medical Journal, 331(7509), 122–123. (Hale, 2016). desired result or success (Bolta 2016, Guerrero

21st Century - Video Games or Traditional Sport Hall, A.K., Chavarria,E., Maneeratana, V., Chaney, B.H., M. et al., 2018). Disciplines? Bernhardt J.M. (2012). Health Benefits of Digital Videogames The use of doping in the Olympic and Paralym- for Older Adults: A Systematic Review of the Literature. pic athletes does not differ significantly. As a Different qualification systems are available Games for Health Journal 1:6, 402-410 The answer is both. While video games show their rule, there is an increase in power and endur- in the sport of persons with disabilities. That advantages having regard to all the weaknesses Kaminsky, L. A. (2010) ACSM Priručnik za procenu fizičke forme ance. There are also similar sanctions, which enables equal and fair competitions for persons traditional games are another story. povezane sa zdravjem, Data Staus, Beograd include disqualification, repossession of awards with different types and degrees of disabili- Kasser, S.L., Lytle R.K., (2013), Inclusive Physical Activ- and all the benefits that they have been given ty (Aleksandrović et al., 2016). Although the People have many different reasons for exercis- ity-2nd Edition, Human Kinetics, Human Kinetics Europe Ltd, after winning the medal (Collier, 2008) system is constantly improving, it may be con- United Kingdom ing. Sport activities provide the health related troversial, because in some cases individuals benefits. The main goals are to lower the risk Misra, M., Pacaud, D., Petryk A., Collett-Solberg P.F., However, in adapted sports activities, there are simulate a lower level of ability. A well-known Kappy, M. (2008) Vitamin D Deficiency in Children and Its of developing health problems and preventable certain characteristics that are specific for example is the Spanish basketball team where Management: Review of Current Knowledge and Recommendations. disease. A person can be well even if he or she Pediatrics, Volume 122 / Issue 2 athletes with physical and mental disabilities. people without disabilities appeared and entered has differences in movement capabilities, wheth- the competition due to inconsistent classifica- Palaus, M., Marron, E. M., Viejo-Sobera, R., & Redolar-Rip- er these are caused by a particular experience oll, D. (2017). Neural Basis of Video Gaming: A Systematic tion procedures (Bolta, 2016). or factors such as cerebral palsy, injury to Review. Frontiers in Human Neuroscience, 11, 248. http://doi. 3.3.6.1. Different technology the spinal cord and paralysis, or advanced age. org/10.3389/fnhum.2017.00248 Disabilities are not considered illnesses or Tazawa, Y. and Okada, K. (2001), Physical signs associ- Athletes from countries with advanced technology References deficiencies. Regardless of ability level, age or ated with excessive television-game playing and sleep and better economic standards have access to a deprivation. Paediatrics International, 43: 647-650. level of experience, exercise benefits can lead better technology that allows them greater com- Aleksandrović, M., Jorgić, B., Mirić, F. (2016). Holistički doi:10.1046/j.1442-200X.2001.01466.x to wellness. (Kasser & Lytle, 2013). petitiveness. This can lead to an unequal posi- pristup adaptivnom fizičkom vežbanju, učbenik za studente master akademskih studija. Fakultet sporta i fizičkog vaspi- tion among competitors (Guerrero et al., 2018). tanja Niš For adapted physical activity, it is considered Some people call it techno doping (Bolta, 2016). that it is one of the most sustainable support Bolta T.(2016) Paraolimpijske igre in Slovenci. Diplomsko delo, Fakulteta za šport, Ljubljana systems for promoting physical activity for people with different forms of disability and for the continuous development of scientific knowl- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 66

Collier, R. (2008). Most Paralympians inspire, but others cheat. CMAJ : Canadian Medical Association Journal, 179(6), 524. http://doi.org/10.1503/cmaj.081279

Guerrero L.A., Drakes S., De Luigi A.J. (2018) Controversies in Adaptive Sports. In: De Luigi A. (eds) Adaptive Sports Medicine. Springer, Cham

Hale L. (2016) A brief history of doping in disability sport. Retrieved from http://www.parasport-news.com/a-brief-history- of-doping-in-disability-sport/10515/ on 15.5.2018 BeNe 4. fITs of PhySI cAL AcTIv ITy

Learning outcomes:

• to outline Physiological and So- ical Activities (APA). cial benefit of Physical activity • familiarizing reader with the benefits • recommendation for physical activi- of sport and APA in rehabilitation. ty in different stages of life

• an understanding of Adapted Phys- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 70 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 71

daily, family, and community activities in order Benefits for the Psychologi- to improve cardiorespiratory and muscular fit- cal and Social Functioning ness, bone and functional health, and reduce the risk of NCD’s, depression and cognitive decline. Sports activity, in general, assumes, of course, a role of “privileged context” within which to In 2008 the U.S. Department Health and Hu- foster relationships and to counter the risk of 4.1. man Services published the Physical Activity isolation, which weighs heavily on certain cate- Guidelines for Americans - Be Active, Healthy, gories of citizens, such as, for example, people BENefiTS fOr thE and Happy! (www.health.gov/paguidelines) that with disabilities. provide achievable steps for youth, adults and seniors, as well as people with special condi- The UN Convention on the Rights of Persons PSYcholOGIcal aND tions to live healthier and longer lives. with Disabilities suggests a set of rights, including:

SoCial FUNctIONing Key Guidelines for Adults a. to encourage and promote the widest possible with Disabilities participation of persons with disabilities in mainstream sports activities at all levels; AUTHORS : MICHELE LEPORI, ALESSANDRO MUNARINI, SILVIA NOCI, PAOLO ZARZANA • Adults with disabilities, who are able to, b. ensure that they have access to plac- should get at least 150 minutes a week of es that host sports activities Key Words: Well being; physical activity; muscular fitness; self-esteem; self-confi- moderate-intensity, or 75 minutes a week dence; social relationship; of vigorous-intensity aerobic activity, or c. to ensure that minors with disabilities can an equivalent combination of moderate- and participate, on an equal basis with oth- vigorous-intensity aerobic activity. Aero- er minors, in recreational activities, bic activity should be performed in episodes leisure and sport, including the activi- of at least 10 minutes, and preferably, it ties provided for by the school system. Introduction 18–64 years old should be spread throughout the week. As the Ministry of Health confirms, sporting • Adults with disabilities, who are able There are many publications in the field of mo- For adults of this age group, physical activity activity produces, a beneficial effect on the to, should also do muscle-strengthening tor sciences and the promotion of health; many includes recreational or leisure-time physi- physical and mental health. activities of moderate or high intensi- studies have been carried out to state both the cal activity, transportation (e.g. walking or ty that involve all major muscle groups value and the importance of motor activity, cycling), occupational (i.e. work), household It is well known that the benefits of sport are on 2 or more days a week, as these activi- physical activity and sports on the psychophysi- chores, play, games, sports or planned exercise, undeniable. Those who play sports live longer ties provide additional health benefits. cal well-being of any individual. in the context of daily, family, and community because they protect their health better example activities in order to improve cardiorespiratory • When adults with disabilities are not able prevents muscle and bone decline. The calming WHO guidelines (2010) provide recommendations and muscular fitness, bone health and to reduce to meet the Guidelines, they should engage action of sports activity should not be forgot- on Physical Activity specific for each age the risk of Non-Communicable diseases NCD’s in regular physical activity according to ten. Doing sports allows you to disconnect from group (following) and concepts and technical (e.g. Parkinson’s disease, stroke, and cancer) their abilities and should avoid inactivity. everyday problems and recharge yourself. Sport terminologies. and depression. makes it possible to become not only stronger • Adults with disabilities should consult their physically but also mentally, giving greater health-care provider about the amounts and Adults aged 18–64 years should aim to do at motivation to achieve increased self-esteem, types of physical activity that are appro- 5–17 years least 150 minutes of moderate-intensity aerobic confidence and optimism. priate for their abilities (ODPHP, 2008). physical activity throughout the week, or at For children and young people physical activity least 75 minutes of vigorous-intensity aerobic All these considerations can thus safely be includes play, games, sports, transportation, physical activity throughout the week, or an In addition, it is important to note that sport transported to the world of sports for persons recreation, physical education or planned ex- equivalent combination of moderate- and vigor- has an important social role, not only does it with a disability; we always tend to think of ercise, in the context of family, school, and ous-intensity activity. help to improve the physical and psychological disabled people as sick, steady, immobile peo- community activities. Physical activity benefits recovery, but it also helps to develop social ple, but if we look at them engaged in sports we include cardiorespiratory and muscular fitness, relationships regardless of the age, the social find them to be tenacious, determined and con- bone health, cardiovascular and metabolic health 65 years old and above origin or the physical difficulties. It is a centrated people. This is because practising a biomarkers and reduced symptoms of anxiety and source of important values such as team spirit, sport and trying to reach a goal creates import- depression. For adults of this age group, physical activity solidarity, tolerance and fair play, contribut- ant motivations. Through the sporting activi- includes recreational or leisure-time physi- ing to personal development and fulfilment. ty the disabled person has the possibility to cal activity, transportation (e.g. walking or improve in different aspects, in particular on cycling), occupational (if the person is still Sport is an important means of social integra- the psychological, social and educational level engaged in work), household chores, play, games, tion by which the person increases social inter- increasing their autonomy, encouraging commit- sports or planned exercise, in the context of actions which subedequently improve self-esteem. ment during training and respect for opponents, EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 72 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 73 teaching courage, promoting loyalty; encourag- Conversely, controlled motivation is unrelated performance and other achievement-oriented being socialization, integration, thus overcoming to long-term adherences and is less malleable haviours necessary for success in the workplace 4.1.4. Attention fears, prejudices and isolation. We must there- (Bean J. Et al., 2007). Autonomous motivation are developed (Richman, E. L.; 2000). fore always put the person at the centre of our is closely associated with motivation for a Regular physical activity helps keep your key project. Sport has some peculiarities that we change in behaviour, and is a person’s confidence An adapted physical activity helps to achieve a mental skills sharp as you age. This includes must always be able to exploit: managing emo- in the ability to perform new activities. This good autonomy in the game and changing room en- sharp thinking, learning, and using good judge- tions, collaborating with others, feeling part notion is often termed “self-efficacy” and is vironment, to develop a gradual transition from ment. Research has shown that doing a mix of of a team, respecting the rules and learning to defined by Bandura (Bean J. Et al., 2007) as the not knowing one’s body to the elaboration of the aerobic and muscle strengthening activities accept their limits, not without trying to go perceived capability of a person to perform a body schema; to find a balance between mind and is especially helpful. Thanks to the sporting further. All these benefits affect all people, specific action required to achieve a concrete body; to reach a personal balance, to improve performance a return is achieved in terms of disabled or not (Munarini A., CSI referente goal. Self-efficacy has been shown to be a strong co-ordinative and conditional skills, to develop improving the strength of determination, vital nazionale attività disabili CSI). predictor of physical activity in individuals laterality, to better perceive one’s own body energy and passion in everyone. with disabilities (Hutzler Y. Et al.; 2007). In through the elaboration of motor and perceptual addition, the degree of impairment is close- experiences (Noci S., CSI commissione tecnica ly related to physical activity in individuals Nazionale disabili) 4.1.1. Motivation with disabilities. However, it is challenging to 4.1.5. Social encounters reach a common assessment of impairment across and Social Skills One of the most influential internal barriers different diseases and disabilities. Pain and addressed in the literature is the attitudes and fatigue are associated with disability, but may 4.1.3. Emotional Well-Being motivations of people with a disability, par- play a unique role for motivation in physical The relationship with the sports opponent or ticularly self-consciousness and low levels of activity. Adapted Physical Activity (APA)-based with the teammate, stimulates interaction with confidence. This lack of confidence and self-es- rehabilitation includes physical activities Sports Reduce Stress and Depression the other, promotes socialization and social teem has been reported to manifest itself in the adapted to the specific needs of each individual integration, offering valuable help to the following ways: with a disability. The goal is to enhance the Those who practice sport prevent bone and mus- prevention of isolation and overcoming fears and subject’s autonomy, motivation and ability to cle decline, protect their health, recharge by false judgements (Noci S., CSI National tech- • Feeling different from the ma- engage in physical activities, and ultimately detaching their mind from everyday problems and nical commission for disabled people). If the jority of the population. increase physical activity over time. Although focusing on movement. The sporting motion pro- physical benefits are evident and known, perhaps this type of rehabilitation is beneficial with duces endorphins, substances that stimulate the the psychological benefits of sport, are less • Feeling unable to fit in at respect to pain and functioning, we have less body to react positively to situations of anxi- experienced, and are a secondary and not very a sporting facility. knowledge about its influence on motivation and ety and stress. The movement not only enhances visible aspect. • Self-consciousness or lack of confi- physical activity levels over time (van Mid- the physical, but also strengthens the mind, dence in asking for help and assis- delkoop M. et al. ; 2011). increasing self-esteem, optimism and self-con- Sport, on the other hand, produces decidedly tance in a sporting environment. fidence. On the sporting level, the technical positive and important effects on a psychologi- knowledge of the sports disciplines is acquired, cal level. Physical activity allows the athlete • A fear of failure on the part of the per- the respect of the rules and the collaboration with a disability to gain greater confidence in son with the disability can present another 4.1.2. Self-Esteem are encouraged, communication is encouraged. On the things they do, helping to restore confidence type of internal barrier, particularly in the psychological level we work on the contain- in their potential. the case of people who have newly acquired Practising sport helps to develop and enhance ment of emotions and on increasing the capacity their disability and with low self-esteem. the potential and autonomy of the disabled for self-control. (Noci S., CSI National techni- In addition, the athlete is able to test their person in respect of the evolutionary process: cal commission for disabled people). skills and abilities, their possibilities and Motivation is essential for physical activity through motor sports activities aimed at the limits, thus acquiring a greater awareness of in the general population and among individuals well-being of the disabled person, it contrib- When you are physically active, your mind is them. with disabilities. Self-determination theory utes to the increase of specific skills to be distracted from daily stressors. This can help (SDT) divides motivation into 2 components. carried out by increasing the opportunities avoid getting bogged down by negative thoughts. Sports practice is very important, because it Controlled motivation is derived from exter- for social integration, using it as a tool for Exercise reduces the levels of stress hormones allows individuals to be inserted or reinserted nal sources, such as physicians, trainers or growth and enhancement of personal skills (Noci in your body. At the same time, it stimulates in a healthy and suitable social context. By media, while autonomous motivation is derived S., CSI National technical commission for dis- production of endorphins. These are natural mood coming into contact with the outside world, an from oneself across 3 basic psychological needs: abled people). lifters that can help keep stress and depression athlete with a disability discovers a healthy autonomy, relatedness and competence. Recent at bay. Endorphins may even leave you feeling collaboration, one that goes beyond personal research has shown the importance of autonomous Individuals with disabilities who participate more relaxed and optimistic after a hard workout benefits, and savours the joy of human relation- motivation for adherence to physical activi- in sports have higher self-esteem, better body on the field. Experts agree that more quality ships. Within the sports world the interactions ty, and that it is associated with increased images and higher rates of academic success; research is needed to determine the relationship that are established are, in fact, multiple activity in people with physical disabilities are more confident and more likely to gradu- between sports and depression. and of different types; for example, you get in (Saebu M. et al.; 2013). It is also noteworthy ate from high school and enrolling in college. touch with the coach, with the teammates, in the that maintenance of behaviours over time re- Furthermore, sport is where skills like team- case of team sports, and with opponents. quires autonomous motivation for that behaviour. work, goal-setting, the pursuit of excellence in EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 74 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 75

These connections allow individuals to experi- children with disabilities be included in phys- with intellectual disabilities that is theoreti- World Health Organization, 2010 “Global Recommendations on ence a wide range of feelings and emotions, to ical education within the school system “to the cally credible in terms of social capital schol- Physical Activity for Health”, 7-8 and c.4 – 16-33. manage any relationship conflicts and to learn fullest extent possible” and enjoy equal access arship and which contains lessons for advancing how to adapt relationships dependent on who they to “play, recreation and leisure and sporting social inclusion in other contexts. Nonetheless, are interacting with. In the interpersonal re- activities” (Convention on the Rights of Persons certain limitations are identified that require lationships to the subject, goals and a specific with Disabilities Article 30); (General Assembly further consideration to enhance athletes’ so- role are recognized, thus enhancing the process Resolution: Sport as a means to promote educa- cial inclusion in the wider community of building his personal identity (Zarzana P., tion, health, development and peace A/RES/69/6); CSI National trainer and CSI formatori nazi- (International Disability in Sport Working onali, Italian National amputee football team 2018). References coach). Bean JF, Bailey A, Kiely DK, Leveille SG. Do attitudes toward The power of sport as a transformative tool is Case studies exercise vary with differences in mobility and disability status? – a study among low-income seniors. Disabil Rehabil of particular importance for women as women 2007; 29: 1215–1220. with disabilities often experience double dis- Background Although the promotion of social crimination on the basis of their gender and inclusion through sports has received increased Chapter Five: Sport and Persons with Disabilities: Fostering Inclusion and Well-Being. 2008, p.167-175. International disability. It is reported that 93% of women attention with other disadvantaged groups, this network of sport and development consultants (INSDC). with disabilities are not involved in sport and is not the case for children and adults with Ilias, Bantekas & Chow, Pok Yin & Karapapa, Stavroula & women comprise only one-third of athletes with intellectual disability who experience marked Polymenopoulou, Eleni. (2018). Art.30 Participation in disabilities in international competitions. By social isolation. The study evaluated the out- Cultural Life, Recreation, Leisure, and Sport. 10.1093/ providing women with disabilities the opportu- comes from one sports programme with particular law/9780198810667.003.0031. nity to compete and demonstrate their physical reference to the processes that were perceived United Nations General Assembly – Seventy-first session Agenda ability, sport can help to reduce gender stereo- to enhance social inclusion. item 11 - Sport as a means to promote education, health, types and negative perceptions associated with development and peace, 7 December 2016. women with disabilities. Method The Youth Unified Sports programme of Spe- Hutzler Y, Sherrill C. Defining adapted physical activity: cial Olympics combines players with intellectual international perspectives. Adapt Phys Activ Q 2007; 24: 1–20 Moreover, by improving the inclusion and disabilities (called athletes) and those without International Disability in Sport Working Group Sport in well-being of persons with disabilities, sport intellectual disabilities (called partners) of the United Nations Convention on the Rights of Persons with can also help to advance the Millennium Devel- similar skill level in the same sports teams for Disabilities International Platform on Sport and Development; 2008. opment Goals (MDGs). For example, sports-based training and competition. Alongside the devel- opportunities can help achieve the goal of opment of sporting skills, the programme offers Frances Hannon, National Disability Authority. “Promoting the Participation of People with Disabilities in Physical Activi- universal primary education (MDG2) by reducing athletes a platform to socialise with peers and ty and Sport in Ireland”. October 2005 stigma preventing children with disabilities to take part in the life of their community. Office of Disease Prevention and Health Promotion (ODPHP), from attending school; promote gender equality Unified football and basketball teams from five 2008. 2008 Physical Activity Guidelines for Americans – Be (MDG3) by empowering women and girls with dis- countries – Germany, Hungary, Poland, Serbia and Active, Healthy and Happy! retrieved from: https://health. abilities to acquire health information, skills, Ukraine – participated. Individual and group gov/paguidelines/2008/chapter7.aspx social networks, and leadership experience; and interviews were held with athletes, partners, Richman, E. L., & Shaffer, D. R. (2000). ‘If you let me play lead to increased employment and lower levels of coaches, parents and community leaders: total- sport’: How might sport participation influence the self-es- poverty and hunger (MDG1) by helping to reduce ling around 40 participants per country. teem of adolescent females? Psychology of Women Quarterly, 24:189-199. stigma and increase self-confidence. Results Qualitative data analysis identified Saebu M, Sørensen, M, Halvari, H. Motivation for physical The UN Convention on the Rights of Persons with four thematic processes that were perceived activity in young adults with physical disabilities during a rehabilitation stay: a longitudinal test of self-determina- Disabilities is the first legally binding inter- by participants across all countries and the tion theory. J App Soc Psychol 2013; 43: 612–625. national instrument to address the rights of two sports to facilitate social inclusion of Sport for Development and Peace-International Working Group, persons with disabilities and sport. Article 30 athletes. These were: (World Health Organiza- “Harnessing the Power of Sport for Development and Peace: of the Convention addresses both mainstream and tion 2010 “Global Recommendations on Physical Recommendations to Government” (2008). Author: Right To Play disability-specific sport and stipulates that Activity for Health”) the personal development on behalf of the Sport for Development and Peace Internation- “States Parties shall take appropriate measures of athletes and partners; (Richman, E. L., & al Working Group (SDPIWG). to encourage and promote the participation, to Shaffer, D. R.; 2000) the creation of inclusive Van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Os- the fullest extent possible, of persons with and equal bonds; (Saebu M.; 2013) the promo- telo R, Koes BW, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic disabilities in mainstream sporting activities tion of positive perceptions of athletes; and non-specific low back pain. Eur Spine J 2011; 20: 19–39. at all levels”. It also calls upon Governments, (Bean JF, 2007) building alliances within local World Health Organization-“Young People with Disability in States party to the Convention, to ensure that communities. Physical Education/ Physical Activity/Sport In and Out of persons with disabilities have access to sport Schools: Technical Report for the World Health Organization”. and recreational venues — as spectators and as Conclusions Unified Sports does provide a vehicle C.Sherrill; International Federation of Adapted Physical active participants. This also requires that for promoting the social inclusion of people Activity (IFAPA), 2004. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 76 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 77

4.2.2. Definition of 4.2.3. The benefits of Sports in Adapted Physical Activity the Process of Rehabilitation – Play, Game Sport 4.2. The history of Sport in Rehabilitation Sport Although the use of physical activity in re- Sports and Phys- habilitation can be traced as far back as 3000 Sport is defined as “all forms of physical activ- B.C. in ancient China (EUSAPA, 2010), the modern ity which, through casual or organised partici- evolution of physical activity and sports as a ical Activity as pation, aim at expressing or improving physical means of rehabilitation is attributed, among fitness and mental well-being, forming social others, to the Swedish scholar Per Henrik Ling relationships or obtaining results in competi- (1776-1839). Ling established a system of medi- Rehabilitation tion at all levels.” (European Sports Charter cal gymnastics in the University of Stockholm, 1992; revised 2001). Sweden after curing himself from rheumatism and paralysis through practising fencing and gymnas- AUTHOR: MICHAEL LAMONT tics (Hutzler, 2010). Adapted Physical Activity (APA) Key Words: sport, rehabilitation, persons with disabilities, Adapted Physical The inclusion of sport and organised competi- Activities APA can be defined as the provision of physical tion in rehabilitation is associated with Sir activity services and programmes to persons of Ludwig Guttmann, founder of the International all ages with special needs (Hutzler & Sherrill, Stoke Mandeville Games in 1948, followed by the 2007). APA includes, but is not limited to, first Paralympics in 1960 and the Special Olym- physical education, sport, recreation, and reha- pics in 1968. Since the 1970s there has been a Introduction rience, or are likely to experience disability, bilitation of people with disabilities (EUFAPA, dramatic increase in the number of international to achieve and maintain optimal functioning 2006, article 5). organisations/associations serving athletes with Sport is a cultural phenomenon and an integral in interaction with their environments. Reha- disabilities (De Pauw & Gavron, 2005). part of society. It is highly visible and touch- bilitation provides disabled people with the According to the International Federation of es almost everyone as participants, spectators tools they need to attain independence and Adapted Physical Activity (IFAPA), APA means: and consumers - DePauw & Gavron (2005). self-determination.” EUSAPA • A service-oriented profession Sport represents an efficient rehabilitation The European Standards in Adapted Physical • An academic specialisation or field of study method for persons with disabilities. Through The European Standards in Adapt- Activities (EUSAPA, 2010) identifies three main regular sporting activity persons with dis- ed Physical Activities • A cross disciplinary body of knowledge areas of benefit of APA for rehabilitation: abilities can achieve greater quality of life • An emerging discipline or subdiscipline and improved social inclusion. For this purpose The EUSAPA (2010) stated that “Rehabilitation 1. Adapted physical activities during, but persons with disabilities need to be provided is concerned with identifying and maximising • A philosophy or set of be- also after the rehabilitation phase have a with the possibility of participating in appro- quality of life and movement potential within liefs that guides practices beneficial effect on an individual’s general priate sport programme, where they can equally the spheres of promotion, prevention, treatment/ physical fitness level, their functional- • An attitude of acceptance that pre- participate. Sporting activities need to become intervention, habilitation and rehabilitation, ity, and performance of activities of daily disposes behaviours a component of rehabilitation of persons with encompassing physical, psychological, emotional, living. Research suggests that physiotherapy disabilities regardless of the nature or degree and social well-being.” • A dynamic system of interwo- programmes often pay insufficient attention to of their disability, age and level of physical ven theories and practices these domains, therefore implementing adapted competence. physical activities within the rehabilitation • A process and a product (i.e. pro- The United Nations Convention on the programme may result in an enhanced qual- grammes in which adaptation occurs) Rights of Persons with Disabilities ity and successfulness of rehabilitation, • An advocacy network for disabili- while also reducing the risk of relapse. 4.2.1. Definition of The UNCRPD (2007) outlined the responsibility of ty rights to physical activity of par- 2. Adapted physical activities have a beneficial states to provide “appropriate measures, includ- ticipants with disability Rehabilitation effect on the patient’s/client’s psycho- ing through peer support, to enable persons with social well-being, reducing isolation and disabilities to attain and maintain their maxi- sedentary lifestyle. Adapted physical ac- The World Health Organisation mum independence, full physical, mental, social tivities offer opportunities to share expe- and vocational ability, and full inclusion and riences and to learn how to accept or come The WHO (2011) defined rehabilitation as “a set participation in all aspects of life.” to terms with an impairment, disorder, etc. of measures that assist individuals who expe- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 78 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 79

3. In addition, individuals experience the ity sport (Cherney, Lindemann & Hardin, 2015). APA and the International Classification Structures, Activities and Participation, and benefits of physical activity and sports Social networks can help people negotiate con- of Functioning, Disability and Health Environmental Factors (See figure 3. below) and with respect to their physical and men- straints to participation, including lack of has been widely accepted among rehabilitation tal and psychosocial well-being, enhanced knowledge about an activity or lack of motiva- APA is strongly associated with an understanding services worldwide (Hutzler, 2010). Codes can be quality of life and the improved execu- tion to participate (Jackson, Crawford, & God- of the interrelationship between the person, the recorded for each classified item within a domain tion of activities of daily living. bey, 1993; Jackson & Scott, 1999). Both children environment and the task (Kiphard 1983; Newell to indicate the extent of ‘problem’ with any (Seymour, Reid, & Bloom, 2009), and adults with 1986; Reed 1988). In 2007, Hutzler and Sherrill of these aspects of functioning. Environmental disabilities report developing friendships as proposed the WHO’s International Classification Factors can be recorded as being either barriers APA vs Physical Therapy (PT) one of the benefits of participation in sport and of Functioning, Disability and Health (ICF: WHO to or facilitators of a person’s functioning APA (Ashton-Shaeffer, Gibson, Autry, & Hanson, 2001) as a conceptual framework for the planning (Bufka, 2009). Hutzler (2010) highlighted that the differences 2001; Lindemann & Cherney, 2008). and implementation of APA. between physical therapy (PT) and APA suggested Helpful resources explaining how to use the ICF by Lorenzen (1961) are still evident today: ICF is a comprehensive classification system are available from the website: designed to capture aspects of human functioning http://www.who.int/classifications/icf/en/ • A medical orientation in PT, compared 4.2.4. Opportunities in the context of a health condition. The sys- to a pedagogical orientation in APA; for Participation tem consists of a hierarchy of classifications for each of its domains: Body Functions and • Intervention goals mostly refer to the impairment in PT compared to the whole UNCRPD, Article 30 person and participation in APA;

• Activity is typically prescribed in PT, Article 30 addresses equal participation of per- compared to self-motivation in APA; sons with disabilities in recreational, leisure and sporting activities and states that State • The participant is passive and ac- Parties shall take appropriate measures: HEALTH CONDITION tive in PT but only active, mostly in group settings, in APA; • To encourage and promote the participa- • The goal in PT is mostly restricted to specif- tion, to the fullest extent possible, of ic biological changes, while in APA the goal persons with disabilities in mainstream is promoting activity across the lifespan; sporting activities at all levels; • The intervention is mostly identi- • To ensure that persons with disabilities BODY FUNCTIONS fied as treatment in PT, compared to have an opportunity to organize, devel- & STRUCTURES ACTIVITY PARTICIPATION (Limitation) (speaking, walk- (Restriction) (work, social, self-determined action in APA. op and participate in disability-specific (Impairments) (bones, liga- ing, jumping, etc) athletic, etc roles) sporting and recreational activities and, ments, muscles, sensation, to this end, encourage the provision, on The Benefits of Sport and circulation, etc.) an equal basis with others, of appropri- APA in Rehabilitation ate instruction, training and resources;

As with the general population, physical activ- • To ensure that persons with disability reduces the risk for chronic illnesses and ities have access to sporting, rec- secondary conditions for persons with disabil- reational and tourism venues; ities (Durstine et al., 2000; Heath & Fentem, • To ensure that children with disabilities ENVIROMENT FACTORS 1997). However the benefits of participation in PERSONAL FACTORS have equal access with other children to (living conditions, occu- sports and APA reach beyond physical rehabil- (age, comorbidities, person- participation in play, recreation and lei- pational situation, social itation (Parnes and Hashemi, 2007), improving ality, etc) sure and sporting activities, including circumstances, climate, etc) independence and empowerment, increasing social those activities in the school system; integration and inclusion, and helping to change attitudes among members of the society in gen- • To ensure that persons with disabilities have eral (Burchell, 2006; Capella-McDonnall, 2007; access to services from those involved in Sherrill, 2004). the organization of recreational, tourism, leisure and sporting activities (UN, 2006). APA and sport promotes rehabilitation through social networks between those who share similar life experiences and through teaching how to function with relative autonomy (Lindemann & Cherney, 2008), this happens in both causal recreational activity as well as elite disabil- Figure 3: ICF example adopted from ‘WHO, How to use the ICF: A practical manual for using the ICF’ (2013). EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 80 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 81

Key Area Key Role Key Functions EUSAPA Functional MAP - Rehabilitation D. Assessment D.1. Evaluate the effects D.1.1. Monitor the long term health related out- & Evaluation of the Adapted Physical comes of the Adapted Physical Activity programme. The EUSAPA (2010) developed functional guidance Activity programme as a part D.1.2. Determine the effects of the Adapted Physical Ac- of the rehabilitation and for the design and implementation of APA in re- tivity programme on functional ability of the patients/ post-rehabilitation process. habilitation, consisting of four key areas: clients in collaboration with rehabilitation team. D.2. Evaluate the pa- D.2.1. Assess and evaluate the patient’s / client’s physical and psy- tient’s/client’s response chological well being and its progress, and remediate if necessary. to physical activity, his/ Key Area Key Role Key Functions D.2.2. Assess the motivation of the patient/client toward the her progress, and compare A. Planning A.1. Assess the role and A.1.1. Identify the responsibilities of the APA programme Adapted Physical Activity programme, and remediate if necessary. with the preset goals. added value of an Adapted as a complementary part of the rehabilitation programme. D.2.3. Monitor and assess the responses to physical ac- Physical Activity programme A.1.2. Identify the strengths and weaknesses of the cur- tivity to ensure safe and successful participation. within the multidisci- rently used rehabilitation and APA programme. plinary character of the D.2.4. Document individual development and progress accord- rehabilitation programme. A.1.3. Identify the available and required resources (fa- ing to the aims of the rehabilitation and the APA programme. cilities, equipment) to implement the APA programme. D.2.5. Identify tools, methods, etc… to optimise the patient’s / cli- A.1.4. Develop a structured Adapted Physical Activity pro- ent’s functional abilities in daily life and in physical activity. gramme in collaboration with rehabilitation team.

A.1.5. Identify the short and long term aims of the Adapted Physical Activity programme. Table 3: EUSAPA Functional Map – Rehabilitation, adapted from EUSAPA (2010) Appendix 3. A.2. Assess the (dis) A.2.1. Understand the condition of the patients / cli- abilities, risk factors, ents and its consequences in terms of function- needs and potential of al (dis)abilities, health conditions, etc... • Limited accessible transportation the patient / client. European Opportunities for Participation A.2.2. Understand clinical investigation data (e.g. X-rays, • Limiting psychological and sociological gait analyses, cardiorespiratory tests) and the conclusions and recommendations of rehabilitation specialists. A detailed list of European organisations, factors including attitudes towards dis- campaigns and initiatives providing people with ability of parents, coaches, teachers and A.2.3. Assess the patient’s / client’s current and potential level of functioning. disabilities opportunities to participate in even people with disabilities themselves sport can be found in the Council of Europe’s A.2.4. Understand the patient’s / client’s response to • Limited access to information and resources physical activity; identify and remediate potential con- ‘Good Practice Handbook, No. 3 – Disability traindications, health risks and risk factors. Sport in Europe, Learning from experience’: B. Education & B.1. Educate patients / B.1.1. Educate the patient / client about his/her functional (dis) Different. Just like you. A psychosocial ap- Information clients about their (dis) abilities, response to exercise, potential health risks, risk http://unescoittralee.com/wp-content/ proach promoting the inclusion of persons with abilities and potential factors and contraindications with regards to physical activity. uploads/2015/04/Disability-Sport-in-Eu- disabilities. through physical activity. B.1.2. Educate the patient / client about the recog- rope-Good-practice-handbook.pdf nition and remediation of symptoms that potential- This Danish Red Cross handbook (2015) provides ly lead to health risks, injuries, etc... practical guidance for organisations and profes- B.1.3. Educate patients / clients about the APA pro- sionals on how to facilitate safe and inclusive gramme and its benefits during rehabilitation. 4.2.5. Challenges that sport and APA: B.2. Provide the appro- B.2.1. Inform the patient / client about communi- https://www.icsspe.org/sites/default/files/Dif- priate information to ty based physical activity programmes, and the short Organisations Face guarantee a continuation and long term benefits of physical activity. ferent.%20Just%20like%20you.pdf of an active lifestyle B.2.2. Provide a database with information regarding com- post rehabilitation. panies and community based organisations to ensure a con- Some common barriers to inclusion in sporting tinuation of an active life style post rehabilitation. activities for people with disabilities have Safety

B.2.3. Provide information regarding legislation about possible been identified as (DePauw & Gavron, 2005; Hut- benefits from national, regional and local governing bodies with zler & Sherrill, 2007): • Wherever possible, select locations that respect to physical activity and sports post rehabilitation. are screened off from the general public. C. Implementation C.1. Implement an individual- C.1.1. Develop a structured and individualised APA pro- • Lack of early experiences in sport (this var- • Before activities begin, all facilita- ised Adapted Physical Activi- gramme in collaboration with the multidisciplinary team. ies between individuals and whether a disabil- ty programme complementary to tors, helpers and participants should do C.1.2. Facilitate and optimise participation the other disciplines within ity is from birth or acquired later in life) through adaptation of the instructions, encourage- a safety check on the playing field. Dan- the rehabilitation programme. ments, rules and settings when appropriate. • Lack of understanding and awareness of how to gers might include glass, garbage, plas-

C.1.3. Initiate community based physical activity. include people with a disability in sport tic bags and wrappings, animal excrement, sharp rocks, wood or any other debris that • Limited opportunities and programmes for could cause injury to participants. participation, training and competition • Use locations that are safe for all us- • Lack of accessible facilities, such ers (e.g. stay away from rivers, em- as gymnasiums and buildings bankments, cliffs, roads, etc). EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 82 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 83

• Make sure there is enough space for all • Be creative and explore new and unconven- OPEN • Obese individuals with at least moderate of the participants to do the activity. tional methods to ensure that every ses- ryone can pl cardio respiratory fitness have lower rates of eve ay sion is fun and rewarding for all. cardiovascular disease (Blair & Church, 2004). • Make sure there is enough equipment for ITY BIL S everyone and that it is the correct equip- • Be aware that there are different impair- A PO • 40% of all cancers may be prevent- S R c I h T a ment for the activity wherever possible. ment groups (blind, deaf, learning disabled M ed by a healthy diet, physical ac- / E D n

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h l y a s c The Inclusion Spectrum i be available, wherever possible. • Exercise can be effective in improving mental well-being largely through improved mood • First aid kits should be available and Developed by Black and Stevenson (2011), this PAR EL a ALL and physical self-perception (Fox, 1999). all facilitators trained in using them. model (figure 2.) is now widely used for the de- bility groups sign and implementation of inclusion for all in • Be aware of participant’s pre-existing physical education and sport. Parnes & Hashemi (2007) highlighted the health health conditions (e.g. asthma, diabe- Figure 4: The Inclusion Spectrum incorporating STEP benefits of physical activity specifically for tes), psychological/emotional problems or The model classifies activities into 5 differ- (Black & Stevenson, 2012) adapted from England Athlet- persons with disabilities: current illnesses or risk conditions. ent groups based on the level of adaptation ics: https://www.englandathletics.org/shared/get-file. • Always plan each session and ensure that the required: ashx?itemtype=document&id=10176 • Persons with Disabilities share many traits activities are suitable for the participants. with the general population, suggesting that 1. Open – minimal or no adaptations to the the positive effects of physical activity on • Rival groups should not be involved in environment or equipment; open activi- cardiovascular diseases are also attributable. competitive games. If competitive games ties are by their nature inclusive so that 4.2.6. Development of are played, rival group members could • Individuals disabled by osteoarthritis the activity suits every participant. play in mixed teams. Choose activi- preventative and health of the knee may benefit from aerobic and/ ties carefully to promote cooperation. 2. Modified - everyone plays the same game or conscious habits or resistance exercise programs in the performs the same activity but the rules, areas of physical performance and pain • Make sure that participants choose team equipment or area of activity are adapt- management (Ettinger et al., 1999). members in a fair way and in a manner that Persons with disabilities have lower levels of ed to promote the inclusion of all indi- does not demean anyone. For example, if physical activity than their peers, consequently • Physical activity and sport participation re- viduals regardless of their abilities. two team captains choose team members in 38% of the population is obese (53% more than sult in improved functional status and quality turn, someone will be left at the end, feel- 3. Parallel - although participants fol- people without disabilities), and engage in low- of life among persons with selected impair- ing they are not wanted in any team. low a common activity theme, they do so er levels of physical activity. High costs for ments and disabilities (Heath & Fentem, 1997). at their own pace and level by working health services caused by overweight (increased • Be sure that there are enough facilita- • Children and adolescents with cerebral in groups based on their abilities. blood pressure, diabetes Type 2, Hypercholes- tors and helpers for each session so that palsy may benefit from physical activity terolemia, stroke, osteoarthritis, sleep apnea, the participants are supervised well and 4. Separate/Alternate - emphasises that, through improvements in strength and abil- etc.) are a huge problem for the European tax are not at risk of harm. Facilitators on occasions, it may be better for a ity to walk, run, jump and climb stairs payers. should be trained in risk management. person to practice sports individual- after participating in a strength-training ly or with their disabled peers. program (Dodd, Taylor & Graham, 2003). A review of the literature (Zakus, Njelesani & Inclusion 5. Disability/APA - ‘reverse integration’ where Darnell, 2007) on sport, physical activity and • Aerobic dance may affect cardiovascular non disabled people are included in disabil- health demonstrated: endurance of adults with intellectual dis- Organisers promote inclusion by building on in- ity sports together with disabled peers. abilities (Cluphf, O’Connor & Vanin, 2001). dividuals’ strengths and interests, rather than • Cardiovascular health benefits occur at • Physical activity may lead to improvements focusing on their impairments. STEP tool - enables organisers to adapt the moderate levels of physical activity and in physical health and well-being. Spe- The key elements in this approach are: activity across the key areas of Space, Task, increase at higher levels of physical ac- cifically, improvements have been noted in Equipment and People. tivity and fitness (General, 1996). coordination, postural alignment and nor- • Do not underestimate the person’s abilities. • Exercise is effective in the manage- malization of muscle tone, improved sitting • Have a plan for positive experiences by ment of diabetes, as it has been shown balance and strength and rhythmical move- setting challenging but achievable goals. to improve glucose homeostasis (War- ments of the upper body (DePauw, 1986). burton, Nichol & Bredin, 2006). • Have a flexible approach to coach- • Aerobic (endurance training) exercise is ing and communication that recog- • Both obesity and physical inactivi- effective in improving general mood and nizes individual differences. ty have similar patterns of associa- depressive and anxiety disorders in se- tion with clinical risk factors, such as lect psychiatric patients. There is no blood pressure (Blair & Church, 2004). harm associated with participation in EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 84 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 85

physical activity and exercise in these pist-led exercise programme specifically designed Capella-McDonnall, M. (2007). The need for health promotion Kudláček, M., Morgulec-Adamowicz, N., & Verellen, J. (2010). populations (Meyer & Broocks, 2000). for people with acquired brain injury, followed for adults who are visually impaired. Journal of Visual Im- European Standards in Adapted Physical Activities, 2010. pairment & Blindness, 101(3), 133. by workshops aimed at improving overall health Lee, J., & Haegele, J. A. (2015). A cross-disciplinary • Participation in sports and physical fitness and well-being. Cherney, J. L., Lindemann, K., & Hardin, M. (2015). Research comparison of published articles: Adapted physical activity activities has been associated with three em- in communication, disability, and sport. Communication & and special education. European Journal of Adapted Physical powerment outcomes: perceived competence as a Sport, 3(1), 8-26. Activity, 8(1). Tom’s wife describe the timing of the programme social actor; facilitation of goal attainment as “a god send, both physically and mentally for Cluphf, D., O’Connor, J., & Vanin, S. (2001). Effects of Lindemann, K., & Cherney, J. L. (2008). Communicating in (including setting and pursuing goals, deter- aerobic dance on the cardiovascular endurance of adults with and through “Murderball”: Masculinity and disability in Tom.” Since starting the programme Tom has made mination, and competitiveness); and social intellectual disabilities. Adapted Physical Activity Quarter- wheelchair rugby. Western Journal of Communication, 72(2), tremendous progress and reports enjoying “being ly, 18(1), 60-71. 107-125. integration (including bonding, broadening part of a group that share similar experiences.” social skills and experiences, and increased CRPD, U. (2007). United Nations Convention on the Rights of Lorenzen H. (1961). Lehrbuch des Versehrtensport [Textbook of Persons with Disabilities. UN, New York. disabled sports] Stuttgart (Germany): Enke Verlag. social inclusiveness) (Blinde & Taub, 1999). Having just been signed off to walk up and down Council of Europe. (1992). The European Sport’s Charter. Meyer, T., & Broocks, A. (2000). Therapeutic impact of the stairs independently before commencing the Brussels: Council of Europe. exercise on psychiatric diseases. Sports Medicine, 30(4), Romano-Spica et al., (2015) highlighted that programme, Tom is now jogging for the first time 269-279. Council of Europe. (2001). The European Sport’s Charter (re- advances in APA technologies and the scientific since his injury and reports using the ‘SMART’ vised). Brussels: Council of Europe. Newell, K. (1986). Constraints on the development of coordi- evidence to date indicates physical activity is goals discussed in the Sports 4 U workshops to nation. Motor development in children: Aspects of coordina- DePauw, K. P. (1986). Research on sport for athletes with tion and control. a priority tool in the prevention of multifacto- increase the distance he walks outside of the disabilities. Adapted physical activity quarterly, 3(4), rial diseases and sedentary lifestyle. programme. 292-299. Parnes, P., & Hashemi, G. (2007). Sport as a means to foster inclusion, health and well-being of people with disabili- DePauw, K. P., & Gavron, S. J. (2005). Disability sport. Human Incorporating sport and APA into rehabilitation “I now have the confidence to go places we hav- ties. Literature Reviews on Sport for Development and Peace, Kinetics. 124. services as well as post-rehabilitation com- en’t been since my injury, like the cinema… and Dodd, K. J., Taylor, N. F., & Graham, H. K. (2003). A random- munity services, as outlined in this chapter, to sign up for another physical activity pro- Rasmussen, T. J., Wiedemann, N., Kryger, L. S., Koenen, K., ized clinical trial of strength training in young people with Trimmel, J. & Boersma, M. (2015). Different. Just like you: A provides an effective means of improving the gramme with the GP.” cerebral palsy. Developmental medicine and child neurolo- psychosocial approach promoting the inclusion of persons with physical activity levels of persons with dis- gy, 45(10), 652-657. disabilities. International Federation of Red Cross and Red abilities, ultimately improving the health and “We were able to visit our son in Scotland, Durstine, J. L., Painter, P., Franklin, B. A., Morgan, D., Crescent Societies Reference Centre for Psychosocial Support well-being of this population. our next goal is to visit our son who lives in Pitetti, K. H., & Roberts, S. O. (2000). Physical activity (PS Centre). Retrieved at: http://www.attiva-mente.info/1. pdf, 15.8.2018 America.” for the chronically ill and disabled. Sports Medicine, 30(3), 207-219. Romano-Spica, V., Macini, P., Fara, G. M., & Giammanco, G. (2015). Adapted Physical Activity for the Promotion of Health Case studies Tom’s wife said “we couldn’t speak highly enough Ettinger, B., Black, D. M., Mitlak, B. H., Knickerbocker, R. K., Nickelsen, T., Genant, H. K.,... & Glüer, C. C. (1999). and the Prevention of Multifactorial Chronic Diseases: the of Brain Injury Matters and the work they have Reduction of vertebral fracture risk in postmenopausal women Erice Charter. Ann Ig, 27(2), 406-14. been doing; we would thoroughly recommend the Tom, 64 with osteoporosis treated with raloxifene: results from a Seymour, H., Reid, G., & Bloom, G. A. (2009). Friendship in Sports 4 U programme to anyone in a similar 3-year randomized clinical trial. Jama, 282(7), 637-645. inclusive physical education. Adapted Physical Activity Quar- In 2016, Tom suffered a brain injury and un- situation.” EUFAPA (2006). Bye-laws. Retrieved from: http://www.eufapa. terly, 26(3), 201-219. derwent two brain surgeries. As a result he eu/index.php/eufapa/bylaws, 15.8.2018 Reed, E. S. (1988). James J. Gibson and the psychology of initially lost all mobility and suffered facial Fox, K. R. (1999). The influence of physical activity on mental perception. Yale University Press. paralysis, affecting his ability to swallow. Tom Reference well-being. Public health nutrition, 2(3a), 411-418. Sherrill, C. (2004). Young people with disability in physi- spent 5 months as an inpatient in hospital. When General, S. (1996). Physical Activity and Health: A Report cal education/physical activity/sport in and out of schools: being discharged from hospital Tom was able to Ashton-Shaeffer, C., Gibson, H. J., Autry, C. E., & Hanson, C. of the Surgeon General. Atlanta, GA: US Department of Health technical report for the world health organization. Geneva: walk with support for very short periods of time S. (2001). Meaning of sport to adults with physical disabili- and Human Services, Centers for Disease Control and Preven- The World Health Organization. ties: A disability sport camp experience. Sociology of Sport in the home, but required the use of a wheel- tion. National Center for Chronic Disease Prevention and Sherrill, C., & Hutzler, Y. (2008). Adapted physical activity Journal, 18(1), 95-114. Health Promotion. chair when travelling outside. sciences. Directory of sport science, 89-103. Black, K., & Stevenson, P. (2011). The inclusion club. Heath, G. W., & Fentem, P. H. (1997). Physical activity among Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health persons with disabilities--a public health perspective. Exer- As a result of his injury Tom experienced left- Blair, S. N., & Church, T. S. (2004). The fitness, obesity, and benefits of physical activity: the evidence. Canadian medical cise and sport sciences reviews, 25, 195-234. association journal, 174(6), 801-809. side weakness and had difficulties with memory, health equation: is physical activity the common denomina- tor?. Jama, 292(10), 1232-1234. Hutzler, Y. (2010). Adapted Physical Activity and Sport in concentration and fatigue. He now needed support World Health Organization. (2011). World report on disabili- Rehabilitation. International Encyclopedia of Rehabilitation, Blinde, E., & Taub, D. (1999). Personal empowerment through ty: World Health Organization. in performing everyday tasks such as getting 2010. sport and physical fitness activity: Perspectives from dressed, cutting food and tying his shoe laces. World Health Organization. (2013). How to use the ICF. A male college students with physical and sensory disabili- Hutzler, Y., & Sherrill, C. (2007). Defining adapted physical practical Manual for using the International Classification of ties. Journal of Sport Behavior, 22(2), 181. activity: International perspectives. Adapted Physical Activ- Functioning Disability. Health. Geneva. “I was motivated to improve my mobility as I ity Quarterly, 24(1), 1-20. Burchell, A. (2006). The Importance of Sport to the Disabled. Zakus, D., Njelesani, D., & Darnell, S. (2007). The use have two sons who live abroad that I would like The Commonwealth Health Minister’s Book, 2006. Jackson, E. L., Crawford, D. W., & Godbey, G. (1993). Negotia- of sport and physical activity to achieve health objec- to be able to visit… but I lacked the confidence tion of leisure constraints. Leisure sciences, 15(1), 1-11. Bufka, L. (2009). International Classification of Functioning, tives. Literature reviews on sport for development and Peace, to engage in physical activity.” Disability and Health: APA Update. Spotlight on Disability Jackson, S., & Scott, S. (1999). Risk anxiety and the social 48. Newsletter, May 2009. Retrieved from: construction of childhood. Risk and sociocultural theory: New The Community Brain Injury Team Physiotherapist http://www.apa.org/pi/disability/resources/publications/news- directions and perspectives, 86-107. letter/2009/05/icf.aspx informed Tom of Brain Injury Matters’ Sports 4 Kiphard, E. (1983). Mototherapie–Teil I. Modernes Lernen, U programme. Sports 4 U involves a Physiothera- Dortmund. Pla 5. nniNg aN adaptiVE PhySIcal ACTiviTy

Learning outcomes:

• Familiarise readers with what needs psychological preparation and strategies to be focused on when planning APA to prepare athletes with disabilities

• Familiarise readers with common principles • Define the importance of motivation and goal of preparation for competitive sports setting in the process of mental preparation

• Gain knowledge of recommendations for • Familiarise readers with the importance of fa- managing risks in adapted sports cilitating physical activities for people with disabilities and identify obstacles they face • Highlight and understand risk factors when planning APA for people with disability • Getting familiar with devices and equipment used by persons with disabilities • Recognise professionals assump- when performing physical activity tions, attitudes and beliefs, analysing them and challenging them • Defining the impact of technological development and the use of modern devic- • Practical examples and strategies in the es and equipment on the integration process of maintaining boundaries of people with disabilities into var- • Familiarise readers with the importance of ious adapted sports activities EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 88 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 89

Persons with a disability can participate in sports for able bodied persons but they may need additional equipment or adaptations. Not all sports are appropriate for everyone. Certain sports can be recommended and appropriate for certain disability. We can also find sports developed specially for people with certain disability, for example goalball for blind (Burger, 2010). 5.1. hOW tO plan 5.1.1. How to choose sports? In the “Participation possibility chart” we can find some of the major physical disabilities and major sporting activities. It was developed by The American Academy of Orthopaedic Surgeons (Adams ADAptIVe Phys- 1991, v Burger 2010). There are very few sports where adaptations are not possible and people with disabilities will not be able to participate. ICal ActivITy

PARTICIPATION POSSIBILITY CHART

AUTHORS: VALENTINA BOLŠEC, JASNA VEŠLIGAJ DAMIŠ

Key words: physical activity, adaptation, Archery Bicycling Tricyclinh Bowling Canoeing/kayaking Diving Fencing Field events* Fishing Golf Horseback riding shooting Rifle Sailing Scuba diving ice) & (roller Skating (downhill) Skiing (cross-country) Skiing Swimming Table tennis Tennis (wheelchair) Tennis Track (wheelchair) Track Weight lifting Wheelchair poling Baseball Softball Basketball (wheelchair) Basketball (tackle) Football (touch) Football (Whellchair) Football Ice hockey Sledge hockey Soccer (wheelchair) Soccer Volleyball persons with disability, sports, barriers AMPUTATIONS

Upper Extremity RA R R R RA R R R R RA R A R R R R R R R R R R R R R R R R R R

R R R R Active living means integrating physical activ- Lower Extremity (AK) R R R R R R I R R R R R R R I A A R R I R R R R A A R I I R R I R R ity into daily routines. Our body was meant to Lower Extremity (BK) R R R R R R R R R R R R R R R R R R R R I R I R I R R R I R R I I I R I R move and be physically active. Physical activ- CEREBRAL PALSY ity includes walking or cycling for transport, Ambulatory R R R R R R I R R R R R R I R RA RA R R R R R R R I I I I R R dancing, traditional games and pastimes, garden- Wheelchair R I I R R I I I R I I R R I R R R R R I I R R I R I ing and housework as well as sport or deliberate SPINAL CORD DISRUPTION exercise (Edwards and Tsouros, 2008). Cervical RA RA RA IA I R X RA R IA IA R RA IA R I I I I IA Any physical activity, movement and participa- High-thoracic (T1-T5) R R R R RA R R RA I R R R IA IA R R R R R R RA RA R R R R RA tion in sports can be beneficial as it has posi- Low thoracolumbar (T6-L3) R R R R RA R R RA R R R R RA RA R R R R R R RA RA R R R R RA tive effects on our health which is particularly Lumbosacral (L4-sarcal) R R R R R R R R R R R R R I R R R R R R R R R R R I I R I I R R important for people with disabilities. When we NEUROMUSCULAR DISORDERS are planning physical activity for people with Muscular dystrophy RA I R R I I R R R I RA R I I I I R R I I I I R I I I I I I I I I I disability, we refer to it as adapted physical Spinal muscular atrophy RA I R R I I R R R I RA R I I I I R R I I I I R I I I I I I I I I I activity (Reid, 2003). Charcot-Marie-Tooth R R R R R R R R R R R R R R R R R R R R R R R R R R R I R R

When we are planning physical activity for peo- Figure 5: https://www.birmingham.ac.uk/Documents/college-les/ Ataxias R I I R I I R R I I R R I I I R R R R R I R I R I I I R I I I I I R I ple with disability particular attention must be sportex/Physical-Activity-Disability-Infographic.pdf OTHERS paid to the adaptation of certain areas. Osteogenesis imperfecta R I R R R I R R R I I R R I I I R R R R R R R I R I I I R X I I X X X R I

Arthrogryposis R I I R R I I R R I R R R I I I R R R R R I R R R X R I I I R

Juvenile rheumatoid arthritis RA I I RA R I I I R I I R R I I I I R R I I I I I I I I I I I I I I I I I I 5.4.7. What do we adapt? Hemophilia RA R R R R R R R R R R R R R I I R R R I R I I R R X I X I R Skeletal dysplasias R R R R R R R R R R R R R R R RA R R R R R I R R R I R R R R • Environment • Rules

• Equipment • Exercises * Clubthrow, discus, javel, shotput Table 4: Participation possibility chart. Adams, 1991 • Sport/play games • Age adaptation – early childhood to R = Recomemended elderly (Wittmannová, 2018). I = Individualized A = Adapted X = Not Recommended EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 90 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 91

Figure 6: PAIE model for planning an Adaptive Physical Ac- • What new skills will an individ- ment, assessment of progress and testing for 5.1.2. Barriers tivity (Vešligaj Damiš, 2018) ual learn in this program? classification in sport (Kasser & Lytle, 2013). Evaluation can be performed by standardized • Is it possible and needed to improve the in- When planning sports activities for persons with tests (tests, questionnaires or scales) or by structions for an individual in this program? disabilities, we also have to refer to different The first component of the PAIE model is plan- non-formal testing (recording, task analysis, barriers. Bragaru et al, 2013, exposed some fac- ning of a sports program or sports activities. • How will his/her quality of life be im- behavioral observation, communication, use of tors that are negatively associated with partic- It involves making decisions about the choice proved after joining the program? support technology, etc.). ipation in sports: of sport - according to the wishes of the athlete with disabilities and according to his/ It is necessary to take into account that we The third component of the PAIE model is the • Technical barriers can include fac- her abilities and consideration of the personal can achieve a better motivation of athletes implementation of sports programs and learning. tors related to transportation, pros- characteristics of an athlete with disabilities, with disabilities by including new activities, Athletes with disabilities actively carry out thesis, information etc. decisions about necessary adaptations, manage- working with athletes without disabilities or the chosen sports activity and gain experi- ment of obstacles and risk analysis. practicing with music. Greater persistence in ence based on their assessed needs. In the case • Social barriers include lack of sup- training can be promoted by the fact that the of involvement in sport, we are talking about port in interactions with so- When planning a sports program or sports activ- participant receives admiration and award when choosing: today, participants should have the cial groups or sports partners ities we must take into account the specifics of he reaches the goal or we can help ourselves option of choosing, and the disabled person has • Personal barriers include factors re- the individual disability as well as the recom- with modern technology, for example, interac- the opportunity to participate in sports activ- lated to physical health or psychologi- mendations for prescribing exercise (frequency, tive computer games involving physical activity ities and sports together with peers without cal attributes and even time management intensity, duration). In addition to general (Saunders, 2016). disabilities and competitors or in separate knowledge in the field of sports, trainers must environments. Accessible activities cover a • There are also many other barriers that also be equipped with knowledge of the specific- Regular physical exercise of the appropriate range of opportunities ranging from “involvement influence participation in sports: older ities of people with disabilities and know the intensity and frequency in people with disabil- in conventional circumstances” to “inclusion age, poor weather, high cost and others. importance and possibilities of physical exer- ities may be hampered by a number of factors. in opportunities for specific disabled people” cise for persons with disabilities. Personal factors include depression, fatigue, (Kiuppis, 2018). A more detailed description and distribution lack of interest, poor perception, inadequate of barriers can be found in the chapter 5.3.5. If sport activities for people with disabilities self-assessment of one’s own abilities, negative The last component is an evaluation that is done Challenges for Facilitators and Service Users. are well planned, they are safe and appropriate values related to physical exercise, fear (from for both athletes with disabilities as well for them and what is important, athletes show falling, to defeat, etc.). Among environmental as for sports programs and activities. It is personal satisfaction in achieving personal factors it is very important that the individual important to check if the program is appropri- goals in sports. For athletes with disabilities, has family and social support. It is also im- ate, satisfies the athlete with disabilities and 5.1.3. How to Plan an Adaptive sport activity is planned according to their portant that training centers are available and allows him/her to achieve their set goals. On Physical Activity? functional abilities, physical capacity, inter- that transport and exercise costs are low. the basis of the evaluation, proposals for the est and accessibility. It can take place in the necessary changes will be made. gym or outdoors, individually or in groups. Sports training also bring a certain risk for Planning an Adaptive Physical Activity can be people with disabilities. Therefore, it is important to make a risk analysis in prepara- Reference When planning a sports program, we tion of the sports program, which covers all

PROGRAM are looking for answers to a num- the possible dangers of the sporting, physical Bragaru, M., Van Wilgen, C. P., Geertzen, J. H., Ruijs, S. G., PLANNING ber of important questions, such as: exercise for people with disabilities. We base Dijkstra, P. U., & Dekker, R. (2013). Barriers and facilitators of participation in sports: a qualitative study on our assumption on the fact that the benefits of Dutch individuals with lower limb amputation. PLoS One, 8(3), • What are the current competencies of an sports activities outweigh the risk. e59881. individual - an athlete with a disability? Burger, H. (2010). Sport for disabled. In M. Kovač, G. Jurak The second component of the PAIE model is the • What kind of activity is appro- and G. Starc (ed.), Proceedings of the 5th International Con- EVALUATION - assessment, which includes the systematic progress Youth Sport 2010 (29-30). Ljubljana: Faculty of Sport, PERSON WITH ASSESSING priate for this individual? PERSON, PROGRAM DISABILITY cess of observing the athlete with disabilities, University of Ljubljana • What skills and abilities need to be on the basis of which his needs and progress are Edwards P, Tsouros AG. (2008). A healthy city is an active evaluated for this individual? determined. It is a multi-faceted approach of city: a physical activity planning guide. World Health Orga- gathering information on the success and ability nization Europe. • What kind of interests does an ath- of an individual. It is an integral part of the Kasser, S.L., Lytle R.K., (2013), Inclusive Physical Activ- lete with disabilities now have and IMPLEMENTA- effective implementation of physical activity. ity-2nd Edition, Human Kinetics, Human Kinetics Europe Ltd, TION PLANING what will he have in the future? United Kingdom) AND TEACHING This is a continuous process that takes place • How effective is the program in satis- before, during and after the implementation of Kiuppis, F., & Kurzke - Maasmeier, S. (2012). Sport Im Spiegel Der UN-Behindertenrechtskonvention [Sports Reflected fying the needs of this individual? the program (Kasser & Lytle, 2013). in the UN-Convention on the Rights of Persons with Disabili- • Will the individual achieve any bene- ties: Interdisciplinary Approaches and Political Positions]. demonstrated using a cyclic model: The assessment covers several areas: screening, Stuttgart: Kohlhammer. fits from participating in this program? decision about support, planning and develop- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 92 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 93

Reid, G. (2003). Defining Adapted Physical Activity. In R. D. Steadward, G. D. Wheeler and E. J. Watkinson (ed.), Adapted Physical Activity (11-25). Canada: The Univerity of Alberta Press

Saunders, D.H., Sanderson, H., Hayes, S., Kilrane, M., Greig, C.A., Brazelli, M., Mead, Ge. Physical fitness training for stroke patients. Cochrane Database of Systematic Reviews 5.2. 2016: CD003316. DOI: 10.1002/14651858.CD003316.pub6.

Wittmannová, J. (2018). Šport za vse: opolnomočenje strokovnih kompetenc z izobraževanjem o prilagojenih športnih CompetITiON aktivnostih. In M. Pajek (ed.), 13. kongres športa za vse, športna rekreacija invalidov (17-22). Ljubljana: Olimpijski komite Slovenije–Združenje športnih zvez iN SpoRTs Figure 5: https://www.birmingham.ac.uk/Documents/college-les/ sportex/Physical-Activity-Disability-Infographic.pdf Re- trieved 12.2.2019 at 9:25

Table 4: Adams R.C., Mc Cubbin J.A. (1991). Games sport, and exercise for the physically disabled. London: Lea & Febiger AUTHOR: LADISLAV MESARIČ

Key words: competition, weather conditions, overload, principle of specificity, principle of progressive development, continuity principle, principle of individuality

Experts acknowledge the importance of sports account both in the choice of sport and in the and recreation in the successful rehabilitation choice of training assets. Every chosen sport of people with different types of disabilities. has its own laws and necessary adjustments. Adapted sports and recreational activities offer In any case, the general principles of sports an opportunity for success in a very short time. training apply to all athletes, with or without Success has a positive impact on self-esteem disability. and focus on opportunities, rather than dealing with what is no longer possible. The ability Many authors have defined different principles to participate in sport offers the opportunity that basically overlap. As a rule, they refer to to reunite with family and friends in a joint the frequency, intensity, duration and type of venture (Sherrill, 2003). sports activity. Frequency describes how often a person deals with a certain sport activity. People get engaged in various sports activities The intensity of the exercise is the strength in order to improve their health, well-being and with which the individual perform a sport. It working abilities. Many of them are not satisfied represents a key point in training planning. with just being active. They want to compare It depends on the maturity of the individuals their abilities with others at sports compe- involved, the current form, the personal goals titions. Increased interest in sports has led of athletes and many other factors. The duration to the development of competitive systems for describes how long the training should last to people with disabilities. Different regulations get the proper results. The duration is inverse- and classifications have been developed for indi- ly proportional to the intensity of training. We vidual sports, enabling people with disabilities cannot train for a long time at a high level of to compete under the same conditions. The clas- intensity. However, the development of aerobic sification of disability is numerous and diverse, abilities requires a longer duration with an some are based on the cause of disability, appropriate lower intensity. The type of exer- others on the affected body parts such as arms, cise relates to the way or form of how a sports legs, heart etc. (Aleksandrović, 2016). exercise is performed. Aerobic abilities can be practised by walking, cycling and other contin- Dealing with competitive sports irrespective of uous activities. We can gain power with weights, gender and age requires proper preparation for exercises with our own weight, and other exer- competition. In the case of persons with dis- cises where we overcome external resistance. abilities, specific limitations arising from the Different types of exercise are crucial for nature of their disability should be taken into involving different people into sports activi- account. These limitations must be taken into ties, each meeting their own needs and goals. Of EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 94 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 95

Training General recommendation course, different sports disciplines have their Continuity principle Recommendations for exercising variables own specific features. However, this principle individual motor skills Frequency 3-5 per week is well established (Ayers & Sariscsany, 2013; Sports training should be carried out regularly Intensity 55-90% of maximum heart rate (de- Bompa & Haff, 2009). so that we can get proper results. As the organ- in an adaptive sports pending on the abilities) ism gradually adjusts to the load and reaches exercise programme Duration 15-60 minutes (in time it The most common are the following principles the appropriate fitness level, at reduced activi- could be increased) (Ayers & Sariscsany, 2013): ty body is adapted to it and the fitness reduces. Type Walking, running, swimming … This training principle helps to understand why The following tables describe the application of continuous activities lifelong sport activities are so important. training principles for flexibility, strength and Overload Increased speed, time or temp aerobic endurance. Progress We predict gradual prog- The overload principle ress in the individual plan. The mobility and extent of movement depend on The principle of overload refers to the fact Principle of individuality various factors. These may be anatomical (joint Application of training principles for training aerobic that the individual needs to be burdened more shape, tendon characteristics) or are condi- abilities (Kasser, 2013) than usual for it to make changes or positive People who are involved in sports have different tioned by neuromuscular factors. The latter adaptation to the training. Progress is achieved physical characteristics and biological poten- are common in adapted sports practice (e.g., by the gradual burden of physical systems with tials for change. Coaching takes into account a spasticity). The usual exercises for flexibility specific exercises and training schedule. Over- variety of factors and has different objectives. are performed in the form of static stretching Less is more load is a positive stress, which is achieved by Opportunity for individually selecting a sports (Kasser, 2013) increasing the intensity of training, increasing program is crucial for creating lifelong habits Successful training is not just the final goal. the number of training sessions, increasing the of engaging in sports. Training General recommendation The aim is to achieve optimal results with opti- variables duration of each training. mum amount of training. We do not need to train Frequency Before and after activi- until pain and injuries occur. Training is usu- ty, minimum 3x per week ally strenuous and often unpleasant, but pain is Intensity Individually depending on the abil- not a regular companion. If it occurs regular- Recommendations for ities, should not cause pain The principle of ly, it should be treated seriously. Unpleasant physical activity Duration 10-30 seconds, 2-3 repeti- progressive development tion of each exercise feelings in particular parts of the training may Type Static stretching, dimanic stretching occur due to the release of lactic acid, which Regardless of the above recommendations, it is as preparation for sports training monitors anaerobic activity, weight lifting and Good sports condition cannot be achieved in a necessary to know how many physical activities Overload Careful movement of the stretching interval training. Fatigue and pain may also oc- short time. Body systems have their own lim- we need in order to achieve our goals and conse- points, increasing of the number of cur due to micro-lesions in the muscles. Delayed itations in terms of the speed of adapting to quently adjust our training plan accordingly. repetition and duration of stretching muscular fatigue and pain that occur 24 hours or the training load. Loads must be gradual. If Progress Slow and easy progress, first big- more after activity are not a result of lactic a load increases in a short time, it can lead Physical activity that provides a variety of ger muscle groups, then extreme acid. Lactic acid is removed rapidly by the and small muscle groups. to fatigue and damage. By contrast, insisting health benefits consists of dynamic and rhythmic blood circulation quickly after the activity. on a certain degree of burden without a gradu- contractions of large muscle groups that trans- Application of training principles for flexibility (Kasser, Activity-related pain usually occurs after new al increase leads to stagnation as a result of mit the body at a distance or act against gravi- 2013) activities and in when some activities have not reduced adaptation to training. ty with moderate intensity over a long period of been performed for a long time and are probably

time in which the body consumes 200 to 400 kilo Training General recommendation related to the micro traumas of the muscles and calories (or 4 kilo calories per kilogram of variables connective tissue. body weight). For optimal health benefits, such Frequency 3-4 x per week with one day break Principle of specificity (aerobic) activity should be carried out every during the exercise days day or at least every other day, and should be Intensity Easy or medium 40-0% of the maximum effort The sports training program must be adapted to supplemented by strength and mobility exercises Duration 3-5 series, 3-7 repetition for strength Organization of training hours the desired result. Training improves only those (Haskell et al., 1985). and 12-20 repetition for endurance skills that we train and have a slight influence Type Exercises with own weight, ex- Each training session must be systematically or- on other abilities. We need to choose the ap- Competitors with higher ambitions need to find ercises with resistance ganized and consist of a warm-up, main training propriate exercises. It does matter, however, appropriate professional help. Overload For strength we gradually increase activity and cool down. This approach helps the which exercises we perform. If we want to im- the resistance, for endurance in- athlete to gradually prepare for the main loads crease the number of repetition or prove the strength of the hands, we will choose duration of repetition or decrease the and gradually reduce the load before the end of strengthening hand exercises, we will increase duration of break between series the training so that there are no fast transi- the mobility by stretching the part of the body, Progress Gradually as trying to avoid injuries tions from one part to another. where the mobility is reduced, and the aerobic abilities will be trained with long-term contin- Application of training principles for muscular strength and uous activities. endurance in strength (Kasser, 2013) EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 96 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 97

Warm-up The influence of the environment significantly more energy than in the normal season. In large cities with constant pollution, on the training process environment. Individuals who train in the cold an adequate alternative is indoor exercise with Warm-up is a low-intensity sports activity weather should have enough energy when they are an appropriate air purification system. Although that takes place before an intense main part of at risk. The feeling of fatigue is the first step polluted air is a serious problem in some plac- the training and serves for preparation of the Environmental effects, such as heat, cold, hu- to hypothermia. Cold wind increases the rate of es, cigarette smoke contains the highest amount body and mind to what follows in the main part. midity, altitude and poor air, can have a strong heat loss. Athletes can themselves cause the ef- of harmful substances. This irritates bronchial Regular and thorough implementation of warm-up impact on health and sports achievement. If we fect of cold wind, when on skies, skates as they pathways, reduces resistance to bronchial in- can significantly reduce the likelihood of sport do not pay attention to the environment, serious are rapidly moving towards the wind. In cases fections, causes bronchitis and hinder oxygen related injuries. problems can arise, which may end up with death. where you are dealing with sports in a cool transportation, causes lung disease, cardiovas- On the other hand, we can adapt to the circum- environment, you should be adequately protected, cular problems, and many other problems. Smok- stances, which makes it easier for us to work, especially the distal parts of the body, eyes ing unlike industrial pollution, is a matter of improves the effect, and helps us to survive and nose. People who regularly engage in sports personal choice. The main part of the training comfortably in different circumstances (Sharkey activities in the cold are psychologically and et al., 2008). physiologically adapted to low temperatures and The main part of the training is the key part enjoy winter activities despite the cold. It is Reference in which we acquire new knowledge and improve especially important that during winter activ- one or more components of the sports shape. By Sport activity in high- ities, due to sweating and breathing fluids lost Aleksandrović, M., Jorgić, B., Mirić, F. (2016). Holistički following the basic principles of training we er outdoor temperature are always replaced. For longer activities, it pristup adaptivnom fizičkom vežbanju, učbenik za studente master akademskih studija. Fakultet sporta i fizičkog vaspitanja, develop motor skills and elements of sports is also necessary to have an appropriate amount Niš. games. The main part can have one or two main During sports activity at high temperatures, we of calories from snacks and energy drinks. contents. can only regulate the temperature balance with Ayres, S.F. & Sariscsany, M.J. (2013) Fizičko vaspitanje za celoživotnu formu. Data Staus, Beograd circular adaptation and sweating mechanisms for a short time. The body absorbs heat when the Activities at a higher altitude Cox, H.R. (2005). Psihologija sporta, konceoti i prmjene, Naklada Slap, Jastrebarsko outside temperature exceeds the temperature of Final part of the the skin. When the air humidity is low, the heat Although a healthy person may not notice this; Haskell, W.L., Montoye, H.J., Orenstein, D. (1985). Activity and Exercise o Achieve Health-Related Physical Fitness Com- balance is controlled by sweating, and when the saturation of arterial oxygen decreases already training (cooling) ponents. Published in: Public Health Reports 100(2):202-12. humidity is high, the sweat does not evaporate at an altitude of 1500 m. But as we climb more, March 1985. quickly enough, the heat is not released quickly the pressure of oxygen in the lungs decreases as Kasser, S.L. & Lytle R. K. (2013). Inclusive Physical Activi- The final part of the training consists of enough, the temperature of the body grows and air pressure decreases. Under such conditions, ty: Promoting Helth for Lifestyle, Human Kinetics, Montgomery low-intensity activities and rests. It usually endangers the working abilities and in extreme oxygen cannot be properly attached to the blood, Sharkey, J.B. & Gaskill, S. E. (2008). Vežbanje i zdravlje, consists of continuous low-intensity aerobic cases the life of the athlete. Therefore, it only a small amount of oxygen is transferred to Data Staus, Beograd activity. Sometimes stretching is also included. follows from this that there is a logical advice the tissues, and these are forced to adapt to Sherrill, C.(2003). Adapted Physical Activity, Recreation, It is also recommended to do a short analysis of to avoid great efforts at high outdoor tempera- the new conditions. As a result, aerobic abili- and Sport: Crossdisciplinary and Lifespan, Mc Graw Hill, New the work done and to help further training. tures. If we cannot avoid high temperatures ties associated with endurance are always re- York and moisture, we must adapt to such situation. duced at higher altitudes. People who live in such environment are usually adapted to these conditions. People from dif- Athletes who train and live at normal altitudes Exaggeration and ferent backgrounds usually adapt within five to must prepare properly for performance at higher exercise dependence ten days. The key principal is hydration and the altitudes. They can do this by spending time in input of minerals. Liquids need to be introduced “climatic chambers”. These are rooms or chambers several times during the activity. Minerals can- that simulate high-altitude conditions. Athletes Although inactivity is a far greater problem, not be compensated by the introduction of clean should be at the competition location at least overloading during training can lead to over- water. Water rinses the minerals from the body. three weeks prior to the competition in order to training in active people. This is the state We can help with sports drinks rich in carbohy- adapt to the conditions properly. of the reduced ability of the immune system to drates and electrolytes. resist infection. Symptoms of overtraining are low motivation, fatigue, insomnia, poor results, Avoiding bad air loss of appetite and poor health. Symptoms come Activities in the cold gradually, so overtraining is difficult to de- Sport activity increases the amount of air we tect. The reasons may be the following: boring Since the metabolic processes of the human body breathe. Injuries due to bad air are propor- and overloaded training, rapid weight loss, produce heat during sport activities, low tem- tional to the amount of exposure time to the inadequate nutrition and inadequate hydration. peratures are not as dangerous as high. If ath- polluted air; therefore, they need to reduce the Overtraining is treated by reducing the volume letes are exposed to low temperatures for a long time of activity in a polluted environment or to and intensity of training, and in many cases time, frostbite can occur, and extreme exposures avoid such activities completely and find another with complete rest. may lead to hyperthermia and death. The intense option. Air pollution is different in many areas muscular activity in cold weather consumes and depends heavily on traffic, industry and EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 98 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 99

RISK FACTORS FOR INJURY INJURY MECHANISMS (DISTANT FROM OUTCOME) (PROXIMAL TO OUTCOME)

5.3. PREDISPOSED SUSCEPTIBLE INJURY ATHLETE ATHLETE risKS iN ADAptED

PhYsICal ACTivITy Internal risk factors: Exposure to external risk factors: Inciting event: • Age (maturation, aging) • Human factors (eg team • Joint motion (eg kinematics, • Gender mates, opponents, referee) joint forces and moments) • Body composition (eg • Protective equipment (eg • Playing situation (eg AUTHOR: LADISLAV MESARIČ, JASNA VEŠLIGAJ DAMIŠ, ZVONKA NOVAK body weight, fat mass, helmet, shin guards) skill performed) BMD, anthropometry) • Sports equipment (eg skis) • Training programme Key words: risk factors, prevention of injuries, regulation of temperature, risk • Health (eg history of previous • Enviroment (eg weather, snow • Match schedule assessment, risk management plan injury, joint instability) and ice conditions, floor and • Physical fitness (eg mus- turf type, maintenance) cle strength/power, maxi- mal O uptake, joint ROM) Fifteen percent of the world’s population lives anisms of occurring must be identified. Sports 2 • Anatomy (eg alignment in- with disabilities, many of whom decide to en- injuries are due to the complex interaction of tercondylar notch width) gage in sports. There are numerous obstacles to several risk factors and events, of which only • Skill level (eg sport, specific the participation of athletes with disabilities some are known (Bahr, Holme, 2003). technique, postural stability) Figure 7 : Risk factors for injury (Meeuwisse, 1994) in sports activities, and sports injuries can have a major impact on everyday life. Therefore, Therefore, studies on sports injuries require prevention of their sports injuries is extremely a dynamic model that takes into account several • It is recommended for the athlete to adapt important (Weiler, Van Mechelen, Fuller & Verha- factors of sports injuries, and considers the 5.3.2. Prevention of injuries to the environment. Athletes must gradually gen, 2016). The number of athletes with disabil- sequence of events that eventually lead to an adapt to exercise at an elevated temperature. ities who participate in organized sports and injury. One of these dynamic models, describing Many factors influence the prevention of injury At the beginning, they should practice in the popularity of the Paralympic Games are con- how injuries occur as a result of several fac- or reduce the risk of injury. Some are general light clothing in the cooler parts of the day. stantly increasing all over the world. Despite tors, is the one adapted according to Meeuwisse and do not depend on the type and degree of dis- They gradually expose themselves to heat for the growing interest and the fact that partic- 1994 (Bahr & Holme, 2003). The model is tested ability. The instructions for Special Olympics a short time and carry out activities even ipation in sports exposes athletes to certain on population without disability, but without contain the following actions: in the hotter part of the day, at the time risks of injury, there is little research about special adaptations can be used for the popula- when the competition takes place. If sport the types of injuries, risk factors and injury tion of athletes with disabilities. Only specific • An appropriate assessment of the fitness involves the use of heavier clothing and prevention strategies for athletes with disabil- definitions of individual expressions are needed. of athletes - the coaching staff must de- equipment, they must first adapt to wearing ities (Fagher & Lexell, 2014) termine the baseline for each athlete es- clothing under normal conditions only then The internal risk factors for persons with tablished on his/her fitness and skill. The in hot conditions. For all games and compe- disabilities are mainly the type and degree of type and complexity of the sport activities titions proper hydration must be maintained. disability. This defines the choice of sports that are taking place depends on this. 5.3.1. Risk factors and injuries activities and risk prevention measures during • They should also get gradually adapt- • The sports performance must be the backbone of sports activity. Among the external risk factors ed to low temperatures. They must learn the appropriate long-term preparation of ath- Traditionally, risk factors are divided into is sports equipment. For persons with disabili- to layer their clothes so that they can letes. The coach cooperates with the athlete, two main categories: internal risk factors and ties, the risk factor is the adequacy of equip- adjust their outfit to the temperature. healthcare staff, the family and other factors external environmental risk factors. It is im- ment adjustments. During the activity, it is If necessary, wear caps and gloves. that influence the long-term development of portant that we can divide the risk factors into necessary to pay due attention to the adapted the athlete. Individual must develop specif- • Competitions at higher altitudes require grad- dependent and independent variables or factors. program of sports training and competitions. ic skills and fitness for the chosen sport. ual adjustment that lasts 10 to 14 days. Exer- Although independent factors such as gender cise should be gradually increased in duration and age can be interesting, it is important to • Special healthcare guidelines and co- and intensity. Without gradual adaptation consider factors that can change with exercise, ordinated activities must be avail- they may experience altitude sickness, such such as power, balance or mobility. However, able for each individual. as nausea, dizziness and shortness of breath. this is not enough to determine internal and • A first aid kit should always be avail- external risk factors for sports injuries. For a • In order to prevent sun and snow blind- able at all trainings and competitions. complete understanding of the causes, the mech- ness due to strong sun athletes need EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 100 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 101

to wear dark glasses with side shields Basic information about specific safety aspects Due to limited access to sanitary facilities acoustic signal, it is necessary to replace the during outdoor activities. Glass- according to the type of disability (Coaching they have difficult access to water. Assisting acoustic signal with a visual one. es must have an ultraviolet blockade. Association of Canada, 2005) staff must ensure adequate hydration during sports activity. • If during sports activity athletes are exposed Athletes with acquired brain injury (ABI) to the sun, they must wear shades and t-shirts Athletes with intellectual disabilities with long sleeves. On exposed parts of the Athletes with mobility disad- The consequences of traumatic or non-traumatic body, such as the nose, ears, face, bald- Close co-operation between athletes, parents, vantages (amputated limbs) brain injuries are manifested in different ways. ness, lips, sun protection must be applied. guardians, trainers and assisting staff regard- Because, as a rule, two people do not have the ing the characteristics and needs of the athlete This group includes athletes with amputated same abilities, it is the task of the coach / Temperature Regulation is crucial. People with Down’s syndrome often limbs and athletes born without limbs. Caring facilitator of the sports activities to deter- have orthopaedic problems due to too much loose for the remaining part of the limb is the key mine what a person can or cannot do. Activities Dysfunction of the sympathetic nervous system, joint envelopes and reduced normal muscular ten- daily activity of athletes with amputated limbs. are carried out slowly by gradually increasing especially important for athletes with spinal sion (i.e., muscle tone). People with DS often Sport activity can cause additional wear on the the intensity, duration and complexity of the cord injury above the eighth thoracic vertebra, have foot problems. Hallux valgus is 2.5 times remaining limb and orthosis. In particular, it exercise. It is important to follow the needs, can cause significant problems in regulating more common than in the general population and is necessary to monitor the skin of the wound to abilities and wishes of individual athletes internal body temperature. These athletes cannot presents an increased risk of subsequent arthro- prevent possible infections. Suitable socks must with ABI, and that we can adapt the activities sweat effectively or have difficulty in vasodila- sis of the underlying joint of the thumb. Due to be used for remaining limb to keep it dry and to accordingly during the activity. In the chronic tion below the level of injury. This can lead to the flat feet of 2- 6% of children with DS, they prevent irritation, scabies and other injuries. period after brain injury, the lack of aware- difficult body thermoregulation, or the body is are more likely to get tired of walking, report- Athletes in wheelchairs should use helmets when ness and insight often impedes the involvement more difficult to cool by sweating or warm up by ing pain in the tibia. Difficulties can occur on beginning with sport. in activities. However this should not be an shaking and vasodilation. all joints due to increased mobility for exam- obstacle to one’s cooperation, as it can reason- ple on knee joint, unstable kneecap, hip, spine ably be expected that the state of awareness and Athletes with a significantly reduced body sur- (Leshing, 2003). It is necessary to determine if Athletes with cerebral palsy insight can be improved over time. Together with face, such as those with bilateral amputation, they have atlanto-axial instability. The insta- an athlete with ABI, we shape realistic expec- should also be considered. Medicines commonly bility in the joints between the nasal bone and Injuries to different parts of the brain during tations during setting goals that he/she can used by individuals with disabilities, such as the first and second cervical vertebrae is due pregnancy, at birth or in childhood are mani- actually achieve. We must also consider all the anticholinergics, sympathomimetics, diuretics, to loss of bonds. It is present in 80% of people fested in muscle weakness, paralysis, poor coor- clinical problems and disorders that are pres- muscle relaxants, and medicines that improve with DS, but for the vast majority of them (90%) dination and uncontrolled movement of the limbs. ent in people who suffer from brain damage. For thyroid function, can cause greater sensitivity it does not cause any problems. If they have not Individuals may also have intellectual disabil- this purpose in Center Naprej, we have designed to heat (Richter, Sherrill, McCann, Mushett and performed this examination or if instability is ities. As there are usually balance problems, recommendations for sports activities (with- Kaschalk, 1998). found, it is necessary to avoid activities such falls are a common risk that we must consider. in the framework of the ReSport project) and a as contact sport, diving, gymnastics, especially It is necessary to remove all potential obsta- risk assessment form, which we complete prior to sports activities with intense neck movements cles from the environment in which they are including an athlete with ABI in sports activity (Büchler, 2003). Congenital heart defects, un- moving. We need to avoid situations requiring (Vešligaj Damiš, 2017). It is important for all 5.3.3. Risks related to sports derdeveloped vascular system and low respiratory demanding movement control, and avoid contact facilitators to familiarize themselves with ABI activities by type of disability capacity are also possible. with other people and objects or perform these athletes and consider them during all sports with the extreme attention of the trainer. We activities. approach slowly to activities, such as climbing, Different types of disability are classified into Athletes with physical disabilities bicycle riding and similar consistently using wider categories, such as motor impairment, protective equipment. sensory impairment, and intellectual disability. These are athletes with impaired mobility 5.3.4. Risk assessment in Disability can be congenital (present at birth) caused by a spinal cord injury that prevents Adapted Physical Activity or acquired (not present at birth resulting from the transmission of nerve signals below the Athletes with sensory impairments acquired injury or disease). Coaches should try level of injury. Spinal cord injury is usually to understand the disability of athletes they due to traumatic injury. The trainers must pay Athletes with vision or hearing impairment need An example of a risk assessment for people train. attention to their feet and toes while pulling accurate and well-established instructions with brain injury in the Center Naprej on various surfaces because people with this in case of a danger. In particular, they must A plan or risk assessment should be made for type of injury feel poorly or do not feel legs. clearly understand the signal for the immediate When we include users with ABI in sports ac- each athlete, including one’s disability, ill- For the same reasons, we must be mindful of the cessation of the activity that will protect them tivities, we must be aware that the latter are ness, relevant characteristics and behavioural surface on which activities are taking place. from continuing and reduce the possibility of often accompanied by various risks of someone or disorders (e.g. epileptic seizures) and other Particular care must be taken that the surface injury. Athletes with hearing impairment cannot something get injured, of a physical or emotion- important information which may have a signif- is not too hot (in the summer) or too cold (in receive verbal instructions from the trainer al nature, etc. To this end, we complete a risk icant impact on the sport performance of the the winter). Individuals with tetraplegia have or co-athletes. Therefore it is necessary to assessment process. persons involved. limited ability to control body temperature, so establish an appropriate alternative communica- they need to be protected against heat and cold. tion strategy. For activities starting with an When making a risk assessment, we identify all EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 102 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 103

the hazards and anything that could cause dam- The problem arises when an individual (athlete Risk Assessment Form - Center Naprej RISKS MATRIX age. Based on this, we decide how serious the with a disability) wants to make a decision Risk Assessment In The Rehabilita- Impact of risks are and how we will manage these risks. We without consent of facilitator and latter thinks tion Plan For Sports Activities the risk Proba- Omitted Small Medium High Catastrophic assess the risk for each sport activity for all that the individual who has made such a decision bility of the risk athletes with disabilities in order to prevent does not fully understand the decisions and its Date of assessment Rare 1 2 3 4 5 possible complications or negative impacts of consequences. The task of the sports activities Name and surname of the user Less probable 2 4 6 8 10 the sport to the individual. The benefits of facilitator and other participating experts is Facilitator of sports Probable 3 6 9 12 15 sports activities must be greater than the risks to ensure that the athlete fully understands activities More probable 4 8 12 16 20 that sport presents to the person. The facilita- the consequences of his/her decision and that Sports activity Almost certain 5 10 15 20 25 tor of sports activities must know and respect such decisions can lead him to a situation in Use of supporting accessories (wheelchair, walking stick, Risk level the limitations of each individual - athlete which he/she can be emotionally and physically orthoses, prostheses etc.) with disabilities. injured. It is important that we work together during the sports activity Very small Small Medium High with an athlete with disabilities in looking for The risks that we know and are aware of can be suitable solutions to the situation, consid- AREAS OF RISK assumed as part of the real possibilities. It is ering different options, goals or find possible RISK RELATED TO: Risk level RISK RELATED TO: Risk level RISK RELATED TO: Risk level important that we understand the risk as some- adaptations. Falling Breathing problems Alcohol abuse thing that is not negative. We are not at risk Balance problems Cognitive problems Swallowing harmful substances Movement control Special disorientation Depression, Anxiety because we expect negative outcomes and conse- Illness and injury of Time disorientation Suicide quences, as we expect positive results involving Figure 8: Risk assessment form (Center Naprej) locomotor system people with disabilities in sports activities. Sensory impairments Leave without informing Other mental health problems Chronic illnesses and conditions Vanish and get lost Aggression towards self Aggression towards others In order to complete a risk assessment, we Reference Amputated/missing limbs Use of staircase/ lift verbal (threads) prepared a risk assessment form at the Center Problems with cardio vascular Aggression towards Naprej. It assesses the risk areas with a risk Bahr, R., Holme, I. (2003). Risk factors for sports injuries system (high blood pressure, Use of equipment/ devices others – physical matrix, which helps us to evaluate the degree of — a methodological approach. British Journal of Sports Medi- Cardiac rhythm disturbances…) cine, 37(5), 384–392. http://doi.org/10.1136/bjsm.37.5.384 Eating disturbances Bladder and bowel dysfunction Self – neglecting risk with regard to the impact of the threat in (exaggerated eating) Büchler, G. (2003),Atlanto-axiale Instabilität Leben mit relation to the likelihood of the risk. Eating characteristics – diet, Socialy inappropriate Alergies Down-Syndrom Nr. 43, September 2003 https://www.ds-infocen- avoiding particular food behaviour ter.de/downloads/lmds_44_sept2003.pdf Sexually inappropriate Epilepsy seizures Swallowing If the risk or impact of the threat and the behaviour – towards self Coaching Association of Canada (2005). Coaching Athletes with likelihood of risk is high (the red field), we Sexually inappropriate a Disabilityhttps://www.coach.ca/files/Coaching_Athletes_Dis- Problems with thermoregulation Smoking behaviour – towards others should ask ourselves whether it is worth risk- ability_update2016.pdf ing or whether such a high risk for the user Other Other Other Fagher K1, Lexell J. (2014). Sports-related injuries is still appropriate. Therefore, for such an in athletes with disabilities. Scand J Med Sci Sports. area / areas we prepare a RISK MANAGEMENT PLAN, Oct;24(5):e320-31. https://onlinelibrary.wiley.com/doi/ which reduces the risk and damage and protects abs/10.1111/sms.12175 Annex 1 the athletes with disabilities. The plan must Leshing, L. (2003) Orthopädische Probleme. Leben mit include measures to reduce the risk. There are a Down-Syndrom Nr. 43, September 2003 https://www.ds-infocen- AREA OF HIGHEST RISK (red areas) number of measures that we need to define clear- ter.de/downloads/lmds_44_sept2003.pdf Impact on the physical activity and impact of the sports with regards to the risk, warnings: ly: how, who and what we will do to reduce the Richter K.J., Sherrill C, McCann C.B., Mushett C.A. & risk. Kaschalk S. (1998). Recreation and sport for people with disabilities. In JA DeLisa and B Gans (Eds.). Rehabilitation RISK MANAGEMENT PLAN: Medicine: Principles and Practice. Third Edition (pp. 853- In the process of risk assessment and the prepa- 871). Philadelphia, Lippincott-Raven ration of a risk management plan, an individual Special Olympics (2003) COACHING GUIDE Sport Safety and Risk who is included in sports activity (athlete with Management for Coaches http://media.specialolympics.org/soi/ disabilities) must be actively involved. We help files/resources/Sports-Rules-Competitions/Sport_Safety-Risk- NOTES, EXPLANATORY STATEMENTS (and other relevant characteristics regarding the individual): him/her to understand the risks and take re- Management.pdf sponsibility for his/her actions. If necessary, Vešligaj Damiš, J., Čeh, M., Majcenovič Cipot, D. (2017), relevant expert people are included in the Risk Priporočila izvajalcem »ReSport« aktivnosti, interno gradivo Management Plan. If the risk of inclusion of a Center Naprej, Maribor RISK ASSESSMENT COMPLETED RISK ASSESSMENT UPDATED WITH CHANGES disabled athlete is greater than his benefit of Weiler, R., Van Mechelen, W., Fuller, C., & Verhagen, E. Assessment Signature: Updated by: Signature: sports activities, if it is harming the ath- (2016). Sport Injuries Sustained by Athletes with Disability: A Systematic Review. Sports Medicine (Auckland, N.z.), 46, completed by: lete or others, and also with various measures Date: 1141–1153. http://doi.org/10.1007/s40279-016-0478-0 Date: and adjustments, we do not achieve sufficient Changes: safety for all, we do not include him in sports activity. Footnote: It is very important to prepare a risk management plan for each area with the highest level of risk (red areas) - Appendix 1. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 104 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 105

es”. These predispositions and beliefs include aspects of parity of participation.” Researchers questions about the purpose of implementing ac- noted that students with physical disabilities tivities, about facilitators responsibility for were often denied participation, not purely achieving specific goals, and about beliefs that because of a lack of resources, but also because users are capable of achieving these goals. individuals’ abilities and desires were not explored and recognised. Slee (2001) drew on the 5.4. In another study Fitzgerald and Kirk (2009) notion of identity and stated that “inclusive have prepared an analysis of the experience of education has been framed as a field for special The ROLe oF adaPt- the persons with disability of physical educa- educational research, training and bureaucratic tion and disability sport. They emphasised some intervention”, in which such perceptions have of the primary concerns when using disability inhibited inclusion in mainstream schools. He Ed PhySICal sports as a tool for change. Considering having suggested that students with a disability were a disability is often associated with a deficit often denied their individuality as it was be- perspective, by default then, disability sports lieved that physical activity may be dangerous AcTIvity EduCAtiOn is thought to be a lesser form of sport. Con- and may cause more complications than benefits. sequently disability sports could be viewed as On the other hand authors like Sharma et al. either accommodating basic principles inherent (2008) suggest that educators’ attitudes needed to mainstream sport or as sports activities to evolve. In their review of literature, Sharma suitable only for persons with disabilities. et al. (2008) outlined that ‘disability physi- 5.4.1. Changing traditional attitudes, cal education’ was the single common variable beliefs and assumptions Research that focused on experience of teachers that influenced educators to be more positive within a teacher education program that en- about physical education. Slee (2001) hoped that courages reflective teaching, Korthagen (1988) pre-service teachers might be the innovators of AUTHOR: YOANA FILIPIC came to important conclusions in relation to future solutions to inclusive education. attitudes in the education process. He suggest- Key words: assumptions, attitudes, beliefs ed that some teachers varied in terms of their Nevertheless, there are a number of characteris- learning orientations from those who learn with- tics that a successful facilitator should hold; in an internal orientation (reflection) to those particularly those related to the exploration Attitudes, assumptions and beliefs are important passing judgement on the behaviour of others”. who have an external orientation (just tell me of his/her own attitudes (who am I, what is my concepts in understanding facilitators’ thought what I should do). As a result of different ori- goal as a facilitator, what am I able to do) and processes, classroom practices, change, and Multiple studies have examined those concepts entations, Korthagen found that they may relate the students’ own beliefs (of their identity and learning to teach. In such adapted programs, and how these beliefs affect facilitators’ con- to their beliefs and theories about how students abilities) as well as alternative beliefs and beliefs and attitudes of facilitators and ser- ceptions of their role. In a study of teachers’ learn. Many students, whose approaches were not practices. In addition, facilitators should have vice users affect what they perform and how they theories of learning, Anning (1988) stated that reflective and therefore not in tune with the the opportunity to engage extensively in the practice sports activities (Sikula, 1996). the theories about student’s learning in her orientations represented in the program, dropped active exploration of different living contexts study were determined “by their own particular out after one year, suggesting to Korthagen that of persons with disabilities. This process may Allport (1967) describes attitudes as “a mental previous experiences of teaching and learning educators should understand both their students’ promote the first stages in the acquisition of and neural state of readiness, organized through in their classrooms”. Debora Britzman (1991) learning orientations and those of the program. practical knowledge. experience, exerting directive or dynamic influ- has wrote useful case studies of two student These findings definitely lead to useful impli- ence upon the individual’s response to all ob- educators that indicated that they held power- cation for our programmes in terms of exploring Discussing and evaluating our work and approach- jects and situations with which it is related”. ful conceptions of the role of educators --both our attitudes and beliefs and those of our users es opens opportunities for new ideas and more Therefore attitudes could be predispositions positive and negative--gained from observing who join the programmes. creative approaches to planning adapted physical that consistently affect actions and consequent- teaching models. Britzman prompted the consider- activity. Therefore we all would benefit from ly strongly influence facilitating activities. ation that these conceptions profoundly affected In their study of 2006 Smith and Thomas implied on-going learning, searching new ways of imple- the student teachers’ classroom behaviours. that some educators support segregation by menting programmes, differentiate facts from Assumptions are something taken for granted; engaging students with a disability in differ- opinions search for information that will enrich a supposition. It is something that you accept All facilitators hold beliefs, about their work, ent activities to mainstream students, which our professional learning and discussions with as true without question or proof (Cambridge their students, service users, their activity, “appears to be strongly associated with the those we work with. Dictionary, 2018). It represents preconceived and their roles and responsibilities. For ex- ‘privileging’ of competitive teams sports over notions about what is good or bad, what is pos- ample, Clark (1988) suggested that their use is more individualized physical activities”. Jer- sible or impossible. not at all consistent with what one might find in linder et al. (2009) declared that “disability Reference textbooks or professors’ lecture notes, for they ought not to matter”, but also concluded that Goodenough (1963) defines beliefs as proposi- “tend to be eclectic aggregations of cause-ef- “it paradoxically seems to matter very much … Allport, G. (1967). Attitudes. In M. Fishbein (Ed.), Readings tions that are held to be true and are “accepted fect propositions from many sources, rules of particularly, in the specific context of sports in attitude theory and measurement (pp. 1-13). New York: John Wiley & Sons. as guides for assessing the future, are cited thumb, generalizations drawn from personal ex- activities for individuals with physical impair- in support of decisions, or are referred to in perience, beliefs, values, biases, and prejudic- ments” who were often judged against “normative EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 106 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 107

Professional boundaries are a key component of pendently singled out an individual client. You Anning, A. (1988). Teachers’ theories about children’s learn- Porter, A. C, & Freeman, D. J. (1986). Professional orienta- ing. In J. Calderhead (Ed.), Teachers’ professional learning tions: An essential domain for teacher testing. Journal of any professional ethics. Not all issues related did not carefully consider the broader meaning (pp. 128-145). London: Falmer. Negro Education, 55, 284-292. to these boundaries are necessarily unethical, of giving a gift to this person. As a result,

Britzman, D. (1991). Practice makes practice: A critical Sharma U, Forlin C & Loreman T (2008). Impact of training on but many of them are (Reamer, 2003). Factors another client in the physical activity group study of learning to teach. Albany: State University of New pre-service teachers’ attitudes and concerns about inclusive such as emotional involvement with a service may have felt excluded. Also the giving of a York Press. education and sentiments about persons with disabilities. user, a desire to religiously indoctrinate him gift can be seen as an attempt by you to cre- Disability & Society, 23 (7), pp. 773-785. Clark, C. M. (1988). Asking the right questions about teacher or her, potential financial gain, and a desire ate a special, personal relationship beyond the preparation: Contributions of research on teaching thinking. Slee R (2001). Social justice and the changing directions in to exploit the user in other ways can sometimes boundaries of the professional relationship. The Educational Researcher, 17(2), 5-12. educational research: the case of inclusive education. Inter- lead to crossing these boundaries in an unethi- reaction of the person may create an element of national Journal of Inclusive Education, 5 (2), pp. 167-177. Goodenough, W. (1963). Cooperation in change. New York: Rus- cal manner (Papouli, 2014; Reamer, 2003). attachment and hope for friendship and socializ- sell Sage Foundation. Smith A & Thomas N (2006). Including pupils with special ing outside the centre. educational needs and disabilities in National Curriculum This means that maintaining professional bound- Korthagen, F. A. J. (1988). The influence of learning ori- Physical Education: a brief review. European Journal of Spe- entations on the development of reflective teaching. In J. cial Needs Education, 21 (1), pp. 69-83. aries can sometimes mean balancing personal and Smith et al (1997) have provided us with a sam- Calderhead (Ed.), Teachers’ professional learning (pp.35-50). professional codes of ethics (Reamer, 2003). ple list of warning signs for facilitators that Philadelphia: Falmer. Fitzgerald H (2005). Still feeling like a spare piece of luggage? Embodied experiences of (dis) ability in physical their behaviour has crossed the boundaries of a Mauerberg-de Castro, E., de Souza Paiva, A.C., Figueredo, education and school sport. Physical Education & Sport Peda- Bowler and Nash’s (2014) training framework professional relationship (Smith et al 1997). G.A., Ayres de Costa, T.D., Rodrigues de Castro, M., Frances gogy, 10 (1), pp. 41-59. Campbell, D. (2013). Attitudes about inclusion by educators includes discussions on the differences be- The list is not exhaustive but it gives a view and physical educators: Effects of participation in an inclu- Richardson, V. (1996). The role of attitudes and beliefs in tween two types of relationship – professional of some common situations when our relationship sive adapted physical education program. Mortis, Rio Claro, learning to teach. In J. Sikula (Ed.), Handbook of research and personal. In terms of behaviour they set with a user has become confused: vol. 19 n. 3, p.649 – 661. on teacher education (2nd ed., pp. 102–119). New York: few important categories - remuneration, pur- Macmillan. pose of the relationship, balance of power in • Frequently thinking of the the relationship, and responsibility for the user when away from work relationship. These categories are very dif- • Frequently planning other users’ ac- 5.4.2. Building Safe Relationships ferent considering their implication in profes- tivities around that user’s needs sional and personal relationship. With regards AUTHOR: YOANA FILIPIC to behaviour, professional relationships are • Seeking social contact with or spend- regulated by professional standards and codes ing free time with the client Key words: safe relationships, boundaries, maintaining boundaries of ethics, on the other hand personal relation- • Sharing personal information or work concerns ships are guided by personal beliefs and values. with the client that can cause user see you Extending beyond education building safe re- stay objective and professional while teach- In personal relationships, no remuneration is as friend, not as professional any more lationships has been a topic of intense theo- ing service users. This is also related to the required, whereas in professional relationships retical and empirical interest within teaching imbalance of power and facilitator must remain the facilitator is paid for providing education • Feeling so strongly about the client’s goals and counselling. The collaborative relationship mindful of the goal of the relationship in order to the client. There is an employment contract that colleagues’ comments or the client’s between facilitator and service user in the to prevent abuse. What is needed is the sense of that states the terms for this payment. or their family’s wishes are disregarded teaching setting is definitely a predictor of closeness and empathy that is needed to under- • Hiding aspects of the relation- programme outcomes. This research area raises stand and react adequately when a person with We have provided you with a sample scenario so ship with the client from others the question of why sport psychology researchers disability is anxious and experiencing distress that this could be useful for helping facilita- have not considered examining the “we” of the (Papouli, 2014; Reamer, 2003). tors understand how to differentiate between the • More physical touching than is appro- relationship, in addition to the two separate two types of relationships in real-world situ- priate or required for the situation “I”s or the two separate individuals in the dyad A sample list of tips to create a safe ations, and how they could benefit from doing so • Romantic or sexual thoughts about the client relationship. relationship: in an effective manner.

The basis for the professional relationship is 1. Honour each member’s style of interaction Situation: You are a facilitator of sports ac- Reference the respect for the dignity, worth and rights tivities working in a centre for rehabilitation 2. Invite users to share experience and of the client. Facilitators demonstrate respect of persons with acquired brain injury. A person Bowler, M. & Nash, P. (2014). Professional Boundaries in thoughts with regards to the program when they maintain “appropriate boundaries and with a traumatic injury was admitted a month ago Learning Disability Care. Nursing Times, 110, 12-15. ensure their relationships are always for the 3. Show gratefulness when lis- and you have become particularly attached to him Papouli, E. (2014). The Development of Professional Social benefit of the persons with disability. Another tened to and respected while spending time on the playground. His fami- Work Values and Ethics in the Workplace: A Critical Inci- important characteristic of the relationship ly is distant and not particularly interested in dent Analysis from the Students’ Perspective. Retrieved from 4. Invite families of other profession- http://sro.sussex.ac.uk/48325/1/Papouli%2C_Eleni.pdf on is trust. Therefore it is the belief that the his success in sports. On his win at a competi- als to participate in special events 29.6.2018 facilitators possess the knowledge and skills tion you buy him a present costing 30€ and make Reamer, F. (2003). Boundary Issues in Social Work: Managing required for particular programme, that they 5. Create time when you see a user in a cake. He is excited. You feel satisfied. Dual Relationships. Social Work, 48 (1). 121-133. will keep confidentiality if shared a personal distress and speak to him/her Should you do this, if so why, if not why? Smith, L.L., Taylor, B.B., Keys, A.T. & Gornto, S.B. (1997). experience. Boundaries are a very important part 6. Respect individual cultur- Nurse-patient boundaries: Crossing the line. American Journal of the relationship as an appropriate emotional Answer: In your excitement to do something spe- al and familial differences of Nursing, 97 (12), 26-32. and physical distance is required in order to cial for the person with an injury, you inde- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 108 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 109

ent from those for athletes without disabili- • And techniques of positive think- 5.4.3. Psychological Preparation of athletes ties. Nevertheless, there are some adaptations ing and hypnosis. with disabilities and challenges we face to be taken into account (Hanrahan, 2014). All these techniques can also be used for ath- The main adaptations that are normally required letes with disabilities, if necessary, modified AUTHOR: JASNA VEŠLIGAJ DAMIŠ in the work of people with disabilities are most according to their abilities or skills and spe- often related to communication issues and other cific limitations. Key words: psychological preparation, relaxation, motivation, goal setting, commu- specific adjustments resulting from disabili- nication, self-esteem ty. Working with individuals with disabilities requires appropriate assistance, communication Relaxation training adaptation and creativity. (Hanrahan, 2015). Progressive muscle relaxation (PMR) may be prob- In modern sports, appropriate psychological achieve success in sport can also be used to The mental preparation of an athlete with dis- lematic for some individuals with physical dis- preparation has become more and more important achieve success in other areas of life. abilities, like an athlete without disabilities, orders. For example, clinical observation shows in order to achieve good, excellent results. The helps him/her to focus, to be self-confident that individuals with cerebral palsy who have purpose of this preparation is improvement of Sports psychologists thus help athletes improve and to have a positive mindset. General mental higher level of spasticity may skip the phase of results, which the individual is able to achieve their motivation, increase self-confidence, in- preparation consists of: tension of PMR and focus only on relaxation, as only if he/she is well psychologically prepared crease team cohesion, and concentration (Kajtna the tension phase may increase spasticity (Han- for all the distress he faces in sports. and Jeromen, 2013). If a sports psychologist • creating a positive philosophical, moral rahan, 2015). cooperates with a disabled athlete, it is im- and ethical attitude towards the world, Good psychological preparation of the athlete portant to focus on the individual’s abilities Alternatively, these athletes may want to con- • creating a positive attitude towards sport, means strong motivation, high concentration, rather than on his disabilities (Hanrahan, sider alternative ways of relaxation, such as high self-esteem and good emotion management. 2007). • Creating a high level of motivation, autogenic training. An athlete who has received good psychological self-motivation (internal motivation), preparation works better, reaches ones potential Athletes with amputated limbs or those in • creating appropriate, realistic goals, and top results. The goal of professional psy- wheelchairs are given the option of selecting chological preparation • managing effectively anxi- the PMR script: the relaxation is performed on However, in order to become a successful ath- ety, emotions and stress, individual parts of the body, where the muscles lete, you do not need to be a professional Through psychological characteristics for an are in place and leave the amputated limbs or • maintaining good and focused concentration, athlete or an Olympic champion. You do not need athlete with a disability, we encourage the body parts that are affected by the spinal cord to have many trophies or cups, you do not need improvement of the performance of the activity, • creating a stimulating social envi- lesion. Hanrahan (1995) found that the ath- to win at the national championship or be on the the achieving of better results and significant ronment where appropriate atmosphere letes with physical difficulties decided about cover of a sports magazine. success in competition. Therefore, we discover and support must be established, 50:50 with regards to the mentioned relaxation the causes of: scripts. • learning effective patterns of behaviour It is essential for an athlete that the sport towards self, situations and others, he/she chooses is important to him/her and he/ • fluctuations in implementation, motiva- It should be noted that abdominal breathing as she is dedicated to it, regardless of the fact tion for sports activities, etc., • learning and using different psy- a relaxing exercise can enhance relaxation and if he/she is a top athlete or a recreational chological techniques. concentration in athletes who do not use abdomi- • managing crisis, stress, player, an athlete with disability or no dis- nal muscles (Hanrahan, 1995). ability, a Paralympic or an Olympic athlete who • setting limits (how much he/she is Psychological preparation involves learning uses sports as a means of rehabilitation. able to perform, where is his/her lim- psychological techniques that allow an athlete it, or limits can be improved); to recognize his or her abilities. This process Visualization and sensory training It is important that an athlete develops desired requires of him/her many hours of training and • differences in performance, when he/ realistic goals that are sufficiently high and persistence. Among the most popular and most The technique of visualization, which is a she works better or worse, realistic according to his/her own abilities. It frequently used techniques are (Tušak, Misja and form of mental representation, is very often is important for the goals to be in accordance • slow progress - the athlete progress- Vičič, 2003): used in sports. It helps to learn new motor- with ones limitations such as, daily life obli- es steadily, but much slower than he/ ic functions and movement elements, eliminates gations, finances, time, disability, etc. Conse- she wants or imagines he/she could. • Relaxation techniques, negative thoughts and feelings and improves quently sport participation enriches the life concentration. • Visualization, sensory, of an athlete, and if he/she values what he/she receives, it is worth the resources he/she has 5.4.3.1. Practical aspects of men- • Concentration techniques, Visualization technique or presentation of invested in sports. tal preparations for work with motoric images can be an extremely useful • Self-speech techniques, athletes with disabilities technique for athletes with physical disabili- At the same time, psychological work for an • Breathing techniques, ties, and can be used as mental preparation for athlete can be of much broader significance since In general, psychological skills programs for training physical skills. Because athletes with the same mental abilities that athletes use to athletes with disabilities are not very differ- disabilities often have limited opportunities EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 110 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 111 and certain training problems that are difficult we build on the clarity of the imagined image of 5.4.3.2. Communication as a chal- When working with people with mental disorders to overcome compared to their healthy colleagues himself, the image control (swim with one hand) lenge for facilitators and per- it is important to provide additional time for (due to problems such as transport, accessibil- and in this way we form an effective strate- sons with disabilities mental training and gradually prepare them for ity, poor equipment etc.), mental exercise can gy for improving his technique, preparing for particular mental ability, each one according to become extremely important. In addition, exer- competition and strengthening his own confidence When working with athletes with disabilities, the situation and behaviour. Learning and train- cise for visual motoric behaviour is helpful for (Hanrahan, 2014). communication is extremely important. For ex- ing more than one mental skill at a time can be athletes with cerebral palsy, because the relax- ample, it is important that a psychologist, as too difficult for them (Gregg et al., 2004). This ation component can reduce spasticity (Martin, Similar to visualization is sensory technique in well as a coach or assistant talk with an ath- is the most common mistake sports psychologists, 2013). which athlete imagines ones sport performance lete in a wheelchair on the same level. trainers and assistants are dealing with. For but it also contains kinesthesia, voices and example: to play tennis, they may explicitly It also assists with preparation for stressful other sensory performances that occur during the As cerebral palsy often affects muscle control, learn to avoid going on the other side of the events and sports performance, as with mental sport performance (Tušak & Tušak, 2003). which is necessary for a clear speech (Nordberg, field during the game to get the ball. imaging the automation and optimization of the Miniscalco, Lohmander & Himmelmann, 2013), it is performance is increased. People with mild mental disorders have improved sometimes difficult to understand athletes, who If a person with intellectual disability is il- their performances in cognitive and motoric are strongly affected by it. Some athletes have literate, we should consider using audio records The visualization technique can be effective tasks through visualization (Screws & Surburg, assistants who can take part in sports events or drawings instead of writing when setting for athletes with physical disabilities. It is 1997). The combination of physical training and and training with them. If assistants play goals or performing other activities that usual- important that athletes see themselves as they visualization in people with mental disorders together with an athlete, make sure that you ly involve writing (Hanrahan, 2004). are and how they do sports (Hanrahan, 1995). For has shown to be more effective compared to only continue to maintain eye contact and communicate example: swimmers with one foot do not swim with physical exercise (Surburg, Porretta & Sutlive, with athlete not with the assistant. When commu- Often, creativity is needed to pass the messag- prosthetic devices, so prosthesis is not part of 1995). nicating with a disabled person, be patient when es effectively to individuals with intellectual the image they represent. they speak and avoid finishing their sentences. disabilities. It is also important to make sure that the messages are correctly understood. It is important to ensure that images of visu- Positive thinking training When communicating with athletes with disabil- As people with mental disorders often agree or alization are precise in terms of what is or ities, it is always important that we are aware accept positive answers (Gregg, 2013), it is what is not included and physically match the During mental preparation we also include the of the extent to which individuals can see or better to avoid asking yes/no questions (because real situation (for example, if a sportsman uses technique control of positive thinking. It is hear, and what forms of communication are best the answer will likely be ‘’no’’, regardless of prosthesis in sport, this prosthesis should also important that we guide an athlete with a dis- for them (for example, reading from lips, large the question). Instead, we ask questions that be part of the visualization image). ability to positive thoughts and self-managing fonts…). It is also useful to establish methods require an individual to show understanding of them. This can be achieved by training positive for gaining attention (eg. flashing lights, touch the answer, or ask the athlete to repeat infor- The clarity of the motoric images (visualiza- thoughts and positive self-talking. The conse- on the shoulder, beeping). mation or message. tion) of affected limbs after complete damage to quences of negative thinking cause low self-es- the spinal cord is maintained, but is weaker af- teem, increase anxiety and worsen performance. When working with athletes who have vision or In the case where a sport psychologist has ter loss of the limb (Malouin & Richards, 2010). The athlete uses different autosuggestion during hearing disorders, it is important to reduce limited contact with a team or the athlete, it the training of positive thinking, which is also background noise. Individuals with visual im- is useful to explain to the coach or to other Short-term physical disorders, such as broken the most important part of the positive think- pairments rely on hearing aids and those with relevant professionals what the team or indi- legs, can lead to reduced clarity of motoric ing. Suggestions must be realistic and specific, hearing impairments (but they are not completely vidual athlete has learned from psychological images, for example those that include the leg. some are focused on correcting problems that deaf) will struggle if the voice overlies noise preparation or intervention (Gregg, 2013), to Immobilisation of the ankle in only 2-4 weeks arise from negative thoughts, and some sugges- from the background. repeat, train and strengthen it during exercises leads to a significant reduction in the clarity tions prevent misconception. Important are also and competitions. Patience and numerous repe- of motoric images in movement of the foot (Mal- the suggestions that improve self-confidence and We must consider that the level of communication titions are important when working with people ouin et al., 2009). self-esteem of the athlete. and understanding is adapted to the abilities of with intellectual disabilities. athlete with intellectual disabilities. If nec- Of course in athletes who have acquired physical essary, give the athlete more time to understand When working with people with acquired brain disorders (as opposed to those who have genetic Routine and respond, talk slowly using short sentences injury (ABI), facilitators of the sports ac- disorders), the use of visualization techniques and wait long enough before asking a new ques- tivities should be aware of the numerous can lead to frustrations that originates mainly When developing preliminary routines for ath- tion. Ensure our sentences are clear and we need consequences caused by ABI and abide by the rec- from the relationship between the image itself letes with physical problems, it is important to speak to them gradually, it may be neces- ommendations of the professional body according- and image before the injury. For example: a to pay attention to the problems associated sary to clarify and explain multiple times the ly. The consequences of the brain injury, which swimmer who has an amputated hand, swims with with accessories for example wheelchairs and purpose of the tasks and the instructions for may affect the sport activity of an athlete with only one hand, and visualizing themselves in the allow longer time for transportation and solving work. We combine verbal instructions with other ABI, can influence the physical activity perfor- picture with both hands as before the injury. problems with accessibility at the competition ways of providing information. The instructions mance as well as mental functioning. Thus, we This can lead to anger, frustration, split image location (De Bress, De Guast et al., 2013). should be simple, short and accurate. Longer and have to devote special attention to the problems of oneself, etc. This is why we must be very more complex instructions should be divided into in executive functioning, motivation, confron- careful when we guide such an athlete through a shorter sequences or steps. tation, problems of setting goals and creating visualisation technique. It is important that realistic expectations etc… EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 112 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 113

Athletes with ABI often have difficulty in plan- Specific goals affect activity more accurately 5.4.3.4. Self-concept and self-con- relationship with oneself. As a consequence one ning and organizing their activities. Problems than general goals. The coach sets them up with fidence of an athlete with disabili- forms values about oneself and the environment have been identified in determining the steps the athlete, and they have to define strategies ties as challenge for facilitators he/she lives in. The one with good self-concept required to achieve the goal and their order for achieving the set goals. In this approach has high self-confidence and vice versa, low (what happens sooner or later). They initiate an the feedback given by the coach to the athlete Self-confidence is by definition an athlete’s self-concept comes from low self-esteem. activity with difficulty and often need detailed after the analysis play an important role. If it conviction or a sense of confidence about the or additional instructions before performing the shows positive progress, the technique will be possibility of successful performance. It is a Self-concept depends on the perception and activity. more successful. subjective factor that arises from an athlete knowledge of one’s own strengths and weaknesses, and has a major impact on his sports engagement. depends on the individual’s opinion of his/hers After brain injury, injured victims face a range Setting short-term and long-term goals has a abilities and the people the individual compares of memory problems. The most common and highly significant impact on maintaining motivation. In some sports studies of people with disabil- with. We separate physical, social and academic unpleasant form of memory disorder is a problem Sub- targets (sub-goals) lead to the main goal ities, the positive benefits of sports partic- self-concept. with short-term or ‘’working’’ memories. This and when one of them is not achieved, this is ipation have been identified to include better means that it is difficult to remember new facts, a sign of the need to change the strategy to self-image, feelings of belonging and many The physical self-concept of an athlete with a new names, faces, agreements, forget where they achieve an ultimate goal. benefits to health (DePauw & Gavon, 2005). disability can be largely influenced by sports left belongings, obligations they have. activities. Sport can be an important stimulus, The athlete must believe that he/she is able to Sports psychologist can help both athletes with which increases the competence of their perfor- When working with athletes with ABI it is im- achieve set goals. Setting goals does not only disabilities or those without with psychologi- mance and improves their physical abilities. Un- portant (as with people with developmental serve as a tool to increase motivation, but also cal preparation to develop psychological resis- fortunately, in practice, it often happens that disorders etc.) to avoid excessive stimulation, to improve concentration and effective time man- tance and build self-confidence and appropriate poorly coordinated individuals with disabilities such as several people speaking at the same aging (Tušak, Misja & Vičič, 2003). motivation. are less active in sports and recreation, spend time, and address him/her directly, slowly, more time watching other better coordinated clearly and comprehensively. It is crucial to This technique of setting goals in sport is The process of achieving high self-confidence individuals with disabilities, consequently eliminate as much as possible stimuli in terms equally applicable in sports for people with in an athlete with disabilities can last for limiting their chances of improvement. of sounds from the background or environment disabilities, regardless of whether it is a many years and the psychologist has a role of (radio, noise in the room, etc.). We need to competitive sport, recreational sport or reha- counsellor. An athlete must set an environment carry out numerous repetitions and behavioural bilitation. At the same time it is important to around him/her that includes people who always 5.4.3.5. Coping with stress trainings due to user’s memory problems and understand why an athlete with disabilities is believe in him/her. Repeated positive sport diminished learning ability. attracted by sport. Disabled and healthy ath- experiences can contribute greatly for achiev- A successful athlete must have the ability to letes have similar incentive systems (incentive ing global and balanced self-confidence (Tušak, effectively cope with stress, and this also are attractive goals). According to Tušak and 2001). applies to athletes with disabilities. Several 5.4.3.3. Motivation and set- Tušak (2013), from existing research we can techniques are known to adequately solve prob- ting goals techniques recognize 7 incentive systems that explain the By analysing the self-confidence of an athlete, lems caused by stressors. motivation of the athlete to participate in we can determine his/her personality. Indi- Practical approaches to motivating athletes with sports: viduals with low self-confidence are afraid of In order to reduce stress we introduce training, disabilities derive from different theoreti- defeats, have negative thoughts, doubt their which include a program for reducing the harmful cal directions, similar to those for athletes • Desires for achievement and success, abilities and feel that they will not succeed. effects of stress. It involves learning self- without disabilities (for example, productiv- Those with too high self-confidence do not see talk, observing one’s thoughts, problem solving • Desire for socialising, ity motivation theory, theoretical directions their mistakes and do not want to fix them, they skills and focusing attention. explained by behaviour, theories based on incen- • Desires for sensual satisfaction, think they are better than they really are, and tive motivation, goal setting theory, etc…). excitement, in case of failure always find excuses. Such It has three phases: problems can often be faced by athletes with • Curiosity The basic characteristics of motivation are ABI, as a result of the injury and inability to • Education about this principle of training, encouraging and guidance (Kajtna & Jeromen, • Aggression create a real image of oneself and one’s abili- • Multiple exercises that involve plan- 2013). One of the most important factors in the ties (Žini, 2018). • Power ning and problem solving, relaxation process of motivation is setting goals. It is a and changing thinking patterns. planned choice of specified goals, which must be • Independence. Parents, relatives, coaches and personal as- precisely defined, realistic and achievable. This sistants have the strongest influence on the • Testing of acquired skills in a controlled technique is used in sports most of the time. The importance of certain incentives varies individual’s self-confidence and self-esteem. environment (Tušak, Misja and Vičič, 2003). from individual to individual. The first two are The right approach includes positive encourage- An athlete sets goals and tries to achieve them extremely important for everyday life, social- ment, praise, positive experience and emotional Sport as an environment where a person with with appropriate behaviour. Goals should meet ization, entertainment and achievements. We support. disabilities can develop connections and reduce athlete’s needs. Motives are goal focused rea- can connect them with the individual’s need for loneliness can be described as an extremely sons for behaviour. Needs arise and maintain mo- experience and activation. Self-concept is a set of individual’s opinions positive activity and a tool for improving the tives until satisfaction occurs (Tušak & Tušak, and attitudes towards oneself based on experi- quality of life. However, in everyday life they 2003). ence and beliefs, reflected in the individual’s may be limited by their disability due to their EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 114 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 115 physical abilities and consequently experience ilarly, access to doctors, therapists, masseurs pic athletes: Apreliminary study. Adapted Physical Activity stress and low self-confidence. and athletic trainers is also limited. They usu- Quarterly,21, 4–18. ally have only coaches and assistants available. Hanrahan, S. J. (2004). Sport psychology and athletes with disabilities. In T. Morris & J. Summers (Eds.), Sport psychology: Theory, applications and issues (2nd ed., pp. Athletes with disabilities are ranked by func- 5.4.3.6. Coping with stress 572–583). Milton, Queensland: John Wiley & Sons. in paralympic sports tionality and competitors are also assigned in this way. Ranking that occurs before the compe- Hanrahan, S. J. (2007). Athletes with disabilities. In G. Tenenbaum & R. C. Eklund (Eds.), Handbook of sport psychology The Paralympic Games, like the Olympic Games, tition can be stressful as athletes may expect (3rd ed., pp. 845–858). Hoboken, NJ: Wiley. are considered to be the highest level of compe- classification at a different level. If athletes Hanrahan, Stephanie J., Psychological Skills Training for tition an athlete with a disability can aim for. reclassify, they will have to compete with bet- Athletes With Disabilities, First published: 09 March 2015, The increased attention paid to the Paralympic ter athletes. It is clear that such a scenario https://doi.org/10.1111/ap.12083 Games and the importance that society, coaches can reduce confidence and increase anxiety in key James H. Rimmer, PhD, Barth Riley, PhD, Edward Wang, PhD, and support staff all attribute to the winners times (Disability and Sport, 2018). Amy Rauworth, MS, Janine Jurkowski, PhD, Physical activity of the Paralympic Games, therefore influence participation among persons with disabilities: Barriers and the experience of the Paralympic Games as very Drug testing has also become an essential part facilitators. Available from: https://www.researchgate.net/ publication/8540158_Physical_activity_participation_among_ exciting and stressful. Athletes with disabil- of the Paralympic Games and can be a new and persons_with_disabilities_Barriers_and_facilitators [accessed ities experience similar pressures as athletes therefore stressful experience. Testing in Jul 05 2018]. without disabilities to achieve victory. First Paralympic Games may be more complicated com- Kajtna, T. in Jeromen, T. (2013). Šport z bistro glavo – often experience increased stress as a result of pared to the testing of healthy athletes. For utrinki iz športne psihologije za mlade increased attention of media and family (Dis- example, many athletes urinate with catheters. Malouin, F., & Richards, C. L. (2010). Mental practice for ability and Sport, 2018) Some may need to ask for exceptions to the use relearning locomotor skills.Physical Therapy, 90, 240–251. of illicit substances as part of their treatment doi:10.2522/ptj.20090029

In addition to related sources of stress ex- in relation to their disability. Malouin, F., Richards, C. L., Durand, A., Descent, M., Poire, perienced by both athletes with disabilities D., Fremont, P., Doyon, J. (2009). Effects of practice, vi- or without disabilities, we can identify some Some suffer chronic pain and can be treated with sual loss, limb amputation, and disuse on motor imagery viv- are unique to disabled athletes, e.g. those in medical marijuana, which can be legally per- idness. Neurorehabilitation and Neural Repair, 23, 449–467. doi:10.1177/1545968308328733 wheelchairs or with prosthetics, such as: prob- mitted at home, but is prohibited in Paralympic lems travelling to the competition, how to get Games. Martin, J. J. (2013). Athletes with physical disabilities. In S. J. Hanrahan &M. B. Andersen (Eds.), Routledge handbook of on the plane, transfers from seat to wheelchair applied sport psychology: A comprehensive guide for students to toilets and back and personal care, how to Most elite athletes are influenced by the events and practitioners (pp. 432–440). London: Routledge. proceed from a long evening trip to competi- and conditions of their sports world. However, Martin, J. J., & Wheeler, G. (2011). Psychology. In Y. Van- tion, gastrointestinal problems, etc. Often, a Paralympic athletes must deal with a number of landewijck & W. Thompson (Eds.), The Paralympic athlete (pp. longer absence from home can also be stressful. unique conditions and challenges that can hinder 116–136). London: International Olympic Committee)

Athletes with disabilities miss their important their optimal functioning. Screws, D. P., & Surburg, P. R. (1997). Motor performance of ones who help them and support them socially children with mild mental disabilities after using mental (Disability and Sport, 2018). Well-developed psychological abilities help imagery. Adapted Physical Activity Quarterly, 14, 119–130. disabled athletes cope with stress. Furthermore Stephanie J Hanrahan, (2014), Psychological Skills Train- Paralympic athletes spend considerable time in sports psychologists play an important role in ing for Athletes With Disabilities, Schools of Human Move- the Paralympic village. Athletes, who compete the psychological preparation and training. ment Studies and Psychology, The University of Queensland, Australia. at the end of games, have to spend a critical amount of time in an unknown environment. They Tušak, M., Misja, R. in Vičič, A. (2003). Psihologija ekipnih športov. Ljubljana: Fakulteta za šport, Inštitut za šport. sleep in a bed they are not used to. A study on Reference Brazilian Paralympic athletes who participated Tušak, M.[Maks]in Tušak, M. [Matej](2003). Psihologija špor- ta. Ljubljana: Znanstveni inštitut Filozofske fakultete in the Paralympic Games in Beijing, shows that De Bressy de Guast, V., Golby, J., Van Wersch, A., & d’Ar- most of them had poor quality of sleep. Anxiety ripe-Longueville, F. (2013). Psychological skills training Vešligaj Damiš, J., Majcenovič Cipot D., Čeh, M., (2017). of an elite wheelchair water-skiing athlete: A single-case was associated with poor sleep, 72% of athletes PRIPOROČILA IZVAJALCEM »ReSport« aktivnosti, Center Naprej study. Adapted Physical Activity Quarterly,30, 351–372 (Internal book), Maribor had a medium degree of anxiety, while only 28% of athletes who were sleeping well were less Disability in Sport, pridobljeno junij 2018 iz http:// Žilni, S., 2018. PSIHOLOŠKA PRIPRAVA V KONJENIŠTVU, DIPLOMSKO psychology.iresearchnet.com/sports-psychology/ DELO, UNIVERZA V LJUBLJANI, FAKULTETA ZA ŠPORT, Kineziologi- anxious. Members of the British team also re- disability-in-sport/ ja, Ljubljana ported that they were dealing with issues about Gregg, M. (2013). Working with athletes with intellectual room sharing and how well they would compete disabilities. In S. J. Hanrahan & M. B. Andersen (Eds.), Rout- after a poor sleep (Martin & Wheeler, 2011). ledge handbook of applied sport psychology: A comprehensive guide for students and practitioners, (pp. 441–449). London: Athletes with disabilities often have less Routledge access to sports psychologists and coaches Gregg, M. J., Hrycaiko, D., Mactavish, J. B., & Martin, G. L. compared to athletes without disabilities. Sim- (2004). Amental skills training package for Special Olym- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 116 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 117

• Adults with disabilities should practice at • Physical activities are recommend- 5.4.4. Physical Activity Recommendations least 150 minutes of weekly moderate exercise ed for all persons with disabilities. activity or 75 minutes of more intense aero- • When performing physical activi- bic activity or an equivalent combination of ties, persons with disabilities fol- moderate and intense motor activity. Aerobic low general recommendations. AUTHOR: VLADIMIR JAĆEVIĆ activity should be performed in episodes of at least 10 minutes, best spread over the week. • Persons with disabilities are led and Key words: recommendations for facilitators, education of professionals, asked by experts on specific issues, such • Adults with disabilities should also per- professionals as how often they are active in the week, form twice a week activities of moder- what is the duration of activities, what ate or higher intensities, which involve is the intensity, what activities they bigger muscle groups to increase muscu- The importance of regular movement activities physical activities related to their age and perform, how to incorporate more physi- lar strength. These activities bring ad- for persons with disabilities and the factors type of disability. Obstacles can be individual cal activities into their life, etc. ditional positive health effects. that impede their inclusion and implementation - lack of knowledge about opportunities engaging • Experts encourage persons with disabil- in physical activity, fears, nature of deficits • In case persons with disabilities are ities to talk about their obstacles and Physical activities are defined as physical move- and pain, lack of energy. There are also social not able to adhere to these guidelines, limitations when performing physical ac- ments that are produced by skeletal musculature barriers, such as the lack of properly trained they should be involved in physical activities. Thus obtain information about and require energy consumption. They include professionals (eg gym trainers, sports education tivities according to their abilities the individual and his/her ability needed activities that are carried out during work, professors with special skills in activities and avoid physically inactive life. to prepare an appropriate program, appro- travel, play, housework and recreation. The adapted for people with disabilities), lack of • They should consult an expert about priate preparation of the venue, necessary World Health Organization advises 150 minutes of necessary equipment for adapted sports practice, the quantity, type and intensi- adjustments, necessary assistance from the moderate physical activity per week (WHO, 2017). underestimation of the ability of persons with ty of physical activities. experts and the extent of social support. In comparison with persons performing physical disabilities by health professionals and other activities in this range, inactive persons have experts. Obstacles may also be environmental • Also, children and adolescents with dis- • Experts need to know the particular opportu- a 20-30% higher risk of mortality due to various when locations for physical activities are not abilities should adhere to specific nities for physical activity of persons with causes (WHO, 2017). adapted for use by persons with disabilities. guidelines for physical activity appro- disabilities and provide them with appropri- (Martin, 2013). priate for their age and abilities. ate instructions and guidance for partici- When talking about persons with disabilities, it pation in various physical activities and is essential to put the individual first. Dis- It has been proven that physical activities play in various organized programs (CDC, 2014). ability does not define the person and is only 5.4.4.1. Professional recommen- an important role in the maintenance of health, a medical diagnosis. According to the medical dation and guidelines for facil- well-being and quality of life. They can help model, disability is defined as a medical and itating physical activities maintain adequate body weight, improve mental 5.4.4.3. The importance of edu- biological problem, the emphasis is on treatment functioning, reduce the risk of premature death, cating professionals in the field compared to prevention and promotion of health. Physical activities are one of the most import- heart disease, type 2 diabetes, and certain of adapted physical activities On the other hand, the social model presents ant factors for improving the health status of types of cancer. Physical activities are very for people with disabilities disability as a uniqueness, without condemna- people of all ages. Therefore, the recommenda- helpful for improving day-to-day functioning tion, and highlights deficiencies in the system tions and guidelines that the general population and for increasing the autonomy of persons with Nowadays, the term is adapted physical activi- and discriminatory behavior as an obstacle to receives from experts is very important. For disabilities (CDC, 2014). ty. It refers to movement, physical activities the integration of people with disabilities into example, in the US, the US Physical Activity and sports activities, with special emphasis on motor activities (Martin, 2013). Guidelines 2008 (2008 Physical Activity Guide- the interests and abilities of individuals with lines for Americans) are applied. The guidelines 5.4.4.2. The role of healthcare and different limitations such as disability, health For people with disabilities, physical activity contain guidance based on scientific evidence other professionals who treat peo- problems and age. This growing field requires is extremely important due to the high degree of to help people aged over 6 years to improve ple with disabilities in the pro- the integrated treatment of people with dis- influence on chronic diseases, due to the posi- their health by appropriate physical activity. motion of physical activities abilities, which includes a multidisciplinary tive effect on cognitive, emotional and social This is even more important for people with approach and professionals from various fields difficulties, psychological benefits in terms of disabilities, as they tend to have less active Healthcare workers significantly influence the (occupational therapists, physiotherapists, improving self-image in positive experiences lifestyle. According to US data, almost half of amount of physical activity persons with dis- social workers, psychologists, coaches, sports during exercise, stress reduction, reduction of the people with disabilities who are capable of abilities engage in as they are more likely to instructors, sports education professors, etc.). pain, improvement of depressive symptoms, due physical activities do not even perform aerobic contact them than other experts. It is also more to the social benefits - better social integra- exercise. On the other hand, disability should likely for people with disabilities to be more The technological development and accessibility tion, improved communication skills, networking not be equated with poor health, since most active if they are recommended by experts. of modern equipment makes it easier to include through communication with professionals and people with disabilities are able to engage in more and more people with disabilities not only other participants (Jaarsma, 2014). regular physical activities. Therefore, there In order to appropriately encourage people with in recreational but also in competitive sports are special guidelines for persons with dis- disabilities to perform physical activities, activities. Therefore, continuous professional Despite these benefits, there are obstacles to abilities in the USA that include the following experts can follow these steps: training is necessary as well as developing and the integration of people with disabilities into recommendations: learning new methods and approaches. Experts EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 118 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 119 with appropriate knowledge and approach can physical disabilities: A systematic review. (2014) Scandina- • Support from others: Unqualified staff that • Health and safety: Maintenance of fitness/ encourage people with disabilities in performing vian Journal of Medicine & Science in Sports, 24 (6), 871-881 cannot modify or adapt individual and group muscle strength, maintenance of functional physical activities, monitoring them and pro- Martin JJ. (2013). Benefits and barriers to physical activ- exercise classes for people with disabilities, independence, walking ability, wheelchair viding necessary support resulting in positive ity for individuals with disabilities: a social-relational not having necessary staff or support, not skills, perceiving health benefits, physi- model of disability perspective Disability Rehabilita- effects on their health and functioning. having knowledgeable staff, lack of interest cal appearance, weight loss, endurance. tion. ;35(24):2030-7. doi: 10.3109/09638288.2013.802377. Epub from the administration to adapt activities 2013 Jun 19. • Location: Transportation, Good weather US Department of Health and Human Services. 2008 Physical • Communication: Lack of specific knowledge Reference • Expense: Better funding of pro- Activity Guidelines for Americans, 2008. Retrieved from about the benefits of physical activity, lack https://health.gov/paguidelines/pdf/paguide.pdf on 20.6.2018 grammes and play areas of knowledge about how to exercise, lack of CDC Centers for Disease Control and Prevention. Adults with WHO. Physical Activity Fact sheet [Internet]. 2017 [cited information about physical activity, no coun- • Support from others: Social support, having Disabilities - Physical activity is for everybody. 2014 01/08/2018]. Retrieved from: http://www.who.int/mediacentre/ selling, limited partnerships between sectors a good trainer, friends are supportive or [cited 01/08/2018]. Retrieved from: https://www.cdc.gov/vi- factsheets/fs385/en/ on 20.6.2018 talsigns/disabilities/ on 20.6.2018 physically active, family is supportive or • Suitability: High level competition, em- WHOa. Prevalence of insufficient physical activity [Internet]. physically active, doing chores at home. Jaarsma EA, Dijkstra PU, Geertzen JHB, Dekker R. Barriers 2017 [cited 01/08/2018]. Retrieved from: http://www.who.int/ phasis on winning, no facilities adapt- to and facilitators of sports participation for people with gho/ncd/risk_factors/physical_activity_text/en/ on 20.6.2018 ed for a person with disability. • Communication: Awareness of opportunities for sport and physical activity, good communication between coaches, so- Psychological: cial contact, asking for help, collabo- 5.4.5. Challenges for Facilitators rative approach between organisations. • Personal perceptions: Lack of motivation, lack and Service Users • Suitability: Training in small groups, of self-confidence about exercising in public, playing individual/dual sports, playing perception that exercise is too difficult, team sport, involving favourite figures/ AUTHORS: JASNA VEŠLIGAJ DAMIŠ, YOANA FILIPIC negative mood, depression, anxieties, fears, interests, programme emphasis on improve- frustration and even time management (a busy ment of social skills and self-confidence. Key words: location, facilities, communication, perception schedule or a busy daily life, taking care of children, daily household activities or work were can be a barrier) (Bragaru et al, 2013). Psychological: This chapter draws on the research and experi- Sport, Coaching and Intellectual Disability. So • Attitudes from others: Discriminatory prac- ence of facilitators in order to outline the we divided bridges and challenges into two main • Personal perceptions: Perception of relaxation tices at fitness centres and other recreational challenges that facilitators/coaches/ trainers categories: and fun, attitude that exercise has health venues, other people´s negative attitudes, and persons with disabilities themselves face benefits, desire to be active, positive at- not having a role model, overprotecting when planning or participating in physical ac- titude towards being challenged, acceptance parents, parental exhaustion and there- tivity. Many authors describe multiple specific Environmental: of the disability, view of sports and phys- fore, the parents themselves discourage characteristics and challenges they face when ical activity as an opportunity for social organizing adapted physical activity programmes • Facility: No accessible build- encounters, feeling accepted as part of a (Bodde and Dong-Chul, 2009; Frey et al., 2005) ings/facilities, waiting lists 5.4.5.1. Bridges to over- group, feeling recognized, feeling rewarded. come those barriers • Equipment: Lack of accessible exercise • Attitudes from others: Important others What we first observe is the learning of mo- equipment, lack of suitable equipment awareness of the benefits of physical activ- tor skills, which should be taken into account In the second part of this article we would like ity, relatives’ perseverance, relatives’ during the implementation of the activity. We • Health and safety: Pain, lack of energy, to suggest possible encouraging factors and assertiveness, being accepted by peers. plan more time for consolidation of skills - health conditions, lack of strength, fatigue, changes that may enable involvement in sports the more complex the skill, the harder it is to longer to develop skills, obesity, decreased and physical activities (Heller et al., 2002; acquire. The degree of flexibility is reduced, ability to understand rules and interpret Howie et al., 2012; Messent et al., 1999; Rob- Aside from the practical strategies, and to and in the activities where coordination is instructions, poor motor skills, prosthesis ertson & Emerson, 2010; Temple, 2007). support people with disability access to sports needed, the rigidity of the muscles is visible. (which can cause corns or blisters during activities there is need to encourage government During the performing of the new skill, there walking or running so a number of athletes for wider access to many other kinds of opportu- are excessive movements that are present for a chose to take part in wheelchair sports or Environmental: nities within individuals’ communities. Limited long time and are difficult to eliminate. People another type of sports in which the prosthe- by dependency on the attitudes of carers people with special needs often strain the wrong mus- sis was not required) (Bragaru et al, 2013). • Facility: Accessible facilities to physical with disability remain subject to significant cles, hyperactivity or muscle hypoactivity also activity or sports in the community, good discrimination. • Location: Lack of transportation, build- occurs. surface for walking or running, parks and ings or facilities located far away. playgrounds available in the community, The challenges are organized according to B. • Expense: Programme and equip- Reference • Equipment: Direct exercise equip- Horne´s criteria in “Making Sport and Physical ment costs, complicated family situa- ment, adapted exercise equipment Activity Inclusive for Disabled People, 2016” tion due to high extra costs for taking Bode, A.E. & Dong-Chul, S. (2009) A review of social and (in Clemete 2017) and Dowling’s criteria in care of person with disability environmental barriers to physical activity for adults with EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 120 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 121 intellectual disabilities. Disability and Health Journal, 2, Howie, E.K., Barnes, T.L., McDermott, S., Mann, J.R., Clark- maintain the functionality of the loco motor The first records of iron prostheses were written 57–66 son, J. & Meriwether, R.A. (2012) Availability of physi- system of persons with disabilities or devices, between 3500 and 1800 BC. Knights who used heavy cal activity resources in the environment for adults with Bragaru, M., Van Wilgen, C. P., Geertzen, J. H., Ruijs, S. G., intellectual disabilities. Disability Health Journal, 5 (1), common for general use - prostheses, orthoses iron prostheses were unable to carry out daily Dijkstra, P. U., & Dekker, R. (2013). Barriers and facili- 41–48. and wheelchairs. activities. The first aluminium prosthesis was tators of participation in sports: a qualitative study on Dutch individuals with lower limb amputation. PLoS One, 8(3), Mahy, J., Sheilds, N., Taylor, N.F. & Dodd, K.J. (2010) Iden- made in 1912. When the materials became lighter, e59881. tifying facilitators and barriers to physical activity for Prostheses are devices that replace missing the functionality of the user’s prosthesis was adults with Down syndrome. Journal of Intellectual Disability parts of the body due to trauma, illness or con- extensively improved. Similar changes have oc- Clemente, I. (2017) Barriers and facilitators to participa- Research, 54 (9), 795–805. tion in physical activity for children with disabilities A genital conditions. The purpose of using pros- curred throughout history in the field of wheel- systematic literature review. (Master Thesis) Retrieved from Messent, P.R., Cooke, C.B. & Long, J. (1999) Primary and sec- theses is to restore the function of the missing chair manufacturing. Progress in biomechanics http://www.diva-portal.org/smash/get/diva2:1107967/FULL- ondary barriers to physically active healthy lifestyles for parts. (“How artificial limb is made,”, 2018). and kinematics influenced the development of ar- TEXT01.pdf adults with learning disabilities. Disability and Rehabilita- tion, 9, 409–419. ticulated and more complex devices. In 1980, the Frey, G.C., Buchanan, A.M. & Rosser Sandt, D.D. (2005) ‘I’d Orthoses are defined as external mechanical de- first sports wheelchair was manufactured. With Rather Watch TV’: An examination of physical activity in Robertson, J. & Emerson, E. (2010) Participation in sports adults with mental retardation. Mental Retardation, 43, by people with intellectual disabilities in England: A brief vices that modify the structural and functional the development of specialized sports activities 241–254. report. Journal of Applied Research in Intellectual Disabili- characteristics of the neuromuscular system. for wheelchair users, arouse the need for spe- ties, 23, 616–622. These are external devices that help individu- cialized sports wheelchairs (e.g. basketball, Hassan, D., Dowling, S., & McConkey, R. (2014). Sport, Coach- ing and Intellectual Disability. London: Routledge. Temple, V.A. (2007) Barriers, enjoyment and preference for al parts of the body to overcome motor deficits races, etc.) (Steadward, Wheeler and Watkinson, physical activity among adults with intellectual disabili- and problems. The orthoses are used for various 2003). Heller, T., Hsieh, K. & Rimmer, J. (2002) Barriers and ty. International Journal of Rehabilitation Research, 30, parts of the body such as belts and bandages. supports for exercise participation among adults with Down 281–287. syndrome. Journal of Gerentological Social Work, 38, 161–177. (Redford et al., 1995) For walking or running, we do not usually need to focus attention on physical activity, as it A special area dedicated to prescribing, making, is automated patterns. In old times, the use of adjusting and maintaining orthoses and prosthe- prostheses and wheelchairs for movement involved 5.4.6. Equipment and Technology ses is called orthotics and prosthetics. It is cognitive activity, attention and regulation a science that links knowledge in the field of by the user. The use of modern gadgets still AUTHOR: VLADIMIR JAĆEVIĆ anatomy, physiology, pathophysiology, biomechan- requires a degree of regulation by the user, ics and engineering, and professionals in this but so-called “intelligent devices” allow more Key words: support technology, prostheses, orthoses field need special education. effective walking for people after amputation using a built-in computer chip. Similarly, the A wheelchair is a commonly used device that is use of electric wheelchairs with the possibili- For persons with disabilities it is common to less points to the connection between technology used when walking is difficult or impossible due ty of external regulation and control (e.g. use be poorly included in physical activities than and functionality. In the field of adapted physi- to illness, injury, or disability. in adapted sports activities for children with for the general population and consequently cal activity for persons with disabilities, the cerebral palsy) (Steadward, Wheeler and Watkin- first have more health problems. At the same primary goal is to improve the functionality of son, 2003). time, there are fewer programs for recreation individuals. So, in this case, the term technol- 5.4.6.3. The impact of the develop- and sports education available for adults with ogy refers to the use of science for manufactur- ment of technology on the use of or- disabilities. (Rimmer et al., 2014). Technologi- ing devices - orthoses and prostheses in order thoses, prostheses and wheelchairs 5.4.6.4. Use of technological achieve- cal development of sports activities for persons to achieve greater functionality for the users. ments and involvement of people with disabilities enables more and more people All devices, equipment, tools, and product Due to technological development, in the area of in adapted sports activities to be involved in sports activities using vari- systems used to maintain and improve the ability the manufacturing of prostheses, orthoses and ous devices and tools. The development of tech- of people with disabilities are referred to as wheelchair, three fundamental changes occurred In contemporary world, people with disabilities nology, especially in the field of materials for the common term supportive technology. Simi- that influenced the use and functionality. The have a full range of specific sports activities the manufacture of devices, allows people with larly, term adaptive technology is also in use, devices have become significantly lighter, more they can engage in. Therefore, they can join disabilities with specially designed prostheses and relates primarily to the use of electronic complex and with the possibility of external recreational activities, participate in various or other adapted equipment to participate in a devices and information technology and devices regulation. One of the most important technolog- organized programs and groups or actively com- variety of sports, individual and collective that are intended and designed exclusively for ical changes in the sports activities of people pete at international level. (Steadward, Wheeler and Watkinson, 2003) people with disabilities (“Assistive and Adap- with disabilities is the use of more modern tive Technologies for HIE”, 2018) materials such as polymers, ceramics, carbon Organized sport for people with disabilities fibres, for making devices. These materials have has existed for more than 100 years, the first 5.4.6.1. Definition of technology in mechanical and physical characteristics substan- sports clubs for people with hearing impairments relation to the physical activi- 5.4.6.2. Definitions of basic con- tially better than conventional materials such existed in Berlin in 1888. Nevertheless, adapted ties for persons with disabilities cepts in the field of equipment and as steel and aluminium. Another essential change sports activities became more widely available devices for adapted physical activi- is the use of computers in the manufacture of after World War II. The purpose was to help According to one of the definitions, the technol- ties for persons with disabilities prostheses and wheelchairs. Computer chips a large number of war veterans and civilians ogy is “the application of science for industri- built into devices can help control the walking who suffered injuries during the war. In 1944, al and commercial purposes” (American Heritage In this chapter, we will focus primarily on (Steadward, Wheeler and Watkinson, 2003). at the request of the British Government, Dr. Dictionary). This very broad definition neverthe- equipment designed to establish, improve and Ludwig Guttman opened a centre for spinal cord EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 122 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 123 injury at Stoke Mandewille Hospital in Great cially for people with disabilities. An example sionals working with persons with disabilities. Lastuka, Amy & Cottingham, Michael. (2015). The ef- Britain. Dr. Guttman promoted the idea of using is the discipline boccia (Italian word, bullet) The choice and prescription of the appropriate fect of adaptive sports on employment among people with disabilities. Disability and rehabilitation. 38. 1-7. sports for rehabilitation purposes (“Paralympics developed for people with cerebral palsy and device is definitely highly individualized ac- 10.3109/09638288.2015.1059497. History - History of the Paralympic Movement”, first presented at the Paralympics in New York in cording to the characteristics and needs of each Boccia - Disabled Sports USA. (2018). Retrieved from https:// 2018). After this, numerous studies have con- 1984. Discipline is now practised in more than user (it is about the motor, health, psychologi- www.disabledsportsusa.org/sport/boccia/ on 20.6.2018 firmed the positive impact of sports activi- 50 countries by people with cerebral palsy or cal, social and other factors). All profession- ties on the physical, psychological and social various neurological conditions involving the als of different profiles involved in disability functioning of persons with disabilities. In use of a wheelchair. The rules and equipment are treatment programs (selected doctors, sports addition to the improvements in the affected adapted to the specific abilities of people with education professors, trainers, physiothera- functions, a positive impact on self-esteem, different levels of disability (people can move pists, work therapists, nurses, psychologists, mood, social inclusion and employability, is balls with a hand or foot, they can throw them social workers) need additional knowledge of essential. Long-term physiological adjustments, or roll them through specially designed ramp the equipment and devices used by the persons as a result of long-term intensive training in (“fusion ramp”) (“Boccia - Disabled Sports USA”, concerned, where they can provide users with athletes with disabilities, among other positive 2018). help and support. It is a field in which there effects, lead to a better respiratory volume, is a trend of very rapid changes. Due to all of reaction time and improvement of executive func- The development of sports disciplines and the this, cooperation and knowledge sharing within tions (Lastuka, Cottingham 2015). inclusion of more and more people with disabil- multidisciplinary teams is essential. It is also ities are accompanied by the rapid development important to regularly train all team members in Over time, sports activities part for rehabili- of technology in the field of the production of terms of specific know-how in the field of orthot- tation developed first into recreational and then accessories and equipment. As an illustration, ics and prosthetics, and in general the use of into competitive sport. Increasing involvement athletes who competed on Stoke Mandewille games science and technology achievements to improve in a wide variety of sports activities is accom- used trolleys weighing approximately 22 kg. Con- the functionality of people with disabilities. panied by the development of technology for the temporary adapted trolleys for competitions are production of various accessories or customized roughly 5 kg. Three-wheel wheelchairs are often equipment and equipment for individual sports. used for competitions, and five wheel wheelchairs Reference With appropriate education people with disabil- are used for ball games. Nowadays athletes in ities can also use recreational facilities that wheelchairs can ski, bake, play hockey, cycle. Rimmer, J. H., Riley, B., Wang, E., Rauworth, A., & Jurkows- are generally used, such as different poles For persons after amputation of legs and arms, ki, J. (2004). Physical activity participation among persons with disabilities: Barriers and facilitators. American (e.g. Nordic walking, gymstick, balance boards, there are special devices adapted to be used in Journal of Preventive Medicine, 26, 419–425. http://dx.doi. balls of different sizes and different materi- specific sports activities (for example, swing- org/10.1016/j.amepre.2004.02.002 als). In addition, the use of modern materials ing prostheses, climbing prostheses, basketball Fox, K. R., & Hillsdon, M. (2007). Physical activity and in production eases adaptation to the needs of prostheses). The use of modern technology in obesity. Obesity Reviews, 8, 115–121. the individual. competitive sports opens up new ethical ques- Steadward, R., Wheeler, G., & Watkinson, E. (2003). Adapted tions about the impact of equipment on sporting physical activity (1st ed., pp. 541-557). The University of In 1948, on the day of the opening ceremony of results. (Steadward, Wheeler and Watkinson, Alberta Press, Steadward Centre. the London Olympics, Sir Guttman organized the 2003). Parant, Aymeric; Schiano-Lomoriello, Sandrine; March- first international wheelchair sports competi- an, Francis (October 2017). “How would I live with tion called Stoke Mandewill Games. These games a disability? Expectations of bio-psychosocial con- later became the Paralympic Games, which first 5.4.6.5. The importance of the mul- sequences and assistive technology use”. Disabili- ty and Rehabilitation. Assistive Technology. 12 (7): took place in Rome in 1960 and were attended by tidisciplinary team and the impact 681–685. doi:10.1080/17483107.2016.1218555. ISSN 1748- athletes of 23 countries (“Paralympics History - of specialized education in work- 3115. PMID 27677931 History of the Paralympic Movement”, 2018). ing with people with disabilities How artificial limb is made - material, manufacture, making, used, parts, components, structure, procedure. (2018). Re- People with disability can compete in various The use of modern equipment undoubtedly results trieved from http://www.madehow.com/Volume-1/Artificial-Limb. sports disciplines in modern times. Most sports in improving the quality of life of people with html on 20.6.2018 disciplines are existing sports, adapted to the disabilities, as well as in the field of daily Redford, John B.; Basmajian, John V.; Trautman, Paul needs and abilities of people with disabilities. activities and implementation of adapted phys- (1995). Orthotics: clinical practice and rehabilitation technology. New York: Churchill Livingstone Inc. pp. 11–12. One of the main disciplines is athletics. We ical activities. On the other hand, users need would also mention adapted swimming, wheelchair professional treatment and a complex approach Assistive and Adaptive Technologies for HIE. (2018). basketball, sitting volleyball, shooting, and when choosing, using and maintaining various Retrieved from https://hiehelpcenter.org/treatment/ assistive-adaptive-technologies/ table tennis. Contemporary sports as curling, technology and equipment. bowling, and netball are somewhat less preva- Company, H. (2018). The American Heritage Dictionary entry:. Retrieved from http://ahdictionary.com/ on 20.6.2018 lent. These activities include the use of specif- Rapid technological development in the field ic equipment that can be specifically designed or of prosthetics and orthotics and the use of Paralympics History - History of the Paralympic Movement. (2018). Retrieved from https://www.paralympic.org/the-ipc/ slightly adapted for persons with disabilities. increasingly demanding devices requires addi- history-of-the-movement on 20.6.2018 Some disciplines and sports are designed espe- tional assistance and involvement of profes- aPpliCa 6. ti•On •Of ADaPTeD PhySicaL ACTivIty Pr•OgramMEs

Learning outcomes:

• Familiarizing readers with the programmes adapting rules, equipment and ter- we implement in the ReSport Project rain for persons with disabilities

• Present useful information about

Adapted Physical Activity Programmes

Based on the developed and performed activities programmes. We facilitated those sports in dif- in the framework of the ReSport project, test- ferent locations and settings in the three years ing results, evaluation and consultations with of the project and researched its implications experts from different sport and rehabilitation for persons with disabilities. fields we prepared a number of adapted physical EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 126 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 127

6.1. SwimMING

AUTHOR: ILONA KOVAL GRUBIŠIĆ

Key words: swimming, adapted aquatics, aquatic activities, therapeutic water exercise, swimmers with disabilities, Halliwick

Swimming and aquatic activities for children Swimming strengthens muscles that enhance the with disabilities can foster physical fitness and postural stability necessary for locomotor and motor skill development within a physical educa- object-control skills. Water supports the body, tion program and during recreational pursuits. enabling a person to possibly walk for the first Photo, Center Naprej, rehabilitation in the water, summer camp in Moščenička Draga, 2018 In the opening scenario, Jack’s parents are time, thus increasing strength for ambulation within their legal rights to request swimming on land. Adapted aquatics also enhances breath as part of their son’s IEP because aquatics is control and cardiorespiratory fitness. Blowing Club activities: defectologists, educators all of whom are former listed as a component of physical education un- bubbles, holding one’s breath, and inhalation swimmers or athletes. The volunteers are the der the Individuals with Disabilities Education and exhalation during the rhythmic breathing of • planning of the work and development of students of the Physiotherapy Studies at the Act (IDEA). Aquatics instruction for students swimming strokes improve respiratory function swimming sport of persons with disabilities Faculty of Medicine in Rijeka. The main goal is with disabilities is neither a luxury nor a and oral motor control, aiding in speech devel- to teach children to swim regardless of their • organizing and conducting regular system- therapeutic (related) service. Adapted aquatics opment (Martin, 1983). disability, ie, they are literally learning atic training sessions for learning and means modifying the aquatic teaching environ- about their motor abilities. improving swimming skills of its members ment, skills, facilities, equipment and instruc- Benefits are not limited to the physical realm. and preparing them for competitions tional strategies for people with disabilities. Water activities that are carefully planned and There are five sections in the club: It can include aquatic activities of all types, implemented to meet individual needs provide an • teaching and training of children and youth including instructional and competitive swim- environment that contributes to psychosocial 1. Therapeutic section • preparing its members for participation ming, small-craft boating, water aerobics, and and cognitive development. As a student with in the city, county or state selection 2. School for non-swimmers skin diving or scuba diving (AAHPERD-AAALF, a physical disability learns to move through 1996). the water without assistance, self-esteem and • care for the health and health pro- 3. Swimming School self-awareness improve. Moreover, the freedom tection of club members 4. Competitors Physical educators, school administrators, of movement made possible by water boosts morale • the overall club activities aim to fos- parents, related service personnel, and special and provides an incentive to maximize potential 5. Recreation ter understanding and adoption of ethi- education teachers must be educated about the in other aspects of rehabilitation. cal values through sporting activities benefits of aquatics and its role in a child’s With our program we want to improve the biopsy- physical education. The physical and psycho- The Swimming-Therapeutic Club Forca is the first • kinesiotherapy chosocial development of the child. The program social benefits of aquatics for students with such club in our area and one of the few clubs is implemented by a multidisciplinary team of disabilities are more pronounced and significant in Croatia whose members are children with In the SC Forca, we gather 120 members with whom kinesiologists-kinesitherapists, physiothera- than for students without disabilities. Because developmental disabilities and persons with we regularly work at the Kantrida pools and in pists, educators and trainers. of the buoyancy afforded by water, many people disabilities - persons with physical disabili- summer on the disability beach in Kostabela. whose disabilities impair mobility on land can ties, impaired sight and hearing and those with In addition to regular activities in summer The Halliwick concept is widely used in the club function independently in an aquatic environ- learning disabilities. The club was founded with schools, more than 200 children and young people program. The Halliwick concept is the approach ment without the assistance of braces, crutch- the basic aim of promoting and developing the have been trained. to teaching of all people, especially those with es, walkers, or wheelchairs. Although adapted sport of people with disabilities in Rijeka and physical disabilities and / or learning disabil- aquatics does not focus on therapeutic water the region. We are a sports club in the County with the ities, to be able to take part in activities in exercise, warm water facilitates muscle relax- most highly educated staff that we have further the water, to move independently and swim. (IHA ation, joint range of motion (ROM), and improved educated at the Halliwick courses. The club is - Halliwick Concept 2000). muscle strength and endurance (Koury, 1996). operated by kinesiologists, physiotherapists, EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 128 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 129

At first, Halliwick was called the method. The In the club, we gathered a special social International Halliwick Organization (IHA) was group, children with intellectual impairments, founded in 1994 with the goals of promoting and who attend a swimming school 3 times a week on developing Halliwick around the world. IHA has recreational and rehabilitation levels, but at chosen to use the term Halliwick concept as the same time, for the interested and serious the word ‘concept’ because it suggests a wider participants, there are opportunities to compete framework within which different practitioners at local, regional and state level. 6.2. can apply Halliwick in different contexts. NoRDic Walk- The concept influenced the traditional ways of teaching swimming and hydrotherapy techniques. At the same time it developed into a special iNG aND GyMSTick therapeutic activity in water.

The Halliwick concept recognizes the benefits - GNW PROGRAM that can be derived from water activity, and sets out the basics needed for teaching and learning in this environment. These benefits are AUTHOR: JASNA VEŠLIGAJ DAMIŠ, LADISLAV MESARIČ holistic and include physical, personal, recreational, social and therapeutic aspects. Key words: nordic walking, gymstick, bands, nordic walking poles, gymstick exercise bands Therefore, Halliwick can have a significant impact on the quality of life of people. The Photo, Center Naprej, rehabilitation in the water with aqua holistic Halliwick approach encourages people to gymstick, 2018 take part in water activities, to float and swim independently, and it fits well within the ICF. The program consists of a swimming school – Introduction • Persons with acquired brain injury (ABI), teaching and perfecting basic swimming tech- • Persons with intellectual disabilities (ID), Therapists who want to solve certain limita- niques – front crawl, backstroke, breaststroke With Nordic Walking Gym exercise bands we can tions can use Halliwick’s structure with special and butterfly stroke. With regular trainings, we modify our walking, cross country or alpine • Visually impaired, emphasis on areas such as movement (including raise the level of fitness for the participants, poles into a Gymstick exercise bar in just a few • Hearing impaired, range of movement, coordination and planning), influence the morphological characteristics of seconds by attaching the NW Gym bands on them. strength, endurance, respiratory capacity, oral the body, teach new motor skills and raise the The combination of poles and bands will allow • Persons with speech and language disorders, control, fitness etc. Water also promotes sensory overall level of motor skills. you to perform a complete workout improving your • Physically handicapped persons, integration. muscle strength, balance and mobility. You can choose to exercise in between your walking pro- • Long-term sick persons, Halliwick helps develop social skills, commu- Reference gram in the open air or at home. This allows you • Persons with learning difficulties, nication, learning abilities, psychological to do both walking cardio exercise and muscle well-being and self-esteem. Working in a group Koury, Joanne M. (1996). Aquatic therapy programming: guide- condition training anywhere, anytime! • Persons with emotional and be- further promotes the development of these abili- lines for orthopedic rehabilitation. Champaign, IL: Human havioral disorders, Kinetics, 280 p. ties. (Lambeck, Stanat, 2001). • Persons with autism spectrum disorders, Martin, K. (1983). Therapeutic pool activities for young Swimming can be an important activity in pro- children in a community facility. Physical and Okkupational 6.2.1. GNW program - • Talented person. Therapy in Pediatrics, 3, 59-74. moting quality of life. As mentioned earlier, who is it for? swimming as a therapeutic tool plays an import- Lambeck, J., Stanat, F.C. (2001). The Halliwick method. Part The program was developed by the Centre Naprej ant role in improving and maintaining health. 1and Part 2. AKMA, 15, 39-41. as part of rehabilitation programs to include The program is intended for those who are users who all experienced severe brain damage. At the swimming school, by methodical approach attracted to this kind of physical activi- and the appropriate props, we approach the ty, but especially adapted for persons with teaching of all swimming techniques: the front disabilities. crawl (freestyle stroke), the breaststroke, the 6.2.2. Why gnw program for backstroke, and the butterfly stroke. The aim is Persons with disabilities are those who devi- people with disabilities or for the participants to adopt basic swimming ate from the expected features and capabilities techniques and to start participating in local defined in a particular environment, and require for persons with ABI? and regional competitions. Attendees of the extra attention and care, like: swimming school are children ranging 4-12 years Good physical condition allows welfare. The re- of age. sult of a systematic and continuous work is also EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 130 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 131

PHYSICAL FITNESS RELATED TO HEALTH

CARDIO- BODY MUSCLE MUSCULAR FLEXIBILITY RESPIRATORY COMPOSITION STRENGTH ENDURANCE

Figure 9: Physical fitness related to health (Source: American College of Sport Medicine)

However, exercising only through walking is Especially important is to maintain muscle mass, not sufficient to prevent the loss of muscle that is, if it is inactive, subjected to rapid strength. Without strength training the muscles atrophy. Both parameters can be in dealing with still become weake and less functional. Ef- the physical form and health considered together fective training has duration of not more than as muscle strength. twenty minutes and requires little effort. The key is to use the exercises in which muscles Mobility is the ability to perform large ampli- work against an external resistance, and to in- tude movements in a certain order or a certain Photo: Jasna Vešligaj Damiš, users of Center Naprej, Piramida, Maribor, 2017 clude all parts of the body. Methods of strength plane. training include the use of free weights, fitness equipment, rubber bands, balls and exercis- All of the above mentioned areas effectively a consequence of mental attitude to live healthy Walking is man’s elemental movement and efficient es with its own weight. To avoid injury start improve due to appropriate exercise at all ages. and active, which also increases confidence. movement workout. It is suitable for all people slowly and build up exercise strengths where Being fit does not mean only physical ability, who can walk and is a completely natural and appropriate. but it touches all areas of our lives. It helps safe recreation that can be performed anywhere, to purify negative patterns, traumas from past, anytime. It does not require expensive equipment Poles also serve as requisite and support for 6.2.3. Gymstick nordic frustrations and focus on what really counts in or special facilities, but only the time and exercises for flexibility. The combination of walking – adaptations for life. Physical activities are critical to main- the will. Regular walking improves both mental walking with poles, exercises for power with taining an active and independent lifestyle. A as well as physical health as it strengthens elastics and exercises for flexibility with persons with disabilities man aged between 30 and 70 years losses about a each and every muscle in the body, while not poles, gives an ideal combination, which meets quarter of his muscle strength, a man who ex- overloading the joints. In addition, the body all the basic requirements of natural (physical) periences 90 years more than half. Movement is after thirty minutes of walking begins with the fitness related to health. The American College Adjustments to the program in terms of age the key to maintaining the health, welfare and secretion of serotonin, the hormone of happi- of Sports Medicine has defined adequate physical working capabilities. ness, and endorphin, thus largely contributing fitness related to health, as a set of five dif- Implementation of the program is not limited to a good and a lot less stressful mood. Due to ferent measurable elements. by age; it can be implemented in all stages of Physical/sport activity may be an important release tension, walking has a beneficial effect life. Therefore it is wrong to think that this factor in the social life of a person. It allows on sleep. Cardio respiratory capacity is defined as the kind of physical activity cannot be carried out him to have fun in the company of others, make ability of the heart, circulatory and respira- by elderly. Ageing is a gradual reduction of acquaintances and friendships, and feel part of The first step towards improving the efficiency tory system that efficiently supplies the active biological functions, and the ability of the the group. of walking is walking with poles (more common- muscles with oxygen at the time of continuous organism. During this process an individual ly known as Nordic walking). Poles have always muscle activity. The structure of the body is facing deterioration of his working, repro- All individuals with special needs can have a been a device for walking. The poles evenly usually refers to the percentage of muscle, bone ductive and creative functions. During ageing variety of problems in the field of physical dis- distribute loads which occur during walking. and fat mass in the body. Normally we monitor changes can be seen at the level of cells, abilities. Despite this, they must be physically They redistribute part of the weight that would the percentage of fatty tissue. Physique is an tissues and the organism itself. Many years of active within their capabilities, because the otherwise put pressure on the hips and knees, organism’s ability to perform activities re- research confirmed the fact that in the process lack of movement leads to new complications that on the hands. Thus, with each step, we are quiring a high level of generation of muscular of ageing regular and balanced aerobic physical prevent a better quality of life. People with strengthening the hands. The intensive work force. activity has a significant impact on the preser- traumatic head and brain injury, which usually period also strengthens the cardio-respiratory vation and enhancement of physical and mental occurs as a result of a traffic accident, fall, function. Poles provide additional stability Muscle endurance is the ability of a muscle or abilities. So it is never too late to start with etc., the basic physical exercises affect the when walking which is especially important for muscle group to perform repeated muscular con- exercising regularly. improvement of motor functions, functions of the people with impaired balance. traction for a long time, or to retain a high locomotor system, relaxation of muscle tone and level of development of muscular force for a Regular exercise can effectively reduce or stimulate the equilibrium reaction. long time. prevent a number of functional problems asso- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 132 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 133 ciated with ageing. Strength training helps to abilities of users. Therefore an Nordic Walking Gym Exercise Bands poles and decrease the resistance by re- delay the reduction of muscle mass and strength, individual training can be ac- leasing the bands from around the poles. which is typical for ageing. This type of ex- complished, completely balanced The Nordic Walking Gym Exercise bands are avail- • When you have adjusted a suitable resis- ercise improves the bone structure, and there- on the personal aims. An import- able in any of the three resistance levels tance, remember to grip the stick with a by reduces the risk of osteoporosis, improves ant part is also risk assessment below: relaxed but firm grip to avoid slipping. the balance and thereby minimizes the risk of of the program because in ev- falling, consequently associated with injuries ery training there must be full • Light/Green - for rehabilitation workouts and • Do not stretch the bands over four times and fractures, and also improves flexibility and safety measures provided for all exercise for the elderly. The resistance of their original length when exercising range of motion. Physical activity has a favour- included. Figure 10: Gymstick Nordic green exercise bands ranges from 1 to 10 kg. able effect on the cardiovascular and respirato- Walking poles • Medium/Blue - for junior athletes and women ry systems. Regular exercise is also connected Appropriate clothing and footwear who want to start exercising. The resistance with the maintenance of cognitive function, of blue exercise bands ranges from 1 to 15 kg. reducing depression and improving self-esteem. 6.2.4. Equipment for gnw programme In order to feel good during the training and to In addition to these, regular physical activity • Strong/Black - for fit women, men who maintain obtain safety we have to pay special enriches the elderly with positive emotion and want to start exercising, and ath- attention on proper footwear and clothing. We Nordic Walking Poles letes. The resistance of black exer- should never put on new shoes or hiking boots cise bands ranges from 1 to 20 kg. for the first long hike. Footwear must be suited Nordic Walking poles differ from regular trek- to activities carried out in nature. We can use king or alpine skiers poles in one main area: running shoes, trekking shoes or light hiking the grips and straps. The Nordic Walking straps boots. Hiking boots shouldn’t be too high, as stay wrapped snugly round the hands and are this prevents proper technical implementation clipped to the slimmer grip of the pole. This of Nordic walking. It is important that the shoe allows the pole to be swung from the hand, with offers good support and has non-slip soles. the downward pressure from the arms quickly applied to the pole when it reaches the desired We can engage in GNW in all seasons, but we position. Carbon is best for pole composition must always dress according to the weather but it costs more and other compounds are en- conditions, because the cold contributes to Photo: Zvonka Novak, users of Center Naprej, Kalvarija, tirely suitable for the recreational Nordic exhaustion. In the case of variable weather Maribor, 2017 Walker. conditions, we have to wear several layers of clothing, which can be, if necessary, removed. Photo: Zvonka Novak, users of Center Naprej, Piramida, Clothing should be light, sporty. Too loose welfare, reduces nervousness and mental stress, Select the correct Length of Poles Maribor, 2017 clothing can hinder us in the activities. If we maintains the mental and spiritual balance, are too hot and we face excessive sweating, we improves sleep, maintains and creates new To choose the right length poles, first determi- need to make sure our body gets enough fluids. In friendships. nate the proper pole by multiplying your height How to use the Exercise Bands the backpack, which should not be too heavy, we by 0,68 or by referring to the chart down. As a carry only the necessary things. We have to make rule of thumb, the elbow should be at 90 degree Transforming the poles to a Gymstick and adjust- sure that our back and neck are protected from Adjustments to the pro- angle to the surface when the poles in a relaxed ing the resistance the cold and wind. Therefore, we should have a gram in terms of gender grip on the ground. For beginners it is recom- spare T-shirt to be able to change clothes. mended to start with a shorter pole. • Take bands from handbag. This program is suitable for both men and women • Put the poles next to each other, han- and there is no need for adjustments regarding Use the following table to select the correct Reference dles pointing to opposite directions, gender. There are also no restrictions in terms length of the poles: with the paw-part extending further out of physical, cognitive and sensory deficits. Retrieved from manual for rehabilitation of persons with than the handle of the other pole. disabilities: Vešligaj Damiš, J., Mesarič, L., Mesarič, P. Quite the contrary - appropriately selected 6’5” 200 135 GNW- Gymstick – Nordic walking program physical activities that improve flexibility, 6’3” 190 • Tighten the poles to each oth- muscle strength, aerobic capacity and other 6’1” 185 130 er with the Velcro. physical aspects, allow better rehabilitation of 5’11” 180 125 • Set the loops on both feet, in the middle of people with various deficits. 5’9” 175 120 the sole, roll the elastic band around the 5’7” 170 bar (both poles) a couple of times and you are For the implementation of the program for per- 5’5” 165 115 ready to begin a Gymstick exercise routine. sons with different limitations two conditions 5’3” 160 110 must be provided: trainers must know the par- • In the beginning of each movement the ex- 5’1” 155 ticularities of the population they are dealing 105 ercise band must be straight but not 4’11” 150 with and must be specially trained to adapt the stretched. You can increase the resis- 4’9” 145 100

exercise to the remaining physical and cognitive Poles of Measure 5: Table tance by rolling the bands around the EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 134 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 135

6.3. stand UP paddle Boarding (SUP) as a NEw form of RE- haBILitaTIOn Of iNDivIDUals With ACqUiREd BRAin Photo: Jasna V.D., users of Center Naprej, Hoška gramoznica, 2017

And last but not least SUP stands out amongst 6. Service users with severely impaired vi- iNJurY (aBI) sports for being a very sociable, calming and sion and those with other disabilities engaging with nature activity (Hammer, 2011, that prevent them from standing, go on Schram, Hing, Climstein, 2016). As we quietly the board with assistants who choose an AUTHOR: JASNA VEŠLIGAJ DAMIŠ float together crossing lakes we have the unique appropriate size of board for two. opportunity to explore and learn about the beau- 7. It offers a very effective workout. The Key words: swimming, adapted aquatics, aquatic activities, therapeutic water exer- tiful nature of Slovenia. constant wobbling of the board means that all cise, swimmers with disabilities our muscles are working to keep the balance of our body (Schram, Hing, Climstein, 2016). 6.3.1. Why is stand up paddle It’s also good for rehabilitation of our service users, to offset the loss of balance Introduction Standing, paddling and taking the pleasure in boarding appropriate for persons which often comes with acquired brain injury. observing the nature we were honestly surprised Stand up paddle boarding, otherwise known as that our users got used to balancing and gained with acquired brain injury (ABI)? 8. It is a fantastic full-body workout. We SUP, once an ancient method of transportation control over the paddle boards very quickly. practice relaxation and at the same time we is now a sport that is easy and appropriate for Even though having fun is important, safety is 1. Because SUP is a fun full body workout ac- facilitate injury rehabilitation. Almost everyone who wants to explore the nature pad- always our priority as any sport may lead to tivity (Green, 2016, Ruess et al., 2013). every muscle in the body is working during dling. Nevertheless, it is also a unique oppor- injuries (Walker, Nichols, & Forman, 2010). paddle boarding. Because of the balance re- 2. It is a great sport for everyone. tunity for developing a rehabilitation program, Boards should be appropriate length and width, quired, leg muscles are struggling attempting practising interesting sports, rehabilitation hull type and we should have accessories like a 3. We can stimulate brain activity ex- to stabilize our centre of gravity, while the exercise for the whole body, exploring nature paddle, PFDs (Personal flotation devices) and a ploring rivers, lakes, sea bays... arms, back, shoulders and higher abdominal and way of meeting new people and sharing expe- leash. Our service users were capable to learn muscles are used to push the paddle in the 4. We have an opportunity to observe the lo- rience (Hammer, 2011, Walker, Nichols, & Forman, how to maintain control of the boards and confi- water. The core, back and abdominal mus- cal scenery from a new angle. SUP gives us 2010). dently floated around in just half an hour. With cles are constantly at work to maintain our a wider view than we would get on land so a lower centre of gravity and a life vest on, balance. Therefore paddle boarding increases we can see and experience the hidden side It is sports enjoyed by young kids, men, women, which adds buoyancy they did not fear much and our strength; improve our balance and endur- of the rivers and lakes we already know. older adults and people of all sizes, disabled falling in off a board when they lost balance ance (Schram, Hing, Climstein, 2016, Vojska, and everyone in between. Saying it is appropri- was the best thing they could possibly do. As 5. Lying on the board with eyes closed, 2017). If we spend enough time in the water ate for the whole family we should not forget they fell on the soft life vest they faced their listening to the sounds of the sea al- paddling quickly we would get a good car- our four-legged companions as paddle boarding is fear of water and slowly overcame it and en- lows us to escape the urban con- dio workout. It is also a good way to burn a fun way to spend time with our dogs. joyed, even more, when they got on the board the fines and reconnect with nature. off excess weight and build lean muscles next time. that would help us in reducing strain on the EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 136 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 137

lower back and the knees (Green, 2016). • Prepare the equipment. We should be careful when choosing a proper board (all round, 9. SUP is an extremely fun and enjoy- solid). We should adapt the volume in or- able activity that could replace in der to fit our weight – we should add 110 to some ways therapeutic work indoors our weight and we would get the appropri- (Schram, Hing, Climstein, 2016). ate volume for us. We should not forget the 10. We can go paddle boarding alone or with accessories such as paddle, PFD (personal friends. It’s very easy to chat to floatation device), leash and proper clothes friends paddling alongside. (t-shirt, baseball cap, sunscreen) and fluids.

11. We would never forget the unique experience while boarding as a group. Basic Paddle Board Equipment 12. Stand up paddle boarding may reduce stress. Floating on water naturally, soothes the • Stand up paddle board body, it is an exercise for mind and mus- • Leash cles. That is why we would recommend this powerful natural stress buster. • Paddle

13. We gain a completely different and more • Sunscreen beautiful perspective of the nature • Baseball cap Photo: Jasna Vešligaj Damiš, users of Center Naprej, Drage, Croatia, 2017 around us when we stand on the board. • UV protection t-shirt 14. It is quite a “green” activity as we need • They paddle as they grip the top of the paddle just a board and a paddle. We do not need an • Water bottle 2. Teaching service users to with one hand and place their other hand at engine, fuel and we do not make noise or dis- stand on the paddleboard • Dry bag a comfortable distance about one - third turb wild creatures in their natural habitat. down the paddle. They should keep their arms • PFD (personal floatation device) • The right combination for gaining balance 15. SUP offers us a lot of opportuni- straight as they extend the paddle forward - being upright on the board, feet shoul- ties – to engage in conversation with for each stroke. When paddling on the right der width apart, knees slightly bent plac- friends, to exercise outdoors or even side of the board right hand stays lower when ing our head in the centre of the board. get an adrenaline adventure. 6.3.3. Educational approach switching sides we reverse our hand position. • We should balance with our hips, so head 16. It is relatively easy to learn and practice, • They should start paddling keeping their lower and shoulders stay still, keeping eyes and it is probably the only activity which shoulder to the front and the top shoulder on the horizon, not on our feet. can be equally enjoyable for everyone. 1. Teaching service users how to stand up back in order to reach far out to the front, on the paddle board their first time out • We should be careful positioning our service preferably – 30 – 50cm ahead as it is the most users on the board as they should not place important thing for making a good stroke. They 6.3.2. General advice and • First, we have to teach the service us- their body in the front of the board as the push the paddle down with their whole upper instructions for stand up paddle ers how to step on the board, how to at- nose will drop in the water and as soon as body moving it from the nose to the tail and tach their leash, to squat on the board they start paddling they will fall. If they then as it reaches the point of their an- boarding with individuals in order for them to be able to stand. stand far back on the board, the tail will kles they take the paddle out, quickly put drop into the water and the speed will de- their body upright again, throwing their hips with acquired brain injury • Gradually we teach service users how to crease. They should stay in the middle of the forward and shoulder backwards. They should stand up, how to gain balance and after board with their feet parallel to the string- not use their arms but use the whole upper they have developed these skills we fo- Preparation er – about shoulder width apart with knees body to push the blade deep into the water and cus on teaching them how to paddle and slightly bent, and back completely upright. pull through. Using upper body and shoulder turn the board in the desired direction. • Start out in flat, calm water – the most rotation for power would make the board move appropriate locations are lakes, sea sur- • We always teach our service users where faster. They should keep the paddle upright face without waves or safe gravel pits. the water is deep enough (at least 80cm) 3. Teaching service users to pad- and closer to the sides of the board, moving to prevent them from hitting the bot- dle (stroke techniques) their core forward using hips and legs to • Safety check access to the water as it tom when they fall. They start out on pull the paddle. As hips move forward board should enable us to go in and out safely. their knees and take a few strokes on each • As soon as service users feel com- slides faster. This technique is appropriate • Prepare the service users appropriately for side of the board until they reach deep- fortable on the board we start teach- for those who are physically and mentally the activity (what is expected to happen, er water, then they slowly stand up with ing them how to use the paddle capable of completing it. Otherwise, we can safety instructions, accessories etc.) Pre- one foot at a time trying to balance. simplify it in order to ensure the safety of • We use adjustable paddles, take the rid- pare a risk assessment for the activity. the users and let them enjoy the paddling. er’s height and add 15 - 20cm to determine the correct paddle length. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 138 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 139

• In order to paddle in a straight line, they Turning the board Always remember: Start with providing a thorough stress and makes us feel better (Schram, should take a few strokes (3-5) on one side stand up paddle boarding and swimming training Hing, Climstein, 2016, Green, 2016). then switch to the same number of strokes for your assistants before teaching your users. on the other. Usually, in the beginning we • SUP is a full-body workout. As paddlers are able to complete fewer strokes that we use different muscle groups. We need to are also shorter. At this point in time, learn to balance which trains core mus- the most important tasks are keeping bal- cles and fingers. SUP strokes require move- ance and getting used to the board. ments of hips and shoulders similar to those in golf, tennis or baseball.

And a frequently asked question: How • The back muscles are of crucial impor- to hold a sup paddle properly? tance and constantly at work as they maintain the posture and stabilize the up- We should hold the paddle so that its angle per part of the body (Schram, 2015). should face away from us. As there are many • The abdominal muscles are at work when pad- kinds of paddles with differently placed angles dling, they are used to propel the paddle- we provide you with a simple way to show you the board into the water and work together with correct way. When faced the right way the blade the back muscles attempting to maintain our will lift and allow us to move faster with less balance (Schram, Hing, Climstein, 2016). effort (derived from https://www.justpaddleboard.com/proper-paddle-form/). Please see the • Paddling strengthens and trains the mus- photos below: cles of the spine, as well as the triceps Photo: Jasna Vešligaj Damiš, users of Center Naprej, Gams and biceps. Our buttocks, thigh and calf Bad, Austria, 2017 Photo: Jasna Vešligaj Damiš, users of Center Naprej, Velen- muscles are also working hard in order to jska plaža, 2018 keep our body upright (Schram, 2015). Once users are able to paddle forward and keep • SUP improves our motor skills, the balance we move on to turning the board. strength, endurance, coordina- This is an important lesson as they need to know tion and mobility (Schram, 2015). how to go back to the shore. We start lessons 6.3.4. The Benefits of Stand when the board is still, making a 180-degrees up Paddle Boarding • SUP activates both sides of the body. Thus, turn as this is the easiest turn. They should the users (persons with acquired brain injury) keep a low stance and pull, towards the tail or also activate their weaker (affected) side backwards, while twisting and leaning to the de- • SUP is having fun outdoors: a little safe of the body, as a result of that they extend sired side with their torso. The important thing sun exposure is great for our body’s need the shortened muscles of this side and rotate is keeping the balance and the core still as the of vitamin D. Our body needs vitamin D that the core, which is extremely important for board may become unstable. keeps our bones strong by helping our body their rehabilitation (Ruess et al., 2013). absorb calcium and phosphorus (Green, 2016). • SUP as mental training. Practicing SUP af- • We can practice stand up paddle board- fects our mental health and mental fitness Paddling faster ing almost everywhere: in the sea (near (Schram, Hing, Climstein, 2016). Stand up the coast, in lagoons, bays, in the open paddle boarding can alleviate stress levels If the service users are successful in learning sea...), in lakes, gravel pits, rivers, wa- and mental tension. On the boards we can get the basic stroke techniques and safety measures tercourses, streams, ponds and even pools. closer to nature and its beauty as it is sci- Figure 11 and 12: Paddle height and paddle position. Adappt- we continue the learning process with teaching entifically proven to have a relaxing effect. ed from: https://www.justpaddleboard.com/proper-paddle-form/ them how to paddle faster completing more and • It is an extraordinary activity that en- SUP enables our overwhelming mind to rest. longer strokes (3-5 on the left side and 3-5 on ables paddlers to get the benefits of The released endorphins improve our mood. Falling into the water the right side). a full-body workout (Schram, 2015). • Stand up paddle boarding stands out as • Spend time to prepare the users for the • SUP improves our overall fitness, it is These are the basic lessons that we teach our a very sociable activity. This is a fun possibility of falling into the water. great workout, which is one of the rea- users. We could always upgrade our knowledge to and safe way to spend time with friends Give them instructions when losing bal- sons that top athletes involved in various knee paddling, advanced turn techniques, one- (Schram, Hing, Climstein, 2016). ance to try falling into the water rath- sports practice it as part of their routine leg, squat paddling, squat paddling, exercising er than on the boards as it is safer. or as part of the rehabilitation process. • SUP is a great opportunity to find adventures, on the board. explore and discover wilderness and reconnect • Users have their boards attached to them • When paddling we train our muscles, with nature. It is a way of travelling and using a leash. In the event of fall, they We focus on the learning techniques finding a “burn” calories, increase our heart rate. conquering interesting places (Green, 2016). should release the paddle for safety rea- calm body of water, once we have learned to pad- Movement relaxes muscles, and releas- sons, swim back to the board and then push dle there we could explore seas where the waves es endorphins (pleasure hormone) in the • SUP is also a popular activity for compe- the board forward with hands to the paddle. are slightly bigger. body, which alleviates the effects of titions (Schram, Hing, Climstein, 2016). EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 140 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 141

6.4. SlACkliniNG OR walking On flAT webBINg

Photo: Zvonka Novak, users of Center Naprej, Velenjska plaža, 2018

AUTHOR: JASNA VEŠLIGAJ DAMIŠ

BODY EXERCISE CARDIO EXERCISE Key words: slackline, balance, basic positions and movement, outdoor sports activities SHOULDER MUSCLES TRAOEZIUS MUSCLES • HEART CHEST MUSCLES • LUNGS ARM MUSCLES The introduction of a novelty, especially new perform tricks, do yoga, etc. It differs from ABDOMINALS sports activities, such as slackline or walking the ordinary rope because slackline is more LOWER BACK MUSCLES on flat webbing is always challenging but at the elastic therefore it can function similarly to a same time exciting. When users perform something narrow trampoline. GLUTEAL MUSCLES new as part of their rehabilitation, they do not THIGH MUSCLES know whether they will succeed or not, regard- In the beginning, we try to keep the balance on less of the experience - if they have already the tape, and from time to time, we try to take

LOWER LEG MUSCLES LOWER LEG MUSCLES tried it before the injury or not, it causes an a step across the whole length or even make a increased level of stress for them. more demanding exercise.

The introduction of novelties is also a partic- Figure 13: SUP - complete workout Adapted: http://www.serenapaddlesports.com/blog/standup-paddleboardinga-complete-workout ular challenge for employees. The employees of Center Naprej tried first themselves walking on 6.4.2. Why slacklining flat webbing. They tested their balance, focus, with persons with acquired • Age is not a barrier for those who want to Maja Vojska (2017). Aktivnosti, ki ti učinkovito pomagajo giving and receiving feedback, managing waves stand up paddle board. It does not matter izboljšati ravnotežje. derived from https://www.bananaway. on the webbing, managing fear of falling, per- brain injury (ABI)? si/7-aktivnosti-ki-ti-ucinkovito-pomagajo-izboljsevati-rav- whether we are young or old, it is suit- notezje/ sistence, and so on. When they had familiarized able for everyone. It offers relaxed rec- themselves with the various aspects, possibil- Walking along the nylon tape is a sports ac- Ruess C, Kristen KH, Eckelt M, Mally F, Litzenberger S, et al. reation and everyone can learn to do it. ities and critical points of slacklining, and tivity with multiple aspects, where awareness (2013) Stand up Paddle Surfing-An Aerobic Workout and Balance We can see children, teenagers, pregnant Training. Procedia Engineering 60: 62-66. gained the appropriate skills and knowledge, we of one’s own body, balance and coordination is women or our grandparents on the boards. started introducing users to this interesting extremely important, and at the same time it Schram B. (2015). Stand up paddle boarding : an analysis of a but also challenging sports activity. influences a wide spectrum of other human psycho- • SUP is also appropriate for practis- new sport and recreational activity. PhD Thesis. Gold Coast: Bond University. physical abilities. While slacklining, people ing by persons with disabilities, and with ABI develop different abilities: we do practice SUP at Center Naprej! Schram B, Hing W, Climstein M. (2016) The physiological, musculoskeletal and psychological effects of stand up paddle boarding. BMC Sports Science, Medicine and Rehabilitation 8: 6.4.1. What is slackline? Reference 32. Sense of the position of one’s own Walker, C., Nichols, A., & Forman, T. (2010). A survey of Slackline is a suspended length of flat web- parts of the body - proprioception injuries and medical conditions affecting stand-up paddle Green, D. (2016). “ACE-Sponsored Research: Can Stand-Up bing that is tensioned between two anchors. surfboarding participants. Clinical Journal of Sports Medi- Paddleboarding Stand Up To Scrutiny?” ProSource. American cine, 20(2), 144. It is most often tensioned between two strong Proprioception is the perception of motion and Council On Exercise. August 2016. https://www.justpaddleboard.com/proper-paddle-form/ trees about 30 - 50 cm above the ground. We can the positions of the body parts. While slacklin- Hammer, S. (2011). Catch the wave of stand-up paddling The tension it just above the ground or above water ing, we perceive the movement, the positions of Providence Journal, Sep. 5, 3. surface, and we can stand on it, walk, jump, the limbs, the pressure on the feet, the speed EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 142 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 143 of movement and the force of inertia that arise help with remaining calm in difficult situations chophysically: we perform various exercises also depends on the length of the tape and during the activity. Thus they improve their and in achieving greater determination. It is for balance training and coordination, teach the force with which the tape is tensed. proprioception. It is important to focus the a preventive activity and helps the treatment them relaxation with breathing, managing • The line is very tense, so care should sight to the horizon. For even more propriocep- of joint damage. It is a good workout for the emotions, awareness of body parts, etc. be taken to ensure that in case of fall- tive challenges, we close our eyes and try to ankles, knees or hips and strengthen the whole • Users have to take off their shoes before ing line does not hit the user. stand and walk on the mice tape. body. slacklining. They are barefoot on the tape. • Even if the line is only a few centime- Bare feet improve the feeling for the line ters above the ground, the fall can cause and help them to start balancing faster. Balance injury (strains, bumps). Injury depends 6.4.3. Tips before starting your • Before users start the activity, we on the surface under the webbing and the Slacklining is a test of balance. Some users’ employment with persons with ABI calm them down and make them relax and type of fall. Therefore, a protective lin- goal is to remain on the webbing, others’ to gain control of their breathing. If he/ ing is recommended under the tape. take a few steps or to move from one end to the she is appropriately prepared, his/her other, others to stretch on the tape. While First, let’s get familiar with the rules import- legs on the tape will be less shaky. slacklining, we are constantly trying to hold ant for all aspects of slacklining. They are • Before slacklining, they need to be lead our body in a stable position and are constantly especially useful for beginners (Nahtigal, 2012) as to how to step on it, to focus eye- on the border between stable and unstable state. and of course when working with our users - ath- sight on the indicated point on the tree. letes with acquired brain injury. When we step onto the webbing we leave the ground (the comfort zone) which we are used to, Some general instructions and enter the state of uncertainty (no comfort). Preparation of the surface The line swings. The main problems are caused • The recommended width of the line by the body and the mind that like known situ- • We select and prepare the surface: the ground is 3.5 cm and the length for be- ations. Let’s confront the unknown, which is a should be flat, preferably grass, prefera- ginners is between 4 and 8 m. good training for all and it is happening to us bly we placed a thin protective pad under • We start with demonstration of each exercise. in everyday life. In fact we are never sure how the line, for safety in case of fall. the day will end. Therefore, slacklining can be • Often, the first attempts to tackle the • Select the appropriate tension points - the said to be an ‘’ out of comfort zone ‘’ activity tape are unsuccessful and the user can- distance of the tensioning. We have to se- or opportunity to cross the threshold of our own not stand alone on the tape. That is why cure enough space around the line (at uncertainties. we offer him support and encouragement least 5 meters on each side of the line) to persistently repeat the exercise. to prevent damage in the event of fall. • When stepping down from the tape, make Stabilization and strength- • Tension the tape to fixing points (e.g. Photo: Center Naprej, 2017 sure that the user does not jump quick- ening of the core two trees). The best fit is with origi- ly from the line. The line is dynamic and nal clips. We must not forget to pro- will respond to the jump with stretch, and Slacklining requires a fairly tight central part tect the trees so they do not get damaged consequently the user will lose control of the body (the core), the upper part of the (e.g. wrap them with a foam sponge). 6.4.4. Basic exercises and fall uncontrollably from the tape. legs, while the arms are released. In this way, • The distance from the ground should be big we stabilize the transverse bandwidth of the • It is best to start in the centre of the so that the tape in the middle at the largest tape. tape, especially for safety reasons. It is Exercises with assis- part is just above the ground (10 to 20 cen- more likely to hit and get injured in case tance while slacklining: timeters), and the distance between the fixing of a fall near the tension point. In the points should be short, 5 to 10 steps, to be A social and healthy entertain- middle, the tape is at the lowest point • Exercises with assistant (hold- as close as possible to the ground to jump. ment for everyone and psycho-phys- and thus reduces the height of any fall. ing the user for the hips). ical abilities training • Stretch the webbing to the desired extend • When slacklining, the user will initially be • The assistant sits on the tape. (the shorter and more tense it is, smaller and most hindered by the fluctuation of the tape, Slacklining is a social and healthy entertain- faster is the wavelength of the oscillation). • The user is holding the assistant’s shoulder. but continuous exercising may improve con- ment for anyone who is able to stand upright and • On both sides of the tension point trol or even eliminate the fluctuation over take a step on solid ground. It is a good phys- (i.e. on both trees), we mark the time. The tension of the line depends on the ical as well as mental exercise that improves Practical exercises point of sight (the horizon). distance between the fixing points. The wave- the management and stabilization of the body and length of the oscillation in the middle is • Training with running poles (2 poles, one helps to cope with feelings (fear, excitement). the largest and slowest; when approaching the pole, the length of the poles is approx- In addition to the above mentioned positive Preparing the users fixing points, the wavelength of the vibration imately to the shoulders of the user) effects, it is observed to help improving body is always short and quick. The fluctuation posture, reaction time, concentration, focus and • Before commencing slacklining it is import- perception. It can be a relaxation technique and ant to prepare the users appropriately psy- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 144 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 145

Examples of exercises for prepar- balanced motion we step on it. Keep the body • Stand on the strap on both legs, ing users for walking along the tape upright throughout the movement. Finish in the one leg should be behind the oth- with various forms of assistance basic position on the tape with one leg on. er, then replace the legs.

• Stand on both legs to swing the tape Exercises on the ground: Note: Do not press down on the foot on the tape, in the direction up - down. as the tape is moving away and the pressure is • walking along the line with higher, feet are shaking quicker. In order to • Stand on both feet to carry the center open / closed eyes, get on the tape, you need some determination. of gravity from one leg to the other.

• walking on a low bench, low lath • Stand on the line on one leg; touch the line with the other foot first in front • exercises on soft surfaces - soft pillows of the holding led then behind it. • exercises on sticks, walking, squats, turns • Take a short step forward. • exercises on balance boards • Take a short step backward. • breathing exercises, relaxation exercises • Stand on the line with your eyes closed.

• Stand on the line with your Exercises for getting used to the webbing hands on your body. - we start all exercises in a way that the user is placed in front of the tape: • Take a few steps forward.

• Take a few steps backwards. • with one foot on the line and push- ing it in all directions; • Step on the line side laterally (the shoulders parallel to the tape) with both legs on. • with one foot on the line, swings, so that the tape pushes the foot back to the ground; • Try to make a turn on the tape.

• with one foot jump on the line, so that the line pushes foot back to the ground; Reference Photo: Center Naprej, 2017 • with one foot on the line and Nahtigal, A. (2012), Učenje hoje po najlonskem traku, cross it with the other foot. Diplomska naloga, Univerza v Ljubljani, Fakulteta za šport, 2. Walking forward - backwards Specialna športna vzgoja, Gorništvo z dejavnostmi v naravi, Ljubljana Exercises for balance position on the line - all exercises are performed while Start position: Basic start position. the assistant is sitting on the line. Implementation: From a balanced basic position, We start with the exercises as we are about 2 we begin to move the body’s center of gravity to meters away from the user. Later this distance the foreleg. Gradually we begin raising the heel between the user and the assistant sitting on of the leg behind. When the body’s center of the webbing is increasing. We can perform: gravity is already completely on the front leg, we make a steady step forward with the rear. The • walking with the help of poles, foot leaves the tape with the fingers, we step on the whole foot, and the center of gravity of the • walking with the help of an assistant. body rests on both feet. The body is upright all the time while the arms are in a slightly bent position. The joints of the feet, the knee and 6.4.5. Movements - basic hip joint are slightly bent. instructions for implementation Exercises:

1. Stepping on the line • Get on the line.

• Stand on the line on one leg. Start position: Basic start position. • Stand on the line on the other leg. Implementation: We focus our weight directly on the leg on the line, and then with a calm and EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 146 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 147

boules, you make the world the playing field. opponent’s balls and thus score points. With the flexible balls, you can now, for example, play on the stairs, in the teams or on the 10th floor of the yard. Your creativity knows no Development of the game: bounds! Each player, in the individual variant, has 6.5. The idea of playing Cross Boccia also “crossed”, three (3) equal balls (colors / drawings / that is, in three-dimensional space, is much patterns) to play; in games between teams, CrOssBOCCIa longer than the term boccia in street itself. each player only has two (2) balls. A player / For example, the use of plastic balls has been team is drawn or selected to start the game by used to bring more movement into the game. The throwing the target ball from a starting point problem, however, was that the balls jumped and he chooses. All other players also have to play AUTHOR: RAÚL CANDIDO the control needed to play the game was no lon- from this same location. The target ball can be ger guaranteed. played anywhere; there is no special or delim- Keywords: Cross Boccia as a trendy sport; physical adapted activity; sport for all. ited play area. The player who threw the target The Cross Boccia as another sport that can be ball must start the game by throwing his first practiced outdoors by everyone, so the inclusive ball. All other players then play their first aspect of the game is very important. People ball as well. The player having the ball far- We are in an age where the participation of that will not let me make friends and relate to with any type of disability can play it, and it thest from the target ball must play the second communities is of the utmost importance for the others, and enter the game. is advisable that this participation has the ball and, if not closer to the target ball, the societies. Sport is a factor that ensures equi- greatest possible autonomy for the practitioner, third ball. All other players also have to play table conditions and has been one of the stron- As I do not hear, I cannot even speak, I am only attending naturally to the minimum safety mea- their second and third game balls, according to gest tools for people with disabilities to take isolated in my corner, because sports are not sures for their practice, in the chosen space. the distance to the target ball. When all the an active role by creating close links in their for me, because most people do not understand balls are played, the points must be counted. communities. me. Just like a game that is fashionable, we set out The player who won the game begins the next game to further develop this opportunity for inclu- by throwing the target ball to a place he choos- The sports phenomenon, when valued by a signif- In a time of such sophisticated conquests these sive sports practice. It provides group inter- es. If in a game set two or more players are icant number of people, allows minorities, in questions are still of the daily life of those vention strategies, space and time structuring, tied in number of points, the player who won the this case people with disabilities, a kind of who have some kind of disability. It is true strategic reasoning, movement skills develop- previous game starts to throw in the next game. affirmation that will pose new challenges, which that adapted sport has grown in implementation ment, body notion, abstract thinking and group will tend to find new answers in search of an in several countries and the number of informal notions. GET THE FUNSPORT! increasingly inclusive participation. Cross Boc- or federated practitioners has increased, but it Points: cia, as a group game, can be a friendly instru- is not enough and we must continue to affirm the ment for socialization, establishing group and need for regular sports to maintain the neces- Each game ball that is closer to the target than family ties, which can help draw attention to sary stabilization and progression of physical 6.5.1. Rules of CROSS BOCCIA any opponent’s ball counts a point. If in any of physical, psychological or group culture bar- adapted activity and sport for all. the two or more opponents’ throws, the balls are riers, which at first sight are not visible, or the same distance to the target ball, then each when they exist seem insurmountable. The Cross Boccia is a trend sport that takes ad- Overall characterization: game ball scores with one point each. If a ball vantage of the basics of traditional boccia and falls on an opponent’s ball and overlaps it, Some dilemmas put on people with disabilities, boules, but adds some aspects to it. The Cross The game consists of sets of three (3) balls of this is called “KO / kill” and the opponent’s such as those that follow, may seem outdated, Boccia, also called soft boccia, is therefore the same color / designs / patterns and a main ball is not counted. The game ends as soon as a but in unfortunately, they are not. an additional development of boccia sport and ball, the target ball, which is smaller and player or team reaches 13 points, but there has therefore equates to sports formats like BMX, different from all the others. It can be prac- to be a two-point advantage, for example, 13-11, Because I use a wheelchair I can´t play, or snowboard, parkour or headis, known as radical ticed by players individually or in teams with 12-14, 15-13, etc. cannot throw the balls with enough strength for sports, which also expanded the game principles three (3) players. In this variant there must be more distance I can never play Cross Boccia. to create a new sport. two sets of three (3) equal balls per team and Note: in these rules, the player who throws the each player has two balls at his disposal. It target ball first and then the first ball of the Because I have visual difficulties I do not The fact is that Cross Boccia can be played ev- is played on any terrain, indoors or outdoors, game did not take it into account, that the op- know my street, my neighborhood, I cannot have erywhere, especially in the aspects of freedom, without space limitations. posing player had to reproduce the same type of friends to play Cross Boccia. spontaneity and creativity. In February 2010, gesture, and other conditions determined. the sport was for the first time in the largest Because I do not understand all the Cross Boc- global start-up competition, “Brand New Award”, Goal: Examples: the ball must be thrown between the cia rules, or I find it difficult to learn some in the international recognition of the brand. legs, the ball has to make two tables on the things on a daily basis, or do not have much The objective of the game is to reach / stay in walls, before going to the target ball, we have concentration, I will therefore be condemned to Cross Boccia is the new freedom. With the contact with the target ball or place the balls to throw on our back, we have to throw with the being trapped in a life, like a force jacket, free-style variant of the well-known boccia or as close as possible to to target closer to the left hand, etc… EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 148 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 149

6.5.2. Annex Pyramid Reference

CALIMAN, Mark C. - https://www.zoch-verlag.com/en/games/ 1. Situation of KO 2. Ball combinations crossboule/ A and its consequences: and punctuation reinforcement: B SCHMIDT, Alexander, OBERMANN, Anika GbR - Der urbane Trend- TARGET BALL sport für Abenteurer | Anleitung Crossboccia® get FREE! - The red (A) ball is KO, it does not count Ball attach to target ball http://www.crossboccia.com Author of photos: All the photos in the Annex are from the catalog of Mark Calin Caliman https://www.yumpu.com/de/doc- C ument/read/50993297/crossboule-regeln-als-pdf-zum-download- A jugglux. Retrieved on 20-07-2017. B

Example 4: Two yellow balls leaning against TARGET BALL A another yellow ball, next to the top making a triangle, touching the yellow ball that is in contact with the smaller (red) target ball, gives a score of 5 points. Example 1: When one ball overlaps another, this Example 1: Whenever your ball (A) is in contact ball, cancels the ball underneath (green - B with the target ball (B), it gives a score of 2 ball covering the red - A) cancels the red ball. points. Flower

Take the ball off a KO ball Worm B

C C A B A C A B B

A TARGET BALL Example 5: All yellow balls in contact with the smaller (red) target ball give a score of 5 1 2 points.

Example 2: In the case of a play in which a red Example 2: The green ball is in contact with ball removes the green ball covering the red, another green ball, which is in contact with the Ball on the target ball the red ball, which has removed the green ball, smaller (black) target ball, gives a score of 3 or the top mountain will be available to the player to be played points. again. The red ball that was covered by green is no longer KO, and can even score if that is the case, being closer to the target ball, than the Snake opponents’ balls. A

TARGET BALL C B A

TARGET BALL Example 6: The yellow ball is on top of the smaller (red) target ball, gives a score of 5 points.

Example 3: Two green balls touching another green ball, which is in contact with the smaller (black) target ball, gives a score of 5 points. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 150 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 151

6.6. SkIINg

AUTHOR: JASNA VEŠLIGAJ DAMIŠ

Key words: skiing, balance, safety measures, outdoor sports activities

Alpine skiing is one of the most popular winter ers. Learning is one of the most complex higher sports. It is accessible to a wider audience of mental processes that the brain performs, and Photo: Center Naprej, 2017 people who poses the appropriate mobility skills any disturbance or damage to the brain causes a and ski equipment. Alpine skiing is sliding on change in this process. 6.6.2. Some tips and instructions Each disabled skier has his companion. For bet- the snow, with ski on your feet. Usually, the for alpine skiing with our users ter orientation and improved visibility on the skier also has sticks in his/her hands. Anyone In Center Naprej, we started skiing with us- track, we use visual support and signs. Proper who likes winter sports and is not afraid of ers who had already skied before the injury or persons with disability preparation and adequate knowledge of skiing of cold can do skiing. Alpine skiing means white and wanted to reacquire and improve their ski the companion and good competence for working slopes, low temperatures and great pleasure. skills. Skiing is a great challenge for us, In order to be able to perform alpine skiing, with people with disability are important. In because besides pleasure it also has a certain the skier must have: order to work with our users, knowledge of the risk. field of work and rehabilitation of persons with • good preparation and physical fitness (aer- acquired brain injury (limitations, specifici- 6.6.1. Who is the program obically sufficient muscular strength ties, rules) is required. appropriate for and why we are and an aerobic ability, especially muscles of the legs, abdomen and back), Skiing with users is usually individual or skiing in Center Naprej? maximum in pairs - up to 2 users per trainer. • ability to maintain balance. Particular emphasis is placed on the safety of Alpine skiing is one of the important programs users, so it is extremely important that we pre- we have included in our sports rehabilitation The ski training consists of two parts: pare a risk assessment for the location and all programs, which we use for training and testing skiers before the skiing starts. the balance of users. It is a comprehensive and 1. physical preparation for ski- very demanding activity with a high level of ing and fitness training, risk for our users. As part of the risk assess- 2. ski training, skiing and racing. ment, we identified weak balance as a major risk 6.6.3. Special features for factor in the rehabilitation skiing program skiing with persons with that causes a high level of risk of a fall and, At the same time, all the above conditions are consequently, a risk of a new brain injury or necessary to be integrated for a harmonised acquired brain injury a bone fracture. Activity, focusing on bal- programme. Only then a specific movement, such as ance training presents great importance for all skiing, would be harmonized - thus recognized as In the case of skiers - persons with acquired day-to-day activities, including self-care and good or successful. This can be achieved through brain injury - we must pay attention to the walking. Photo: Center Naprej, Weinebenne 2017 a well-planned ski preparation program and care- following: ful implementation of this. Only in this way, The Alpine skiing program is intended for skiers we can expect a successful snow movement, which 1. choose appropriate ski slopes and ski trails with disabilities with acquired brain injury, will be pleasant and safe for the user. Without according to the individual’s capabilities who have at least basic ski knowledge that they good preparation, skiing will not be successful. (physical and cognitive) and knowledge; had acquired before the brain injury. Skiing It includes fitness training, skiing “gymnastics” 2. the load during exercise should not ex- belongs to a very complex physical activity, and maintenance of the motor fitness throughout ceed the individual’s ability, and it would be very difficult and risky to learn the year. We also help with the ProSki simulator after such heavy injuries suffered by our us- training. 3. users must be appropriately dressed, EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 152 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 153 so that they can move properly, that The fact is that the affected part of the • improves flexibility of joints, mobility, cles bending knees, the muscles of the buttocks they are not cold or hot and that this brain may disable initiating, motivation and are most affected. • has a positive impact on raising gen- does not hinder their activity; planning capability. It is sometimes very eral motivation due to activation and difficult to distinguish between these dis- Skiing is also good for managing body weight. 4. due to cold, we must pay atten- achievement of success in sports, turbances and non-cooperation on purpose. The steeper the terrain is, the more calories tion to the skin care and the prob- • strengthens the abdominal muscles, you burn. Greater inclination of the ski slope lem of thermoregulation; 13. Skiing should be a fun and pleasant activity. requires investing more efforts to balance and • improves functioning of the car- 5. brain injury can damage the centre of bal- using more energy. The reason for losing weight diovascular system, ance, which affects the balance of the is also the low temperature in the environment, individual. In case of weak balance, the • positively affects cardiorespiratory if it is below zero body causes body tempera- risk of a fall and new brain damage or health and increase aerobic capacity, ture to rise and you spend more calories. All bone fracture is very high. Therefore it this also applies to our users, although we do • increases anaerobic abilities - muscle is important to make an appropriate risk not ski with them on very steep and demanding strength of the legs, back and abdomen, assessment and prepare actions to cope ski slopes, but carefully choose the difficul- with these problems before skiing. • improves balance and coordination - coordi- ty of the route according to their skills and nates the movement of all large muscle groups, knowledge. 6. We need to be alert to the visibility angle of persons with neglect (where part of • outdoor skiing in nature im- the visual field fail) and to take appro- proves stress management, priate safety measures at the ski track. • enables learning, renewal and main- 6.6.5. Skiing equipment 7. We must take into account and anticipate tenance of ski skills, users’ needs and physical comfort. Users • allows you to compete and entertain, can become agitated and restless when they Technical equipment are tired, hungry or feel pain, often fail- • provides training in social skills ing to recognize latter. We must determine and group activities, • alpine skis, which must be properly pre- the breaks during the activity and the pared and ready for snow with bindings, • provides training for receiving and performing length of skiing individually, depending on instructions and executing functions training, • ski poles. fatigue, attention deficit and other abil- Photo: Jasna Vešligaj Damiš, 2018, Weinebene ities. Fatigue consequently affects both • provides memory and communication training. physical and cognitive ability, and in- For seated skiing, we use: “biski, monoski, creases the risk of injury and accidents. For our users, it is a unique effort to try to kartski, tandemski” and stabilizers with skis 6.6.4. Advantages, positive stay upright while skiing. They must work with (instead of sticks) - which we have not prac- 8. When preparing for skiing with users, it is the abdominal muscles to remain balance, with ticed so far in our centre, because there have important that we form realistic expecta- effects and goals of the program those abdominal muscles located deeper and begin not been similar needs or opportunities. tions setting goals that users can achieve. on each side of the spine, swirl around the body 9. Avoid excessive stimulation in the ski Exercise has many positive effects on the human and end up in the pelvis. These are the key ab- track. We give short, clear instructions. organism including a number of disease preven- dominal muscles that shortened act as a “corset” Personal equipment tion effects. The most important thing is that and squeezing the lower abdomen. Other abdomi- 10. We use learning by model: we teach our activities are carried out in nature in the nal muscles also strengthen and stabilize the • personal clothing: jacket and ski pants users giving example and thus provide winter, in the fresh air. spine, so it does not bend when leaning forward them with adequate patterns of behaviour or falling. Improving the strength of the abdom- Jacket should be warm, waterproof. The ski pants and consistency in various (burdensome) The main goals of the program are to improve or inal muscles helps them to improve balance and must be extremely warm so people do not get cold situations. Demonstration: Sometimes maintain physical fitness, to improve and promote coordination. in the legs. it takes several demonstrations to un- a healthy lifestyle, to develop an appropriate derstand; let the person do the exer- attitude towards nature, to use its properties Half an hour of skiing without breaks is a • mandatory helmet cise; repeat the necessary steps, etc. for a healthy lifestyle, to promote positive good exercise for the cardiovascular system, 11. Users need a lot of directions, di- self-image and personal satisfaction in life, to no matter how you ski, that means an increased The helmet must allow the user comfort from the rectives and guidance. The least em- increase the self-confidence in performing tasks, heartbeat, increased blood circulation, and more inside, especially in the area of the ears, and phasis should be on errors. We focus acquire knowledge and skills. intense nutrients and oxygen flow through the at the same time strength from the outside to on encouraging achieving success. body, extra substances discharged. At the same protect the head from possible hits. Also im- Some of the health and psychosocial benefits that time, more calories are burnt when skiing, mus- portant is the locking system of the helmet, 12. The skiing needs to be planned well, because skiing brings to our users: cles are prepared for more oxygen and blood, the which keeps the helmet stable in case of fall. ABI users can have problems with the sim- capillaries are more loaded and the muscles are plest tasks due to problems with executive • improves general fitness be- able to stretch. Skiing strengthens the entire • ski gloves functions and motivation, rather than as- cause the whole body works, body and is good for all the main muscle groups. suming that he/she does not want to do this. The inner and outer muscles of the thigh, mus- Ski gloves must be warm and at the same time EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 154 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 155 provide good grip on the stabilizer. For people Accessories for making ski- with impaired motoric hand functions, they use ing more appealing gloves for one finger, due to the difficulty in using gloves. • cones,

• flags, • ski shoes • flex poles, etc. 6.7. Ski boots, like other equipment, must keep feet warm but at the same time they must have appro- F•O•OTgoLF priate hardness and not be too demanding. Reference

• a reflective jacket Alpsko smučanje za osebe s pridobljeno možgansko poškodbo v Centru Naprej. Interno gradivo Centra Naprej. Maribor, AUTHOR: JASNA VEŠLIGAJ DAMIŠ oktober 2014. The reflective jacket is highly recommended, especially in ski resorts where there are more Key words: footgolf, footgolf rules, outdoor sports activities people, as the skier and skier’s reactions are longer than in individual skiing. With this, we remind other skiers to pay more attention to us at the ski resort. hole. The size of the holes must be adapted to 6.7.1. What is footgolf and the size of the ball. Each player has his own • ski goggles or sunglasses for whom is it appropriate? ball. Footgolf can be played individually or in small groups. The group consists of a maximum They are recommended mainly due to the reflec- of 4 players who count the number of theirs and tion of light from the snow cover. They are also Footgolf is a sport where we replace the golf others hits. During the entire game, the player important in case of bad weather and fog. ball with a soccer ball. It is played by golf can use 72 shots. If a player moves his own ball rules. This represents a unique and fun sport while searching or preparing for a shot, he gets that combines the passion of football and the a penalty spot. During the game, it is necessary Personal equipment of the precision of golf and is a unique opportunity to wait until the ball stops completely be- trainer / assistant to socialize in a slightly different way. It’s fore the player kicks it. The footgolf match is an easy and fun sport for everyone who is able shorter than the match of golf, and it usually • alpine skis to kick the ball. According to the tactics, the lasts for more than two hours. footgolf is similar to playing golf, but the Usually we recommend shorter skis (slalom), for players kick the ball with their leg. It can be easier handling and medium hardness. Assistants played as a group activity or individually. The must have skis light enough to make them swiv- advantage of this fairly new sport is in its 6.7.2. Why are we playing el, and at the same time must be able to manage simplicity. After acquiring basic knowledge of footgolf with the users themselves and the skier. the rules and the good manners on the footgolf course, we can very quickly start enjoying the of Center Naprej? • ski shoes game. It is suitable for individuals from all generations. People with acquired brain injury (ABI) suf- They are usually softer, because preparation and fer from serious consequences that permanently heating require a lot of work without skis for Footgolf offers us: affect their daily functioning and their sur- the trainer, walking in ski shoes, opening and roundings. Although the person with ABI can ex- closing the skis, track assistance, etc. • a pleasant environment and the possibili- perience various chronic physical disabilities, ty of socializing over fun activities, it is generally the cognitive, emotional and be- • personal clothing and helmet havioural disorders that restrict the individual • a competitive spirit in a green environment, the most resulting in many problems in interper- and in the winter time on a snowy slope, The gloves should be thin but warm, with good sonal relationships, creating and maintaining a grip, so that they are not a hinder. • interesting recreation and intense play, social network, integrating into daily leisure activities, sports activities and employment. • a football spirit on the golf course These disorders most often change lives of indi- for an unforgettable entertainment, viduals completely, affect their family life and • relaxation from everyday worries. their integration into the community.

The classic footgolf course has 18 holes, which In Center Naprej, therefore, we are constantly can also be scribbled. There is a flag on each looking for new ways to encourage users to join EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 156 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 157

4. improvement of visual - motor coordination

5. improving the functional body position

6. activation of proprioception

7. activation of several muscle groups

8. socializing while having fun in the nature

9. encouraging a competitive spirit

10. relaxation in the nature and in pleasant company

11. training precision, patience, memory, positive behavioural patterns and clothing

12. training acceptance and implementation of precise instructions.

6.7.5. Necessary equipment for footgolf

Photo: Center Naprej, 2018 The mandatory equipment of the player includes: activities that would be fun on the one hand, We took care of appropriate clothing and foot- • appropriate clothing and footwear (rec- and on the other hand have rehabilitation ef- wear depending on the weather. In the winter, ommendations: shirt with a collar or fects in order to manage more effectively their we were dressed in comfortable warm clothes and polo shirt, short trousers to the knees, limitation. At the same time, we want to encour- suitable hiking boots, and in warmer months more suitable footwear as indoor soccer age them to improve their strong areas. loose clothing (T-shirt, shorts). Appropriate shoes or shoes for artificial grass) footwear is important. • ball. That’s exactly why we started with this completely new for us sport, footgolf, that com- In case you play footgolf outside of the official bines fun and recreation. It is an activity course (if you do not have a footgolf course If you do not play footgolf on a footgolf where users can relax, have fun, and at the same nearby), be careful where making holes and ar- course, you can prepare it on your own because time have to follow certain rules, improve their ranging the terrain so that it is properly pre- there is no footgolf without a course! physical as well as mental abilities, and learn pared (remove branches, obstacles, litter etc.). to improve their tolerance levels. Users have learned how to play footgolf very quickly, they The rules of footgolf have to be well presented Reference enjoyed playing and had fun. to the users (counting shots, penalty points, when the ball can be hit) so that there will be http://www.footgolf.si/footgolf-pravila/, retrieved on no complications. 18.10.2018 https://en.wikipedia.org/wiki/Footgolf, retrieved on 6.7.3. Some tips and instructions 18.10.2018 for playing footgolf with our https://www.golftrnovo.si/kaj-ponujamo/footgolf, retrieved on 6.7.4. Advantages and positive 18.10.2018 users or people with disabilities effects of playing footgolf

When we started playing footgolf with our users, we did not have the right course available. We 1. improving fitness made the course on a grass surface, and in the 2. improving balance, winter on a snowy terrain, where we marked the course and made large enough holes in the snow 3. learn to transfer and take weight to for the balls to fit in. The holes were marked the weaker (affected) side and ac- with flags or cones, in order to be well visible tivate that part of the body to users with vision disturbances. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 158 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 159

6.8. SnowShOEiNg

AUTHOR: JASNA VEŠLIGAJ DAMIŠ Photo: Center Naprej, 2018

Key words: showshoeing, safety measures, outdoor sports activities heel, which can be fixed if necessary. When snow- 6.8.6. Some advice and shoeing, it is advisable to use walking poles instructions or preparation to improve the balance, while at the same time form of movement that can be learned by everyone doing exercise for the entire body. for safe snowshoeing 6.8.1. Snowshoeing – lost in the with a little exercise. Above all, it is import- beauty of the white wilderness ant that, when walking with snowshoes, you move Although exercise at first glance may seem com- as naturally as possible, and enjoy it. pletely simple and undemanding, snowshoeing 6.8.5. Who is the program can replace intense cardiovascular training by There is nothing more beautiful than spending intended for and why are we activating most of the body’s muscles. However, an active sunny winter day in nature. Take the when snowshoeing with users (people with ABI), snowshoes and go on a hike. Snowshoeing can be a 6.8.3. How it looks? snowshoeing in Center Naprej? you need to be particularly careful about the particularly magical experience: walking through following: the white winter landscape, spending the day in Snowshoeing is, in fact, walking in the snow, The program of snowshoeing is intended for users the nature, filling your lungs with fresh win- with specially adapted footwear, which has a of the Center Naprej - people with acquired • Select a safe location and select the ter air, and at the same time doing some good large surface area, so during the walk, the foot brain injury who can walk or move with the sup- difficulty of the route according to exercise. does not sink into the snow. It is also possible port of others or a crutch. the individual’s capabilities or lim- to walk across very deep and soft snow cover- itations (physical and cognitive). Considering this, it is necessary also to pro- ings with snowshoes - in the snowy provinces of It is an easy and safe way of walking and run- • Choose a location and terrain that match- vide good protection for the face against sun Canada and Alaska, this was once the main way to ning across the snowy surface. The technique of es the competence of people with dis- rays, since the sun is reflected from the snow go from place to place. Snowshoes were also used walking or running is not demanding, which is ability. The load during exercise should cover and therefore is even more intense. It is in Scandinavian and some Asian countries. Today, why users learn it very quickly. It is one of not exceed the individual’s ability. also advisable to wear a hat and gloves, because snowshoeing is especially popular as a form of the most popular winter activities, which pro- regardless of how sunny and warm the day is in recreation. We activate the whole body during vides excellent exercise for the cardiovascular • Remove larger objects from the sur- the snow your body begin to cool down. the activity, so this excellent winter exercise system; it is suitable for people with little face for walking. ensures higher heart rate and intense muscle physical fitness, for the elderly and people • Practice on trodden trails, such as cycling strengthening. And the most beautiful thing is after injuries. trails or trail routes closed for traffic. that at the same time, you can enjoy the view of 6.8.2. What is snowshoeing? snow-covered nature around you. You can snowshoe by yourself or accompanied by • Check the route before starting the activ- friends, you can discover the unknown landscape; ity. Avoid narrow paths dense with trees Snowshoeing is walking on snow-covered surface you can take part in guided hikes. In the Cen- and ice paths that allow high speeds. with snowshoes, attached to winter hiking boots. ter, we do it in small groups, organize a compe- • Check all equipment before ex- Snowshoes, due to their shape and surface, pre- 6.8.4. What are snowshoes? tition and have fun in the nature. ercise or competition. vent you from sinking in the snow, thus enabling walking safely on it. Snowshoeing is an ancient Snowshoes are a kind of footwear that we attach Snowshoeing is fun for people of all ages, even • Check the first-aid kit and com- way of walking in the snowy landscape, as snow- to hiking shoes in order to make it easier to for the youngest. Older users can also join plete it if needed. shoes were used by our ancestors when hunting. walk on the snow. They work on the principle the hike, because they can learn the skills • Assume emergency procedures (haz- Snowshoeing is very similar to walking or run- of allocating an individual’s weight over the relatively quickly, and at the same time, walk- ards). Teach all participants how ning, but doing it in the snow - where you can entire surface of the snowshoes, which prevents ing will not pose a dangerous burden on their to act in case of emergency. enjoy the wonderful winter day. In this form of sinking in the snow. Therefore walking on the joints. We can snowshoe during the daytime, but recreation, everyone can experience something snow is much easier and more energy saving and we can also go on night walks. • If necessary use helmets. nice, because it is an undemanding, interesting it is also supported by functional ties and free EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 160 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 161

• Have mobile phones and drinks with you. is carried out in nature breathing fresh air. Reference • Train and compete on windless terrain. 6.8.8. Dry training - Although it is known that anyone who can walk preparation of disabled can snowshoe, this activity nevertheless re- Priročnik Krpljanje: Krpljanje, hoja in tek s krpljami, Spe- • Attach the snowshoes properly to the quires some skills, such as the basic elements cialna olimpiada Slovenije -SOS, http://www.specialna-olimpiada.si/si/za-clanice/knjiznica/, Pridobljeno 17.9.2017 feet and check the fasteners. athletes for snowshoeing of this sport: hiking uphill, hiking downhill, • The user must be adequately dressed so walking in an arc, so that no unnecessary prob- that he7she does not overheat while walk- In order to successfully carry out the activity, lems and falls occur during a serious hike. ing and his/her clothes do not pre- it is necessary to: Snowshoeing is very similar to cross-country vent him/her performing the activity. skiing or Nordic walking, as it is highly in- • have good physical fitness (suffi- tense, but less burdensome to your joints than • Pay attention to skin care and the problem cient aerobic muscular strength, an- many other winter activities. of thermoregulation due to cold and freez- aerobic ability in particular muscles ing in the snow or due to the strong sun. of the legs, abdomen and back), Some of the benefits that snowshoeing brings to our users (ABI people): • Because of the brain injury, the centre of • be able to maintain balance. balance can be damaged, which affects the balance of the individual. In case of a 1. Improving fitness. Athletes should be prepared for snowshoeing poor balance, the risk of a fall, another 2. Improving balance and coordination. brain injury or bone fracture is high, so appropriately and in time – enable them to try it is important that we do an appropriate activities for improving their psychophysical 3. Improving joint flexibility. fitness. This can be achieved through a well- risk assessment and prepare actions to cope 4. Social skills training and group activities. with these problems before snowshoeing. planned fitness training program and its cautious implementation. Only in this way can we expect 5. Acceptance training and implementing in- and provide a successful movement on the snow, structions and executing functions. which will be pleasant and safe for the user 6. Communication and memory training. 6.8.7. Trainers / assistants (person with disability). safety checks 7. Competition and fun. Type of training: 8. Physical activity in nature.

The safety and well-being of people with ac- 1. exercise for training specific mus- quired brain injury are the most important. cle groups (lower limb muscles, ten- Snowshoeing is not a dangerous sport, but it dons in the knee, hip flexor and 6.8.10. Necessary equipment includes speed and variety of conditions that quadriceps - four-head thigh muscles), for snowshoeing require caution. Accidents can happen. The main 2. walking and / or running according to task and responsibility of the trainer/coach the length of the snowshoe trail, assistant is to reduce the chance of accidents For this unique sport you need: to a minimum. 3. specific exercises in the physiotherapy cabinet, • a pair of snowshoes,

4. aerobic exercises and stretching. • waterproof hiking shoes, What is necessary for successful snowshoeing: • walk bars, Every person with disability, who does the • appropriate suit for movement in win- • During exercise and competition, introduce activity, has an assistant. In order for users ter conditions, gloves and hat, clear behavioural rules from the beginning. to orientate better and to increase visibility on the track we use visual support and signs. We • a headlamp (in the case of night hiking), • No one should hike alone. provide users with individual guidance and help. • helmet (in the case of a user with • Encourage disabled athletes to wear ap- a weaker mobility or balance). propriate clothing and shoes.

• Pay attention to changes in weather. 6.8.9. Positive effects And of course, snowshoeing is not possible with- • Ensure that disabled athletes per- of snowshoeing and goals out a large amount of snow. form appropriate stretching exercises before and after the activity. of the program

Snowshoeing has many positive effects on the human body and at the same time health prevention and effects. It is important that the activity EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 162 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 163

WD C GD 6.9. WA GS GA NeTBaLL GK GK C GA GS WA AUTHORS: RAÚL CÂNDIDO, CARLOTA CUNHA GD WD 6.9.1. Rules of the game GK - Goal Keeper - Can move anywhere within the defensive third of the court, but cannot leave Netball, mainly practised in England and the it – goalkeeper; DEFENSE/ATTACK ZONE CENTRAL ZONE ATTACK/DEFENSE ZONE United States of America, initially began to be played by men and women. However this sport has GA - Goal Attack - Can move anywhere within the always been more popular among female players. attacking third and the center third of the in the field, attack and score through basket, 6.9.2. Inclusive / adapted Today it is practised in some European countries court – forward; avoiding the interception of the players of netball proposal such as England, Holland and Germany, but mainly the opposing team. The player who receives and in the United States of America and Australia, WD - Wing Defense - Can move within the center passes the ball shall, at least, always have one but only in the female variant. third and the defensive third, with the excep- foot in contact with the ground. Netball’s adaptation proposal for tion of the shooting circle – lateral defense; players with locomotor disabili- We do not know an inclusive version with the Each player must have the ball in his / her pos- ties and other disabilities adaptations for people with disabilities, a GS - Goal Shooter - Can move anywhere within the session for a maximum of 3 seconds, after which solution that we will propose later after a sum- attacking third of the court, but cannot leave he / she must have executed a pass or throw We have tried to adapt this sport to an inclu- mary characterization of the game in its formal it – pivot; into play zone. The player of the team that is sive version for athletes with locomotor and aspect. defending, that is that does not have the pos- other disabilities. The game is intended for C - Centre - Can move anywhere across the court, session of the ball, must maintain the distance players who have locomotor disability, wheel- Netball is a collective sport, consisting of apart from either of the shooting circles – mid- of about one meter of its opponent that has the chairs users or not, intellectual disabilities teams of seven elements, played in a sport pa- dle field; ball. Contact is not allowed in the game. and able-bodied, playing on the same team. We vilion. The goal is to score in a basket; this used identical approach to the original game, is achieved through passes between the players, GD - Goal Defense - Can move anywhere within The infractions / fouls occurring when there is with some adaptations according to the athletes who occupy specific and pre-defined zones in the the attacking third and the center third of the contact between players, offside (player who and their functional capacity, mainly for loco- field. It is in these areas that the players have court – defense. Only the ‘Goal Shooter’ and invades another position in the field, other than motor disabilities. their action in the game. The objective of the ‘Goal Attack’ of a team are allowed to score di- their zone), or dribbling, give place to the game is to score more points than the opposing rectly, and can only do so when they are in the loss of ball, or placement of the missing player Physical Rehabilitation Centers and other dis- team, and the players who occupy the attack position’s goal circle. in a position, behind the player who can receive ability support institutions are target groups zone, the semicircle or the launch area that is the ball. which allows both disabled and non-disabled closest to the basket, positions occupied by The basket is similar to that of korfball, has players to interact, so that the physical ther- the pivot and the attacker, can only score the no table and is on a pole 3 meters from the The players of the two teams are distributed apists, physicians, other staff at the Center points. ground. in the field by doubles, in situation of oppo- and the players’ families and friends can be sition 1 to 1, according to the pre-determined involved. Our formula that consists of the use In order for the positions of The ball used is specific to Netball. positions. of this sport as rehabilitation, and can later each player to be perceptible explored more formally, as a regular practice WA in the field, the shirts they The dimensions of the field are 35 meters length The winning team will be the one that scores the variant, and that they can play it in full in- wear have the initials of the by 20 meters wide, being divided by 3 zones, most points. The game is played in four parts clusion with other potential players. The game positions they occupy on the defense, central and attack. of 15 minutes each, without stopping the game’s is mixed can be played by athletes with and playing field. timer. without disabilities. They are eligible for the The players cannot dribble or run with the ball. game, players with locomotor disabilities, upper WA - Wing Attack - Can move within the attacking As already said, this is a positional game above and lower limbs, intellectually handicapped and third and center third, with the exception of all, in which the passes are decisive, since able-bodied players, making it an all-inclusive the shooting circle – lateral forward; it is from these that the teams try to progress sport. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 164 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 165

In each team there must have, at least, two 10. Remaining fouls, the ball passed players who use a wheelchair. In terms of ad- to the opposing team. aptation of the game, players who play in a 11. Only GS and GA can score every time wheelchair can only be marked / striking by they are inside the throwing circle. opposing players who also has this device of compensation. Wheelchair players will be allowed 12. Each goal is worth one point to dribble (hit the ball on the ground) at least for the team that scores. 6.10. once and move with the ball in the lap. The 13. The height of the basket may be type of wheelchairs can be sporty, like basket- 3 or 2 meters off the floor. SpORT ball-style, or simple daily wheelchairs, while not ideal, but make the practice possible and more accessible with more rudimentary materials Reference OriENTATioN and then less high equipment costs. Netball, http://www.educacaofisica.seed.pr.gov.br/modules/conteudo/conteudo.php?conteudo=212. Retrieved 12.2.2019. Adapted game AUTHOR: RAÚL CANDIDO

As players distributed by zones according to Keywords: A Sport for Intellectual Disability; Sport for all; Alternative rules of the regular Netball, this is a game communication. that privilege the ball pass, strategic placement and field positions, marking the zone of the opponent, for the conquest of the ball through movements of defence and attack, with which it • Make prior recognition of the space when- is possible to get to score. The movements in 6.10.1. Adapted Orienteering ever possible, while marking the course. the wheelchair in the zone of action and the – A sport for all accurate and speed in the pass, are fundamental This may help to predict some less “friendly” for the success in the game. situations and create strategies for greater Adapted Orienteering (a variation of Sport and better involvement, but also the safety of 1. Game of 40 minutes with four Orienteering) is a sport that, above all, pro- participants. Thus, aspects like the signaliza- parts of 10 minutes. motes a fruition of outdoor spaces, removing tion and the marking of the route can bring many people with intellectual disabilities, but also advantages. 2. The game starts in the center with children, young and old participants of a cer- player C (center) passing the ball. tain passivity, bringing them into contact with When you score a point the game re- nature, in an active and interplay with others turns to the center of the field. and with the environment in a playful way. 6.10.2. Building the 3. Wheelchair players can move with circuit for the game: the ball within their zone. When we are sharing the activity with people with intellectual disabilities, we must take 4. Wheelchair players can propel the chair with into account some strategies so that activity Nature walks adapted for more participants the ball on your legs; you can only rotate can proceed without precariousness and keep the that are elderly, young children or people with the chair with the ball on your legs. participants interested and involved. disabilities. It is a type of “vulnerable” 5. There is no contact with oth- participants, with losses of balance, or higher players or chair. Is important: er levels of fatigue, intolerance to heat and cold. It is necessary to avoid sharp gradients 6. The chair of a defending play- • If possible, a previous approach in the terrain of the course; to prevent fatigue er must be away one meter from the with educators or monitors to mea- that can compromise the success of the game, other player with the ball. sure the types of needs of the group. with negative consequences for the rest of the 7. Player only being allowed 5 seconds with the participants, as well as for the most vulnera- • If possible, request previously for ball in the hands; if it exceeds 5 sec- ble participants. Concern about travel course global group characterization. onds the ball is passed to the opponent. time and hydration should be quite compensated • Participants with total need of sup- factors. 8. Only GS and GA can score goals while port to do the activity; still within the throwing circle. In case of need, delimit the route / trail • Partial need for support to do the activity; 9. Penalties are scored when there is contact for orientation reasons and safety of the with the player or wheelchair, or obstruc- • Almost independent to do the activity. participants. tion of the player who has the ball. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 166 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 167

Simple elements and reference points should be associations for example the food chain. An area considered so that participants with more lim- with games that can help you relate to elements itations can be able to identify them. One of and objects that you find along the trail will be the characteristics that present a significant available. part of the participants with moderate or even severe intellectual disability is related to the Use exercises / games like: Stone, scissors, decoding of the symbols. Thus, the greater the paper; Boxes of different sizes for a color possibility of association with known elements, puzzle. symbols and codes, the greater will be the ten- dency towards a more autonomous exploration. Identification of groups: With t-shirts, vests, badges, bracelets, etc. to ensure that the par- Seek to use simple messages in communication. ticipant does not get lost and is not endangered The instruction must be detailed, and must by rough terrain which gives security to educa- tell what the activity consists of, such as the tors and monitors. course and the necessary safety measures. Adapted Orienteering is mainly a game that You should be patient and make sure that the should help to achieve situations of autonomy, participant understands and memorizes the in- in terms of space and time for people with instructions, as the attention and interest in the tellectual disabilities. For example, for those instructions, is usually low. It is necessary participants who do not know the letters and to use simple and pragmatic messages during numbers and even some colors, we can use tex- communication. There may need to receive re- tures so that they can make associations to the inforcement in the repetition of messages and images / pictograms in the cards and the plates instructions. in order to achieve the combinations for the answers. Before the orienteering trail, a body warming should be done, using music or dancing in a combination of fitness. Through augmentative language, schematics or three-dimensional models, you can help to structure the adventure of what will be found in the trail route, bringing to the choreography elements of increased communication, with the symbols of the cards, maps and the colours that will appear on the course. 6.10.3. Brief history and basic rules of the sport The spots on the map of course must be easy to relate to elements that the participants can Based on his work, we create these guidelines, that we will have on route and that are marked make simple association: ex. doghouse, water Orienteering is a competitive sport, practised which can help all to perceive this variant of on the map. well, flower beds, mill, lake, etc. in many countries, particularly popular in this sport and enjoy it as an activity practised Northern Europe. outdoors, in contact with nature. 1. At the place of departure, which will also be For this purpose, several strategies can be that of the arrival, the judges give each player used, such as: In Portugal, Mr. Joaquim Margarido, blogger, Let us get started! or team, a map and control card, with the number photographer, a nurse practitioner, in the of points that we must visit in our route, (fig- • Words with rhyme; Sounds; Graphics; Move- Prelada Hospital, in the Oporto region, and pas- ure 1). Each player or team will have a map with ments, facial and body expressions. sionate about nature and orienteering, has been different routes. Near the map, we have a card linked to this sport for several years, decided, 6.10.4. Activity development drawn that has three colors and numbers that are Endow the educators / monitors of groups with to make a variant in which all people with and and materials: the various points / beacons, through which we extended versions of the elements of the game. without disabilities of all ages could partici- will have to go through, to do the course. Next Such elements would be provided separately in pate, he created Adapted Orienteering in 2014. to the colors, there is an empty square, where order that different puzzle sets can be made. Adapted Orienteering is a game which runs along there should be a symbol / picture. For example: color plates, symbols, and numbers, He created a simple scheme with the use of maps a route drawn on a map. In the map are marked like the Bliss symbols, which are shown on the of basic routes, with cards where basic colors, spots / points, that we call beacons, that must 2. On the control card with symbols (figure 2), game cards. red, green and blue are used, together with be found and visited in a sequential way; It that is given with the map to each player or effective language pictures or symbols invented must start at the first point on the map and team, can also place your name/team name and A map in A3 format allows a short story to be by Charles Bliss, so that people with more deep finish at the last one that is proposed. When we the hour and minutes of your departure. The devised making use of the symbols and creating disabilities, can use for a basic communication. draw the map we can choose the number of points card will serve to mark the passage through the EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 168 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 169 points indicated on the map, attesting that you have found the various points noted on your route map.

3. Each point on the map signalled with a bea- con, which we see in the next image, will have a check punch attached that will be used to per- 6.11. forate our control card in the square to confirm completion of the points. TABle TenNIs

4. Each point on the course will be allocated with one number, 4 stakes, 4 plates with the colors, red, green or blue, which may be in AUTHOR: MICHELE LEPORI another order, and one of the symbols we have already talked about. Key words: Tennis table, Adapted sport activity, Equipments and rules

5. Then we look at the plates, to choose the one that has the right answer following the correct sequence of colors plus the corresponding picture. Next we mark the picture on the control Introduction 6.11.2. Why Table Tennis? card with check punch marking what we think is right and move on to another point. If none of Table tennis training can be very flexible and Table tennis can be interesting for a number of the color matches the desired sequence, mark can satisfy a wide range of needs. Adding a factors. Like all sports, it brings benefits to square with X. warm-up and improvement of resistance skills, the physical condition that has already been in addition to training specific skills, can stated in these guidelines. Specifically, it is 6. When we finish our course after visiting all give life to a complete routine that improves very challenging in the eye-hand coordination the points, we return to the starting point and balance, coordination, mobility and muscle skills and in the ability to perceive one’s own deliver our card with all answers perforated. strength. Speaking of activities for rehabili- spatiality, that is, to manage one’s movements Judges of the game, who have a card with all the tation purposes they do not necessarily require coherently with the environment around us. correct answers, color sequence and pictures expensive materials and, with simple precau- will compare with yours and provide a score for tions, you can adapt the workouts to your needs. However, the greatest benefits are in terms of all correct answers. Orienteering is a very common sport in Europe integration. In many institutions, especially and is increasingly gaining ground. for youth, you can find a table tennis table, 7. If players or teams tie, in the number of bats and balls. This gives the opportunity to correct answers, the team who take the least have the tools available to play, without having time to complete the entire course will win to purchase expensive materials. In addition overall. 6.11.1. Table tennis you can play in the same places and schedules - Who is it for? of able-bodied boys, by reacquiring the disabled boys their qualification of athletes in all Reference respects. Joint training and integrated activi- Table tennis is a sport that lends itself to ties between able-bodied and disabled people are Margarido, Joaquim in http://orientovar.blogspot.com/2012/10/ many types of disability, both physical and to be encouraged and can also be used to create orientacao-adaptada-um-desporto-para.html Retrieved on intellectual relational. For physical disability real tournaments (for example in double). 02-10-2018 there are specific measures and regulations, de- Figures and photos from: Joaquim Margarido’s Blog veloped by the high level activity, which cover Accessibility of table tennis tables in common practically the whole range of possibilities. areas will help to integrate the boys socially. Even for the most serious cases it is possible They will be able to practice table tennis even to find ad hoc solutions. outside of training facilities, public gathering centres, parks... The most difficult case is for people with visual impairments. These limit the ability to see the ball, already small in itself, to make it impossible in the event of complete blindness. For 6.11.3. How to adapt the activity this type of disability we advise against table tennis. The table tennis practice does not discrimi- nate against age and gender. Indeed, it is easy EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 170 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 171 even in high-level federal tournaments, to find NETS: There are different types and prices. Al- athletes of very different ages in the same most all of them consist of two clamps that hook category. to the table and support the net. Those approved by the international federation are of very For wheelchair athletes (category 1-5 according resistant material, they allow to control many to the criteria of the international federa- variables (height of the net, tension, length), tion - ITTF site citation) or with other types obviously they are more expensive and do not of motor disabilities (6-10) there are minor always adapt to any type of table. Other cheaper regulatory adaptations, which do not specifically solutions are based on the same principle, vary- affect our rehabilitation activities. ing only the reliability of the materials. They are specifically created to adapt to any type of Obviously athletes with amputations, paralysis table, even kitchen tables, desks etc. or similar to the upper limbs, have the possibility to use special bats. They may use velcro BATS: the costs vary a lot. In this case, how- bands to secure the racket to the hand or to the ever, we suggest the economic solution. The prosthesis. benefits of high-cost bats are not understood by the athlete until he/she has developed some For athletes with intellectual-relational experience. In addition to each frame and each disabilities (class 11 according to ITTF clas- rubber correspond some specific characteris- sification) there are no particular general adap- tics. These are used by coaches to support tations, we will proceed to train progressively, the athlete’s type of game at a higher level. reacting to the specific needs of children. Therefore, for the bats, you can easily use the cheaper solution. Different specifications for For all three groups, preparation is necessary the various disabilities that affect the upper before moving on to the actual practice. limbs. Those who have difficulty in shaking a bat can use special accessories (extended handles, In the case where athletes have difficulty co- velcro strips...). These are solutions that must ordinating and hitting the ball in flight, you be evaluated on a case-by-case basis, almost can proceed as follows. Mount the side barriers tailor-made for each athlete. The general rule to the table, lift the net, and use soft rub- is that adaptations do not interfere with the ber balls (of decreasing size depending on the part of the bat covered by rubber or increase skills) with special bats (or even the hands). the surface. In this case the ball will be slid on the surface of the table, rather than bounced. BALLS: There are also different types and prices. It makes no sense to start with the expen- It is an exercise that can be quite challenging sive balls of competition grade (which could for some types of disability (those with the become useful only after a certain technical greatest impact on the abilities of the boys), level acquired by the boys). The most economi- but also a good exercise of introduction to more cal solution is valid, especially taking into advanced training levels. account the fact that many will be broken during training.

To decrease the breakage of many balls it is 6.11.4. Equipment useful to give only one / two to the table, or have a supervisor to help you collect them. To proceed with the activity of table tennis we need: a table, a net, bats and balls.

TABLES: Approved tables can be costly and heavy, but offer the possibility to train at the highest level and to be able to organize competitions approved in the future. From that point of view all the intermediate solutions are possible, with non-approved tables (lighter and cheaper), up to adapt to alternative solutions (see chapter nets). Photos: Center Naprej, 2018 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 172 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 173

6.12.3. Why do it? 6.12.5. Equipment

Energy, excitment, involvement. These are three Cheerleading, in its less demanding form, does key words in cheerleading. This allows the wall not require special equipment: of pietism and sadness to be more effective- 6.12. ly eliminated, which too often accompanies the activities of disabled children. Even public Clothing CheeRLeadINg accustomed to contact with the Paralympic activity will be infected by the choreography, the The impact of a uniform is fundamental, at least invitation to action and rhythmic music. during performances. Various solutions are possible. An equal suit for everyone is a good AUTHORS: MICHELE LEPORI, ZVONKA NOVAK Furthermore, cheerleading is not just a compe- starting point, up to the professional uniforms tition sport. Born as a “sideline” activity, (which require an important budget). Keywords: cheerleading, fun, balance, cooperation, support, affiliation. that is to say the field of a sporting event, to entertain the public and encourage it to cheer. It’s a component that can still be exploited Pom poms today, leading the team to perform at large or small events in the area and help promote and Old-fashioned in the collective imagination, they Introduction pear. Groups can make use of boards with signs, raise awareness of the sport. are not absolutely necessary elements in sports coffees (pom poms), megaphones, flags and other. cheerleading. Also in this case there are cheaper Cheerleading is a very common sport especially Cheerleaders include choreographers with rather “training” versions up to the professional ones. in the United States. In Europe it is catching difficult acrobatic elements (jumping, pyramid), on, thanks to a movement that is gaining more but choreographies of pom pom groups should not 6.12.4. How to adapt the activity and more competence and professionalism, coming contain acrobatic elements. Important part of Audio system out of an initial phase of improvisation. The the choreography is the clothes that need to be The activity is adapted, as already underlined, goal of cheerleading is to combine choreography matched in color. In the pom pom dance groups, depends on the difficulty of the choreography. The choreography is designed based on a musi- composed of elements of gymnastics, dance and the pom poms need to be matched in color also The simplest elements are those of the dance cal composition. This must be played during the acrobatics, to create routines. Cheerleading is (Zveza znps: Navijaške in plesne skupine, 2019). that should be well exploited with intelli- tests. It will therefore be necessary to equip designed to encourage teams on the playing field gence. The routine must be simple enough for the oneself with a system to reproduce the chosen during matches. For this reason, an element of kids to perform but interesting enough for the track. This is what is needed to carry out a excitment and encouragement to the public is audience. very basic choreography, composed of elements of never missing in the choreography, to increase 6.12.2. Cheerleading pure dance. As training difficulties increase, its involvement during the performance. - Who is it for? If for the users with relational intellectual other equipment will also be needed. Mattress- disability coordination, memory and spatiality es and artistic stripes are essential to train should be taken into account, for the Paralym- stunt and artistic gymnastics safely. Cheerleading is very versatile and, working on pics users others factors must be taken into 6.12.1. Cheerleading - What is it? the complexity of the choreography, it is possi- account. ble to adapt it to almost all types of disabili- Cheerleading is a routine of dance. This is a ty. For example, there are integrated teams with Artificial arts may not be a problem in the sim- 6.12.6. Example - cheerleading group dance that includes cheering, aerobics, physical and intellectual relational disabili- plest choreography, but they could become a risk in Center Naprej gymnastics and more. It began to develop in the ties, which perform with great ease. in the more complex ones, becoming blunt ob- 19th century in the United States as a support- jects. Always pay close attention. Wheelchairs, ive activity in other sports (»rtv slo: otroški Obviously the basic level will be composed on the other hand, are not an insurmountable In Center Naprej, we offered users the oppor- portal - Navijanje«, 2019). mainly by elements of dance, leaving the parts obstacle. There are also many examples in the tunity to join the pom pom dance group. We made of artistic gymnastics (flip, wheels...) or dance world, from which it is possible to take a two groups of users who expressed their desire There are 2 types of cheerleading: the first is acrobatic (jumps, stunt...) only to athletes cue. to participate in the group. Different mov- competitive cheerleading, and the other is the whose disabilities allow it. The element of able structures, jumps, dance steps and spatial pom pom groups (Cheerleading, 2018). spectacularisation that cheerleading brings When athletes have more physical possibilities, changes affect the balance, coordination, flexi- with it should not be underestimated. It is not they can include elements of artistic gymnastics bility and memory of the involved users. Because It is common for both of them that their main by chance that the term “exhibition” is used. or even acrobatics. Recall that these elements the activity is group-based and requires cooper- purpose is to enhance the sporting atmosphere The choreography is made to bring attention to should be well considered and evaluated on a ation and consistency, we also actively work on at competitions and to represent the society, the guys who are doing it, to engage the public case-by-case basis. In addition, you should social skills like cooperation, customization, school or institution. Choreographies are made on an extrovert and energizing way. That is an devote much effort and introduce them gradual- acceptance... up of dance steps performed with rhythmic music, aspect that could help young people to relate to ly, so as to make them as perfect as possible and is very cheerful, where the vocal power of a more or less extensive public. (during the performance the emotion could play We adapt choreographies to the abilities and performers, their energetic and originality ap- tricks). limitations of the users involved (problems with EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 174 balance, motor interference, memory disturbanc- Typical foot positions: es, poor coordination...). Although the ultimate goal is the composition and implementation of • stands apart (wide range), the choreography, which the group performs as • a step forward and to the side, synchronously as possible, it is very important in the rehabilitation sense that we include users in the planning of choreography, costume Basic movements with hands: design, music selection, preparation of cheerleading equipment and pom poms. • high and low “V”,

• an archery position,

• position “L”, 6.12.7. Recommendations for work: • diagonal,

1. Involvement of users in the plan- • position “T” (half), ning of choreography and the prepara- • punch, tion of equipment, clothing and music; • position “K” (Zagorc, Korošec, Če- 2. Adapting choreography to the abilities bela and Fajmut, 2009). and limitations of the users involved;

3. Suitable footwear (comfortable, soft, non-slippery);

4. Heating before the start of the exercise (walking, jogging, leg lift) and stretching (neck, shoulders, arms, back, abdomen, chest, legs, ankles)

5. Dance part (progressive learning of steps, change of positions) without music by counting, later with music;

6. Adapting the choreography to the capabilities of the involved;

7. Talk and relaxation after the training session.

Basic movements

Basic palm positions: Photo: Center Naprej, 2017 • fist,

• “blade” (straight palm, fingers together), Reference • jazz position of the hands. Navijanje, retrieved from https://otroski.rtvslo.si/bansi/ Basic foot positions: prispevek/1694 13.2.2019 Cheerleading (2018), retrieved from https://sl.wikipedia.org/ • extension (“spikes”), wiki/Cheerleading 13.2.2019

• flexion, Zveza znps: Navijaške in plesne skupine, retrieved from http://www.zveza-znps.si/predstavitev.html 13.2.2019

• normal position. Zagorc, M., Korošec, N., Čebela, D., Fajmut, N. (2009). Priročnik za navijaške skupine. Ljubljana: Fakulteta za šport, Inštitut za šport EvalUa 7. ti•On of Sp•Ort Pr•O GramMEs

Learning outcomes:

• An understanding of monitoring and evaluation. tion of sports programmes.

• An understanding of why it is import- • Examples of physical, psychological and so- ant to evaluate sports programmes. cial outcome measures used in evaluation.

• How to plan effective evalua- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 179

7.1. ThE PUrpOse Of mOnitORIng anD evalUating sPOrTs ProgrammEs

AUTHOR: MICHAEL LAMONT

Key Words: monitoring, evaluation, outcome measures and tools

Introduction Evaluation is systematically assessing a completed or phase of an ongoing programme. What is monitoring and evaluation? Evaluations appraise the collected data and information, informing strategic decisions and The online platform Sportanddev.org (2013) thus improving the programme and outcomes in defines monitoring as the systematic and routine the future. Evaluation is made up of a number of collection of information from projects and pro- progressive steps, the most important of which grammes for four main purposes: is the collection of appropriate data that is subsequently used to make a judgment about the • To learn from experiences to improve prac- value of a programme (Dugdill & Stratton, 2007). tices and activities in the future; Sportanddev.org (2013) states an evaluation • To have internal and external ac- should help to draw conclusions about five main countability of the resources used aspects of the programme: and the results obtained;

• To take informed decisions on the fu- • Relevance of the programme to pre- ture of the programme; determined goals.

• To promote empowerment of bene- • Effectiveness of the programme. ficiaries of the programme. • Efficiency of the implementation of the programme. Monitoring is defined as a periodically recurring • Impact of the programme. task which begins in the planning stage of a programme. Monitoring allows results, processes • Sustainability of running the programme. and experiences to be documented and used as a basis to steer decision-making and learning pro- Information gathered during the monitoring cesses. Monitoring is checking progress against process provides the basis for the evaluation. plans. The data acquired through monitoring is The evaluation process is an analysis of the used for evaluation. collected information which looks at the rela- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 180 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 181 tionships between the results, the effects and pears to be central to this. Self-esteem and helps to build relationships within communities. overall impact of the programme (“Sportanddev. confidence can increase through the opportunity For volunteers, motivations and outcomes over- org”, 2013). to develop new skills and relationships. There lap at the personal and the community level (for is potential for sports and physical activity example, bonding with others increases a sense The World Health Organisation recommends that programmes to reduce the symptoms of anxiety of community and citizenship). between 10-20% of the total intervention costs and depression in participants. Other outcomes should be spent on evaluation (Dugdill & Strat- include improved cognitive functioning, benefits ton, 2007). However, evaluation can be seen as for people with dementia, and impacts around problematic, time consuming and can take lower emotion regulation. 7.1.5. Economic development priority compared to delivery of the programme (Stratton et al., 2005). The sources reviewed use a wide variety of techniques to calculate economic value and it was A recent review (Sport England, 2017) assessed 7.1.3. Individual development not possible to accurately assess the strength the evidence to date supporting the impact of of the evidence base without a critically ap- sports programmes on 5 key areas: To date substantial evidence indicates the po- praising the full range of these methods. tential for positive outcomes from taking part • Physical Wellbeing or volunteering, particularly for young peo- There was some evidence on the direct impact ple, but the wider set of circumstances around of the sport sector on the economy, largely in • Mental Wellbeing an individual will determine effectiveness in terms of gross value added and job creation. • Individual development relation to these outcomes. Evidence was identi- There was more evidence on the indirect impacts, fied for improved educational attainment, either including reduced healthcare costs due to a • Social and community development directly (improved grades and behaviour) or healthier population, reduced crime and improved • Economic development indirectly (enhanced skills like concentration employability. and teamwork). The review outlined the evidence supporting the positive benefits of sports and physical activity There are positive impacts on employability programmes in each of these areas, including: (employment opportunities, earnings, job per- This review concluded that: formance and satisfaction), including (limited) evidence for younger people ‘not in education, The evidence base is strongest for the physical employment or training’ (NEETS). Sport can and mental well-being outcomes, then the indi- 7.1.1. Physical wellbeing promote self-efficacy (motivation and commit- vidual development outcome. It is weaker for ment), for groups including elderly people and the social and community development and econom- Good evidence for the prevention of illness, disaffected young people. Other outcomes are ic development outcomes. increased therapeutic and management effects an increased willingness to volunteer and the in rehabilitation, improvements in strength, development of soft skills (such as integrity, More longitudinal studies could help strengthen balance, gait and motor skills, and maintaining responsibility and leadership). the evidence base by identifying the longer-term a healthy weight. Other outcomes include im- effects on mental well-being, individual devel- proved sleep, increased energy, healthy early opment and social and community development. year’s development, reduced engagement in risk behaviours such as smoking, reduced mortality, 7.1.4. Social and The main focus of this review was examining effective pain management and improved quality Community Development the evidence of the impact of sports programmes, of life in ageing. rather than how to design programmes to effectively achieve outcomes. A number of other Outcomes can be defined in relation to a range of working groups have focused on developing a concepts that are often challenging to evidence framework for identifying, monitoring and eval- 7.1.2. Mental Well-being (such as social capital, trust and networks). uating outcomes of sports programmes, including Many of which are positively associated with The Sport for Development Collation (2013). There is a strong association between taking participation or volunteering, but the effec- part in sport and physical activity and posi- tiveness of any intervention is dependent on tive mental wellbeing outcomes, but the causal a broader set of conditions. Sport acts as a mechanisms are less well understood. There are conduit for people of different backgrounds to challenges around the varied definitions used in interact, can bridge divides between groups such the field, and the subjective nature of measures. as men and women and people with different em- There is much evidence that sport and physical ployment backgrounds, and play a key role in the activity contributes to enjoyment, happiness, integration of migrants. A small body of lit- and life satisfaction. Social interaction ap- erature on bonding capital suggests that sport EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 182 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 183

Individual achievements and behaviours Benefits to society • Increased physical wellbeing* • Less need for health services

• Improved mental wellbeing* • Contribution to economy through par- EXTRINSIC ticipation to the labour market • Sustained participation in sport 7.2. and physical activities* • Less dependence on welfare • Positive health behaviour • Not subject to the criminal justice system

• Reduced anti-social behaviour • Strengthened community through leader- ThE SPort fOR ship and democratic participation • Improved attitudes to learning and attendance to school • Increased fairness and equality • Improved educational attain- DeveLOpmENt ment and achieving qualifications • Enhanced career prospects CoLLaTIon Out- • More securely housed

Social, emotional and cognitive capabilities Inter-personal relationships cOMes MoDEl • Self-efficacy* • Increased social capital and trust* • Self- esteem • Increased volunteering

• Motivation • Increased community cohesion and spirit

• Managing emotions • Positive parenting The focus of the Sport for Development Colla- intrinsic elements of their nature (self-esteem, tion is to define a collective and sector-led managing emotions, motivation), and also support • Resilience understanding of how to improve the outcomes them to develop certain extrinsic behaviours • Social skills

of sports programmes, provide advice on how to (play sport, be active and healthy, learn and INTRINSIC • Cognitive functioning design programmes and promote the use of shared have a job). and consistent measurements of impact in an Figure 15: The Sport for Development Collation Outcomes Model (2015, adapted from: https://londonfunders.org.uk/sites/de- attempt to further strengthen the evidence base Sports programmes deliver outcomes for the in- fault/files/images/SfD%20Framework_0.pdf) in this area (Sport for Development Collation, dividual person or for social groups and commu- 2015). nities. For example, a programme can change an Definitions of the outcomes identified in each section can be found below: individual’s emotional skills and behaviours, The Sport for Development Collation Outcomes and as a result influence theirfamily lives, Social, emotional and cognitive skills Model (2015) defines outcomes across two contin- communities and wider society. Self-efficacy* Perceived self-confidence in their current abilities and future tasks. uous sequences - from intrinsic to extrinsic, It is task specific; a person can view themselves as good at one task but not another. and from individual to social. The two sequences The model identifies four distinct groups of A person’s sense of self-efficacy can play a major role in how they approach goals, tasks reflect the strong evidence that links emotional outcomes: and challenges. It involves recognition that they can make a difference to their own life skills and behaviours to positive outcomes in Self- esteem An individual’s overall sense of self-worth (personal value), self-re- other areas of life. • Social, emotional and cognitive capabilities spect, selfperception and self-awareness. It involves beliefs about the self, such as appearance (body image), emotions and behaviours • Individual achievements and behaviours Sport programme outcomes can either be in- Motivation The process that initiates, guides and maintains an individual’s goal oriented behaviour. Motivation is what causes a person to act and achieve something: trinsic or extrinsic, for example a programme • Inter-personal relationships a person’s ambitions and aspirations. Sometimes individuals are motivated by per- can support a person to increase essential and sonal gratification and other times for external rewards (such as money, recog- • Benefits to society nition or praise). Motivation involves initiating action (active initiative) and continued effort even though obstacles may exist (determination) Managing emotions An individual’s ability to recognise their emotions and their effects (self- awareness) by examining and regulating emotions, thoughts and resulting actions (self-reflection, self-management) and keeping disruptive emotions and impulses in check (self-control, self-regulation, self-discipline) Resilience An individual’s perseverance and persistence when faced with obstacles (grit) and their flexibility in handling change (adapting, coping) Social skills How an individual interacts and relates to others. It can apply to simple social contexts and work environments. It relates to confidence in social interactions (social competence), forming relationships, working effectively in teams and interpreting others. It includes the ability to lead peers and be a role model, and to empathise and motivate others. It also includes communication skills such as expressing, presenting and listening Cognitive functioning The mental processes (such as perception, attention, memory and deci- sionmaking) involved in an individual’s problem-solving, time management, critical thinking, creativity and intellectual flexibility EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 184 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 185

Individual achievements and behaviours Benefits to society Increased physical Improved functional fitness, cardio respiratory fitness, muscular strength, adiposity/ body Not subject to the crim- Improvement in pro-social behaviour, reduction in crime and reduction in anti-social wellbeing composition; cholesterol levels, bone health, joint health and immune system function inal justice system behaviour particularly through lower levels of recidivism, drunk driving, use of illegal drugs, crime and suspension from school, property crime, shoplifting and juvenile crime Improved mental wellbeing Improved mood, feelings of happiness and life satisfaction, and reduced levels of stress and anxiety Strengthened community Increased civic engagement (citizens participate in the life of a com- through leadership and munity in order to improve conditions for others or to help shape Sustained participation in Increased intrinsic motivation for physical activity; cre- democratic participation the community’s future); and greater social cohesion sport/physical activity ation of sporting habits; and belief that ‘sport is for them’ Increased fair- Improved equality of opportunity and reduced stigma and discrimination for all, Positive health behaviour Improved diet (healthy eating), safe sex, reduced substance misuse, and smoking cessation ness and equality at work, in public, social and political life, and in people’s life chances Reduced anti- Improved pro-social values and reduction of behaviour likely to cause harass- social behaviour ment, alarm or distress to others. Increased positive social interactions Improved attitudes Improved engagement with school; improved behaviour in school; reduced abenteeism Figure 16:. (i-iv) Definitions of the Sport for Development Collation Outcomes (2015, retrieved from: https://londonfunders. to learning and attendance to school org.uk/sites/default/files/images/SfD%20Framework_0.pdf) Improved educational Improved learning, academic performance, attain- attainment and achieving ment at school and achievement of qualifications qualifications Dugdill & Stratton (2007) highlighted the RE- Enhanced career prospects In a secure job or accessing training opportunity; improved skills and experience AIM framework planning tool as a useful way for More securely housed Adequate and sustained accommodation practitioners to think about structuring their evaluation:

Inter-personal relationships • Reach - Who did the intervention reach? Increased social cap- Social capital describes the pattern and intensity of formal and informal networks among – e.g. monitoring of participant num- ital and trust* people and the shared values which arise from those networks. Aspects of social capital bers through registers, post codes, include increased levels of trust, increased membership of various groups and improved questionnaires, facility usage. access to networks and amount of social contact individuals have in their lives. Differ- ent types of social capital can be described in terms of different types of networks: • Effectiveness - How effective was the inter- • Bonding social capital describes closer connections be- vention at meeting its aims and objectives? tween people and is characterised by strong bond – e.g. physical activity increase, decrease • Bridging social capital describes more distant connections between peo- in body mass index or increasing the con- ple and is characterised by weaker, but more cross-cutting ties templation to become physically active. • Linking social capital describes connections with people in posi- • Adoption – Have significant parts of tions of power and is characterised by relations between those within a hierarchy where there are differing levels of power the intervention been adopted else- Increased volunteering Frequent activity that involves spending time, unpaid, doing something that aims to where? -e.g. programme has been ad- benefit the environment or someone (individuals or groups) other than, or in addition opted by other organisations. to, close relatives. Volunteering must be a choice freely made by each individual • Implementation - How was the intervention Increased community A cohesive community is one where there is a common vision and a sense of be- cohesion and spirit longing for all communities; the diversity of people’s different back- implemented and managed? How was the interven- grounds and circumstances is appreciated and positively valued; and those tion funded? What skills did the staff have? from different backgrounds have similar life opportunities • Monitoring: What were the monitoring Positive parenting Improved parenting skills and styles, improved parent mental well-being, reduced behaviour difficulties in children and evaluation strategies used to assess the quality of the intervention? Is the intervention sustainable?

Benefits to society Less need for Improvement in physical health by increasing fitness and reducing obesity; pre- health services venting a number of chronic diseases (cardiovascular disease, coronary heart disease, diabetes, some cancers, strokes, osteoporosis, hypertension); and providing therapeutic benefits for the management of existing diseases and illnesses. Im- provement in mental health by lowering the risk of depression; managing anxiety and stress; increasing an overall sense of wellbeing; and helping with some systems of clinically diagnosed personality disorders (such as schizophrenia) Contribution to econo- Healthy employment market; increased productivity for goods and services; increased my through participation innovation and new businesses; and increased revenue gerenated through taxable income in the labour market Less dependance on welfare More people better able to meet the expenses of daily living for a prolonged period of time and not be reliant on government welfare benefits (such as heating and housing benefits, Jobseeker’s Allowance and low-income benefits) EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 186 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 187

The Physical Activity Questionnaire for Old- Pedometers er Children (PAQ-C) and Adolescents (PAQ-A) (Crocker et al., 1997): The PAQ-C and PAQ-A are Pedometers provide information on walking. Self-administered 7 day recall questionnaires, A person’s individual data such as stride assessing general levels of physical activity length, body weight and age can be input into in 9 to 15 year old children using 10 questions. some pedometers. The in correct input of stride 7.3. There are no valid questionnaires for children length is arguably the largest cause of error in under the age of 9. estimating physical activity energy expenditure SPEcific OUt- and distances covered during walking. The best The Borg Scale of Perceived Exertion (Borg, use of pedometers is for recording steps and 1982): The Borg RPE scale is a self-report rat- pedometers should always be manually checked for cOme MEaSUres ing scale assessing a participant’s level counts by using a calibrated shaker table or by of perceived exertion during physical activity. hand (by counting each shake 1, 2, 3 etc. and checking against the device) (Dugdill & Stratton As the resources and skills available for eval- Self-report tools 2007). For representative data to be obtained uations are often limited, it is important to Heart rate Monitors participants it is advised participants wear a decide at the planning stage of a programme what Self-report tools are one of the most commonly pedometer for 3 days (Tudor-Locke et al., 2005). will be measure and why (Dugdill & Stratton, used outcome measure as they are less time con- Heart rate monitoring usually come in the form 2007). For the purpose of these guidelines we suming than other measures and are easily ad- of a belt that fits around the chest and detects Pedometers are a low cost method of generating have categorised outcome measures into three ministered. Self-report tools can take the form electrical impulses from the heart and converts accurate and reliable data (depending on the categories: of diaries, questionnaires or interviews. They these to beats per minute. These data are either quality of the pedometer; Schneider et al., can be completed both by the participant and by stored in the belt or transmitted to a receiver 2004). The daily target for physical activity • Physical outcome measures another person significant in the participant’s in the form of a wristwatch. Heart rate monitors is 10,000 steps per day (Tudor-Locke and Bas- life e.g. parent, carer, sibling or child. can be programmed to record heart rate second to sett, 2004) for persons without physical dis- • Psychological outcome measures second or minute to minute (recording interval abilities. However 15,000 and 12,000 steps have • Social functioning outcome measures A person’s ability to understand a survey ques- is called an epoch) continuously for weeks. The been recommended for male and female adoles- tion and their ability to accurately recall and main advantage of heart rate monitoring is the cents, respectively (Tudor Locke et al., 2004). communicate their activity pattern will affect relatively low participant burden and ease with The key aspect for activity intervention is not the reliability and validity of their self-re- which data is collected and analysed. The in- necessarily the debate over number of steps but 7.3.1. Physical outcome measures port, therefore the most reliable tools tend to struments require a PC for collected data to be whether total steps increase as a result be 3 day or 7 day recall tools (e.g. a partic- downloaded. Although these tools provide objec- of engaging in an activity intervention. Recent There are a variety of methods available for ipant recalling and communicating their level tive measures of physical activity, the cost and pedometer evaluations in schools have suggest- measuring sport/physical activity levels but of physical activity participation over past technical expertise required for use and data ed that pedometers work as motivational tools there is no gold standard (Welk, 2002). 3 or 7 days) (Dugdill & Stratton, 2007). These analysis may restrict the feasibility of use (Butcher et al., 2007) and stimulate increases self-report tools are recommended as they have for evaluation purposes. in physical activity (Dugdill & Stratton 2007). Key parameters for physical activity measurement shown adequate reliability and validity in large include: populations (Welk, 2002). Berg balance scale (BBS) (Berg, Wood-Dauphinée, Accelerometers Williams & Maki, 1992) • Frequency (when/how often does it occur) International Physical Activity Questionnaire Revised (IPAQ): The IPAQ (Booth, 2002) comprises These small devices are usually placed on the The BBS is a qualitative measure that assess- • Intensity (how hard is the activity) a set of 4 questionnaires. The purpose of the waistband or the wrist in wheelchair users and es balance via performing functional activi- • Time (the duration) questionnaires is to provide common instru- record the vertical (uni-axial) or vertical, ties such as reaching, bending, transferring, ments that can be used to obtain international- horizontal and diagonal (tri-axial) accelera- and standing that incorporates most components • Type of activity (walking, run- ly comparable data on health–related physical tion of the body. These accelerations are then of postural control: sitting and transferring ning, swimming etc.). activity. converted to gravitational counts per epoch safely between chairs; standing with feet apart, duration. These instruments can record in second feet together, in single-leg stance, and feet Dugdill & Stratton (2007) stated the challenge Global Physical Activity Questionnaire (GPAQ) by second or minute-by-minute epochs (Dugdill in the tandem Romberg position with eyes open is selecting a measure that is valid, accurate (“WHO: GPAQ Questionnaire): The GPAQ covers sev- & Stratton 2007). As with heart rate monitors, or closed; reaching and stooping down to pick and reliable, defining a valid instrument as one eral components of physical activity including the cost and technical expertise required for something off the floor. Each item is scored that measures what it purports to measure and intensity, duration, and frequency. the use and data analysis of accelerometers may along a 5-point scale, ranging from 0 to 4, a reliable measure as one that produces stable restrict the feasibility of their use for evalu- each grade with well-established criteria. Zero and repeatable results when used under the same The Active Lives Questionnaire (“Sport England”, ation purposes. indicates the lowest level of function and 4 conditions. 2015): The Active Lives Questionnaire collects the highest level of function. The total score data on demongraphics, geography and engagement ranges from 0 to 56. The BBS is reliable (both in sport/physical activity and takes roughly inter- and intratester) and has concurrent and 15 minutes to complete. construct validity. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 188 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 189

• There is also a 6-item Brief Multidimen- tion after life changes, but it is also suitable son’s state of mind, relationship with the world sional Students’ Life Satisfaction Scale. Systemic Observation as an indicator of quality of life at any point around them, and the fulfilment they get from in time life. It can be understood as how people feel Systematic observation involves a trained per- and how they function, both on a personal and a The Friendship Scale (Hawthorne 2006) son observing and coding predetermined physical The Life Satisfaction Questionnaire (LISAT) social level, and how they evaluate their lives activity behaviours of participants over a set (Fugl-Maeyer et al. 1991): The LISAT is a self as a whole. It is linked to a range of other This short, user-friendly 6 item scale measures period of time, e.g. sitting, walking, running or interviewer-administered rating scale, outcomes, including mental health. 6 of the 7 important dimensions that contribute etc. The SPACES system (Systematic Pedestrian taking approximately 5 minutes to administer. to social isolation and its opposite, social and Cycling Environmental Scan, Pikora et al., The LISAT-9 has 9 items; one is a global item Copps & Plimmer (2013) divided the measurement connection. 2002) is an example of a comprehensive observa- for ‘life as a whole’ and 8 are domain-spe- of personal and social well-being into on 3 tion tool used to assess walking and cycling. cific items for ‘vocational situation’, ‘finan- categories: Lubben Social Network Scale–Revised (LSNS-R) Systematic observation requires observers to cial situation’, ‘leisure’, ‘contact friends’, (Lubben et al., 2002) have undertaken specific training and can be used ‘sexual life’, ‘activities of daily living’, 1. Feelings about self. to assess participants in real time or video ‘family life’, and ‘partnership relationship’. The LSNS-R is designed to gauge social isolation 2. Relationships with family and friends. recordings. Although providing vaild data, the The LISAT-11 has 11 items, which includes the in older adults by measuring perceived social time and specific training required for this same items as the LISAT-9 but with two additions 3. Perception and connected- support received by family, friends and mutual technique may reduce its feasibility for evalua- evaluating ‘physical health’ and ‘psychological ness to the community. supports (eg. neighbours), including confidant tion purposes. health’. relationships. The tool has an abbreviated version (LSNS-6) and an expanded version (LSNS- World Health Organization Quality of Life In- 1. Improved feelings of self 18) and takes approximately 5-10 minutes to strument (WHOQOL-BREF) (WHO, 1998): The WHO- administer. 7.3.2. Psychological QOL-BREF instrument comprises 26 items, which Examples of valid outcome measures discussed in outcome measures measure the following broad domains: physical Psychological Outcome Measures section. Other UCLA Loneliness Scale – Revised (Russell, Pep- health, psychological health, social relation- examples include: lau, & Cutrona, 1980) ships, and environment. The WHOQOL-BREF is a The Warwick-Edinburgh Mental Well-being Scale shorter version of the original instrument that • The Self-concept Scale This 20-item scale is designed to measure a (WEMWBS) (Tennant et al., 2007): The WEMWBS was may be more convenient for use in large research (10-items) (Marsh, 1992). person’s subjective feelings of loneliness and developed to enable the monitoring of mental studies or clinical trials. The questionnaire social isolation. • The Resilience Scale (14-item) (Wag- wellbeing in the general population and the captures many subjective aspects of quality of nild and Young, 1987). evaluation of projects, programmes and pol- life (QOL) and is one of the best known instru- icies which aim to improve mental wellbeing. ments for cross-cultural comparisons of QOL and • The Children’s Society’s Wellbeing In- 3. Improved perceptions of and con- SWEMWBS is a shortened version of WEMWBS. This is available in many languages. dex (Rees, Goswami & Bradshaw, 2010). nectedness to the community is a 7 item scale for which item scores need transforming. The Beck Depression Inventory (BDI) (Steer, Copps & Plimmer (2013) defined this as a per- Beck, Brown, 1996): BDI is a 21-item self-re- 2. Improved relationships son feeling part of a meaningful community or Rosenberg Self-esteem Scale (RSES) (Rosenberg, porting questionnaire for evaluating the se- with family and friends communities, feeling connected to the envi- 1965): The RSES is a 10-item scale that measures verity of depression in normal and psychiatric ronment around them, and feeling included and global self-worth by measuring both positive populations. A shorter version of the question- Examples of valid outcome measures included: involved. Approaches to measuring these aspects and negative feelings about the self. The scale naire, the BDI Fast Screen for Medical Patients of well-being tend to be survey-based and depend is believed to be uni-dimensional. All items (BDI-FS), is available for primary care use. The Multidimensional Students’ Life Satisfaction on the responses of individuals to questions are answered using a 4-point Likert scale for- That version contains seven self-reported items Scale (MSLSS) (Huebner, 2001) about their feelings and perceptions. Many of mat ranging from strongly agree to strongly each corresponding to a major depressive symptom the tools tend to be very similar and are often disagree. in the preceding 2 weeks. The MSLSS is designed to provide a profile of derived from the same research base but differ children’s life satisfaction across key domains. slightly in length and emphasis. Overall, there General Self-Efficacy Scale (GSE) (Schwarzer The 40-item scale is completed by children and is no firm consensus on what the best tools are. & Jerusalem, 2010): This scale was created to young people and captures information on five assess a general sense of perceived self-effica- 7.3.3. Evaluation of domains: In practice, where they are in use, well-being cy with the aim in mind to predict coping with Social Functioning approaches tend to be combined with measures daily hassles as well as adaptation after ex- • Family (7 items) specific measures tailored to the intervention. periencing all kinds of stressful life events. As in many areas of measurement, there remains a • Friends (9 items) The scale is designed for the general adult The New Philanthropy Capital’s Outcomes Map: skills gap in analysing and interpreting data. population, including adolescents. Persons below Personal and Social Well-being (Copps and Plim- • School (8 items) There is a clear need to create tools that are the age of 12 should not be tested. The measure mer, 2013). practical and can be applied by non-experts • Living Environment (9 items) has been used internationally with success for (Copps & Plimmer, 2013). two decades. It is suitable for a broad range of In this NPC publication, Copps & Plimmer (2013) • Self (7 items) applications. It can be taken to predict adapta- defined personal and social well-being as a per- EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 190

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Learning outcomes:

• what regular physical activi- els of physical condition and motivation ty means and how important it is • Factors influencing the participation of • how and in what ways people with phys- people with disabilities in community sport ical disability can be motivated to do exercises regularly • What can the trainer do?

• what the expert can do according to the lev- • What is team sport and community sport? EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 194 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 195

8.1. InTroDUctioN rEGuLar PhYSi- CaL ACTIvity AUTHORS: ZSUZSANNA KOVÁCS, ZSUZSANNA ANTAL

Suppositions, studies and questions about quality of life and longevity are not new at all. AUTHOR: ZSUZSANNA KOVÁCS, ZSUZSANNA ANTAL Perhaps it is one of the most ancient questions of mankind: the question of what makes a human Keywords: disability/impairment, physical condition, motivation, guiding satisfied, what makes life meaningful and happy, and what is the secret to have a full and good life. The basic aim of human existence is to It is useful to consider factors affecting life • It affects the function of the im- practise human functions as fully as possible. quality in terms of those ones we can influence. mune system advantageously. The living conditions of mankind have changed Our health state is such a factor. If you think • It prevents obesity and ill- to a great extent, but the final aim remained the that we are merely passive sufferers of the na- nesses connected to it. same - reaching happiness and integrity. ture of our genetic map that is not necessarily true. We can do against the encumbered gene pool • The oxygen supply of the organism improves. There are many conditions influencing one’s qual- for example by attending regular screenings or ity of life. Including, but not limited to: cul- by doing regular physical activity and sport. As a bonus, regular physical activity also has a ture and leisure activities, economic situation, good impact on our psychological well-being: environmental conditions, infrastructure, secure and health state. These factors are of course • It reduces anxiety and depression. all related to each other, and they cannot be 8.1.1. Conceptual definition • It maintains memory. examined on their own. Just a simple example: financial wealth influences the consumption rate Advantages of regular physical activity are • It increases self-esteem and self-confidence. of healthy food as well as the total spent on well-known, “regardless of sex and age”. Beyond • It stimulates endorphin production that brings health insurance. The quality of our nutrition the general, favourable impacts of physical about the growth of long-term happiness. and the money spent on relaxation and recreation training and sport, it can be applied in the influences our health state, etc. prevention, treatment and rehabilitation of some • It increases libido. illnesses. Based on the stand of several Hun- Life length and life quality cannot be separated garian and international statements it can be Even a moderately intensive and a moderate time from each other, either. The higher our quality stated that: of physical activity has a positive impact (e.g. of life is, the more likely that we will live to 30 minutes of walk done 4-5 times a week) as it a higher age. If we spend the last 5-10 years of • Regular physical activity reduces the is able to improve one’s state of health and our life ill, then we speak about a lower life number of illnesses and early deaths quality of life. quality. due to hypertonia, diabetes, coronary-artery disease and obesity. Regular physical activity and recreational sport activity are an important element of • Its advantageous impact at- health behaviour as it has an important role tunes the motoric system. in the prevention and intervention of several • The regulation of central ner- chronic illnesses. Regular physical activity vous system improves. has a significant life quality-raising impact both among healthy people, those suffering from • The capacity of the endocrine system grows. chronic illnesses and those with disabilities. • The metabolism will become more economical. It improves corporal and mental health, as well as psychosocial well-being and the ability of coping with stress. EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 196 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 197

In places where there is lower economic depri- regular physical activity can create stability 8.1.5. Relationships and guiding in the interest of the vation, the frequency of doing regular sport in the individual’s life. Not only because this successful training of people with disabilities activity decreases, thereby contributing to can contribute to the development of a routine, lower health indicators of these groups. How- but also because certain exercises contribute to ever, there are unexploited health development the production of endorphins, thus promoting the Table 1: The relation between the Table 2: Different life stag- opportunities that could be addressed by move- feeling of happiness. type of physical impairment and es and motivational strength ment intervention programmes that could target the main goal of physical train- these groups. With the use of adequate tools ing/adapted physical education Life stage Motivation and measures this could provide a cost-efficient Child Acquiring reward solution to increase the physical and mental 8.1.3. Models and methods The type of impairment Goal Teenager Reducing dependen- health of this population. Physical impairment Restoring former phys- cy on parents acquired by stroke ical condition Here, the physically injured have to be empha- Unmarried Starting an independent life The question of social responsibility has been sized since for them, regular physical activity Cerebral palsy acquired Achieving the possible during/after childbirth highest level of self-care Married Commitment in a rela- brought into the foreground, according to which means life itself. Therefore, this is the only Person suffering from Delaying the impair- tionship and family sport has a positive impact on the individual means by which self-care may be promoted or muscular atrophy ment of condition at the Divorced/ Widowed/ El- Preserving the abil- and on wider society. Higher economically and facilitated. possible highest level derly single people ity of self-care as socially developed countries have already rec- Injury or limb loss Restoring former phys- long as possible. ognized that quality of life in society contrib- There are several models (ICF, IMAPA) and acquired by accident ical condition utes to the economic success of the individual, methods (Dévény Anna, Pető András) which aim Person with multi- At least maximising Source: Data colection of Zsuzsanna Kovács made among her his/her broader surroundings as well as to that to improve the state of people with physical ple impairments physical condition disabled sport mates, 2018 of the country. On the contrary, where people injuries. are struggling with illnesses and psychological Source: Data colection of Zsuzsanna Kovács made among her disorders this can place a large burden on the However, it is well-known that models only serve disabled sport mates, 2018 social security of the given country. as a theoretical basis as they often simplify reality. On the other hand, methods only provide solutions for certain types of diseases. Conse- Table 3: What the expert can do according to the lev- quently, the combination of different methods or el of physical condition and motivation 8.1.2. What can regular modified versions may be the solution. physical activity mean to Physical condition Intrinsic motivational level What can the sport expert do? The development of Very motivated (from instinct) Diversified exercise series, maintenance people with disability? physical condition has of interest/curiosity is essential, 8.1.4. Individualised physical just started (child) training/physiotherapy for Rehabilitation fol- Very motivated (from instinct) Diversified exercise series, maintenance lowing an accident of interest/curiosity is essential physically injured people Rehabilitation following Motivated, (the hope of a physical con- Not only a diversified exercise series, but a reconstructive sur- dition being better than the previous), also a diversified environment (background Before creating a training plan, the charac- gery correcting former however, this can diminish quickly if music, exercises done outdoors, diversified injury/impairment there are no small senses of achieve- training program (floor exercises – swim- teristic features and the symptoms of a disease ment since it may happen that the physi- ming – horse-riding) is necessary. have to be studied, in addition to its develop- cal condition has to be improved from the ment. This information is important as it can lowest level as a result of the surgery. influence and explain how unmotivated or motivat- Physical condition Unmotivated (It may have been triggered In the first case, diversified training ed the individual is and influences the end re- that has been stagnat- by the same exercises that had to be done program, exercise series, environment, and ing for a long time too many times and also by little sense of surmountable challenges are essential. In sult to be achieved. In addition to this, family achievement or by too great goals or the lack the second case, motivating conversations background is also of great importance. The key of goals together. Respectively, the individ- supported by powerful arguments are necessary to regular physical training/physiotherapy is to ual is satisfied with their state and thinks (With physical training the next stage of the continuously set achievable goals and promote a that it is enough to take actions if the next impairment of condition can be delayed and/ stage of the impairment of condition begins.) or its degree can be decreased. The de- sense of achievement. crease/termination of possible pains or the control or termination of the assuaging of pain with medicine can also be achieved.) Continuously deteriorat- Unmotivated (embittered, tired of, re- Combination of various methods, devel- ing physical condition signed themselves to their condition) oping new methods in close collaboration with the individual in order to stop or Photo: Zsuzsanna Antal, Boccia, Human Profess, Szombathely, reverse physical deterioration or showing 2017 a tiny ray of hope regularly in any way.

Irrespective of having physical, intellectual, mental, psychosocial or sensory disabilities, Source: Data colection of Zsuzsanna Kovács made among her disabled sport mates, 2018 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 198 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 199

To achieve and maintain the demand for regular physical activity, we have to continuously affect the individual’s emotions either by encouraging, praising, warning, or sanctioning which depends on the individual’s personality to a large extent. 8.2.

Reference COmmuNItY acTIVE

DSGM Retrieved from: http://www.dsgm.eu/index.php?option=com_ content&view=article&id=20&Itemid=2&lang=en (2018. 07.26) liVINg pROgraMmEs Meet the needs of all individuals with IMAPA Retrieved from: https://uk.humankinetics.com/blogs/excerpts/meet-the-needs- of-all-individuals-with-imapa (2018. 07.26)

Method by Pető András Retrieved from:http://semmelweis.hu/ AUTHOR: ZSUZSANNA KOVÁCS pak/en/ (2018. 07.26)

The International Classification of Functioning, Disability KEYWORDS: INDIVIDUALIZED CONDITIONS, TYPES AND ADVICE OF TEAM/COMMUNITY SPORT and Health (ICF) Retrieved from: http://www.rehab-scales. org/international-classification-of-functioning-disability-and-health.html (2018. 07.26) respecting others, solidarity, principles of 8.2.1. It’s better to discipline all foster active citizenship, social sport in a community! integration, and they discourage from crime.

Community sport goes beyond what exercising means in order to preserve one’s health. Exer- cising in a team, or even together at the same space creates a community: it helps you to make new relationships, it strongly motivates you, it inspires you and it fills you up emotionally. It strengthens the social network around the people, it motivates for playing, it inspires, and participants thereby can reach a “flow”-experience.

If we do sports in a team, then the good participation of the team depends on the cooperation of the individuals. It is a common interest of every team member; let it be either an occasional leisure community, or a permanent one, not to speak about athletes involved in top-level sport, to be part of the game and of a potentially winning match. For this, it is necessary Photo: Zsuzsanna Antal, Gymstick-Nordic walking, Human Pro- to have the skill of cooperative behaviour, fess, Szombathely, 2017 the altruistic cooperation built on realistic self-knowledge, the humility and the effort towards the common aim. The feeling of group identity and belonging together, which provides 8.2.2. Factors influencing the security, can be established based on these val- participation of people with ues. (Rétsági, 2015) disabilities in community sport In the publication entitled White Paper on sport (2007:7), made by the Committee of European • Personality (how motivated a person is, at- Communities, we can read that belonging to a titude, determination – impressionability) team, the fair competition, keeping the rules, EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 200 EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 201

on of direct demonstration is exemplariness • The character and degree of impairment c. does not accept either instructions or advice leisure communities, not to mention partici- and faultlessness. Therefore, demonstration (physical and intellectual condition, ac- pants of high-performance sports and first-class d. carries out instructions, but performed by the trainer seems to be more cess to the establishment and to the scene) sports, that they should be participants of does not accept advice effective. However, it is possible that a games involving experience and possibly of a • Living conditions, financial situation greater stimulating effect can be achieved e. is a pessimistic or optimistic person winning match. For this, the skill of cooper- (travel expenses, purchase of equip- if demonstration is done by an experienced ative behaviour, the altruistic cooperation ment’s, activity that can be performed f. is an introvert or extrovert person fellow sufferer. The tools of direct demon- based on realistic self-knowledge, humility, and in parallel with learning or work) stration are: drawings on board, magnetic g. is an unmotivated or persuad- effort toward a common aim are essential. Team board, pictures, videos, common match, vis- • Access to the establishment, its facilities able or suitably motivated person identity and belonging together which gives the iting competitions.The greatest motivating and degree of accessibility with wheel- feeling of security may develop based on these h. is a person who easily runs away from power is embodied by the two latter tools. chair, (Zsuzsanna Kovács, own experience) values. (Rétsági, 2015) problems or is a persistent one • Practical methodical procedure: providing and ensuring assistance, and exercising. In In the publication entitled White Paper on Sport What are the individual’s liv- case of assistance, if it is not provided (2007:7) made by the Commission of the Europe- 8.2.3. The trainer has to be ing conditions like? What about by the trainer, but it is given by a vol- an Communities, we can read that belonging to aware of the following things: their financial situation? unteer, it is important that expertise of a team, fair competition, following the rules, a certain degree is necessary in this case respecting others, solidarity, principles of a. is it or is it not a problem for the in- too, and they also have to know the train- discipline all promote active citizenship, so- For what reason does the indi- dividual and for their relatives to en- er’s and the individual’s all vibration. cial integration and discourage from crimes. vidual choose the sport? sure the conditions of doing sports? Assistance shall only be provided if the indi- Proposals of the White Paper (2007:7) aim at the a. external pressure: it was recommended What are the most important cri- vidual needs it. However, assistance should be improvement of the situation: by a doctor or the person was persuad- teria, symptoms and consequenc- continuously guaranteed. ed by family, friends and acquaintances es of the individual’s disease? Exercising: Depending on the aim of doing sports b. own decision Zsuzsanna Kovács, own experience and on the individual’s disease, either the quality or the quantity is a priority. What is the primary goal of doing sports? a. to gain community experiences 8.2.4. As a trainer what can 8.2.6. If necessary, I have to b. preserving or developing health/ I do with knowledge of the physical condition/appearance above mentioned things? decide, to whom I turn for help. c. proof, self-realisation, competing Based on the cause, the aim, the personality, For example: The individual’s family, friends, on the individual’s idea and disease, it has to or a doctor, a physiotherapist, a masseur, What kind of ideas does the individu- be decided whether I am able to choose the right (sport) psychologist, a social expert. al have on their own sport facilities? type of sport, the suitable training method and the appropriate motivational tools thus, the If it is required by the living conditions and a. has no idea strategy either individually or with assistance. the financial situation, we have to try to create an optimal condition more carefully than usual, b. has an idea at large, but it is not realistic either by ensuring accessibility with wheelchair Photo: Zsuzsanna Antal, Nordic walking training, Human Pro- c. has a realistic idea at large or providing ideal training time and occasion or fess, Szombathely, 2017 8.2.5. Educational methods: simply by providing the available information. d. has a concrete idea, but is not realizable Typical methodical procedures (Zsuzsanna Kovács, own experience) e. has a concrete, realistic idea ‘The Commission furthermore encourages Member States and sport organisations to adapt sport • Verbal methodical procedure: explanation, infrastructure to take into account the needs instruction, word of command, exhortation, To what extent can the individual be 8.2.7. Team sport and of people with disabilities. Member States and stimulation, encouragement Take the indi- influenced or guided? What is their at- local authorities should ensure that sport ven- vidual’s age, preliminary training and dis- community sport titude? What is their habitus like? ues and accommodations are accessible for people ease into consideration. There is a great with disabilities. Specific criteria should be emphasis on employing explanation, exhor- a. does not accept help either from The good participation of a team depends on the adopted for ensuring equal access to sport for tation, stimulation and encouragement. helpers or volunteers cooperation of the individuals constituting all pupils, and specifically for children with • Visual methodical procedure: direct and the team. It is a common interest of every team disabilities. Training of monitors, volunteers b. accepts help from helpers and volunteers indirect demonstration. The basic criteri- member regarding either occasional or permanent and host staff of clubs and organisations for EUROPEAN RESPORT GUIDELINES FOR IMPLEMENTATION OF RESPORT ACTIVITIES 202 the purpose of welcoming people with disabilities will be promoted. In its consultations with sport stakeholders, the Commission takes special care to maintain a dialogue with representatives of sportspeople with disabilities.’

Photo: Zsuzsanna Antal, Netball training, Human Profess, Szombathely, 2018

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