Physical Activity

Pre-Participation Evaluation in Athletes with Special Needs

Nelly Khalil/ Head Nurse Athlete Screening Department
07 February, 2017

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Participating in sports is becoming more available to individuals with physical impairment and special needs. Sports participation provides the same benefit for athletes with special needs as for athletes without special needs. These benefits are numerous and include: muscle strength, improved cardio-vascular function as well as reduced anxiety and improved self-esteem. Furthermore, extra benefits are specific to the athlete with special needs such as fewer infections and fewer pressure ulcers.

Pre-participation evaluation:

The Athlete with special needs will benefit from a Pre-Participation Evaluation as it is an opportunity to promote their health and safety both in training and competition.

The goal of performing Pre-Participation Evaluation for athletes is to ensure that they are medically fit to participate in their chosen sport and to identify any risk factors that might predispose them to injury or illness. Physicians should be aware of the common problems that might be associated with specific disabilities in order to identify anomalies and treat them accordingly.

During the Pre-Participation Evaluation, the medical professional will review the athlete’s health history, complete a comprehensive physical assessment and perform specific testing when indicated.

Medical History:

The medical history should be completed by the athlete if possible, or their parents/guardian who are familiar with the athlete’s medical history. Determining the type and cause of disability, as well as evaluating the level of athlete’s independence is essential. The medical history also includes a detailed summary of previous injuries and medical illnesses.

Physical Examination:

The physical examination of the athlete with special needs should include all components of the examination of athletes without disability. However, special attention should be given to the below:

  • Visual system: assessing visual impairment such as strabismus or poor visual acuity
  • Cardiovascular System: such as congenital heart disease
  • Dermatological System: for example pressure ulcers
  • Neurological System: such as spasticity
  • Musculoskeletal system: including limited range of motion

Further Testing:

Further testing will also be required to determine eligibility for sports participation such as: electrocardiogram, echocardiogram, vision tests, pulmonary function testing and radiology imaging. This list can expand depending on the individual needs.

Special equipment might be required in order to assess the athlete with special needs such as the chair weight scale to weight the athlete with paraplegia or hemiplegia.

Medical Clearance:

The clearance to participate in sports for athletes with special needs should follow the same principle as for athletes without disabilities and depends on the outcome of the evaluation and the type of sport in which the athlete wishes to participate.

A multidisciplinary approach to determine the eligibility to play sport for the athlete with special needs is important and it might involve several specialties such as physical therapists, surgeons, cardiologists and psychologists.

Athletes may be provisionally cleared pending successful completion of a specified examination, treatment, or test. Rarely, athletes may be disqualified completely from participation.



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