Guttman’s efforts led directly to the creation of an international sports movement for the spinal cord injured. This movement was identified for many years as the International Stoke Mandeville Games Federation (ISMGF), which sponsored the first international games for people with disabilities in 1952. Its name changed more recently to International Stoke Mandeville Wheelchair Sports Federation (ISMWSF).

Other organizations developed their identity with specific disability groups, such as blind, deaf, cerebral palsy, amputee, and intellectually impaired. Within these organizations, control of the direction, staffing, and goal setting was made by persons who, for the most part, came from the medical or educational systems.

The wheelchair sports movement in the United States was sparked by Ben Lipton, director of the Bulova School of Watchmaking, in New York. He established the U.S. National Wheelchair Association (NWAA) in 1957, which sponsored the annual national wheelchair games. For many years these games were held on the grounds of the Bulova School of Watchmaking in Queens, New York. In 1994 the NWAA was renamed Wheelchair Sports USA, a name it has retained.

There was another quite separate and distinct influence that led to a change in the character and direction of sports for people with disabilities. This was based on the concepts of the value of sports in its own right, and the perceived need to identify the participants as true sportsmen and sportswomen, rather than part of a rehabilitation process. This effort has led to the development of an international governing body, the International Paralympic Committee (IPC), which is associated with the Olympics movement. Through this development, the Paralympic Games have gained stature and have served as the showcase for elite performers in disabled sports. In the 2000 Paralympic Games held in Sydney, Australia, 3,842 competitors (967 women and 2,867 men) from 122 countries participated before crowds that included 340,000 schoolchildren, 1.16 million paid spectators, and 300 million television viewers (10). The 2002 Salt Lake City Winter Paralympics totaled 416 competitors (88 women and 328 men) from 36 countries. This development has led to a close link between national governing bodies for Paralympic sports and the Olympics sports movement. It is estimated that over 500,000 athletes worldwide compete in Paralympic Sports (Table 41.1) (11).

Sports development at all levels, until recently, has been mostly identified with specific disability groups. Wheelchair sports is primarily for people with spinal cord injuries and bilateral lower extremity amputations, and it developed through an organizational structure at international, national, and local levels, from the Stoke Mandeville organization down to local community groups.

Cerebral palsy sports, both wheelchair and ambulatory, achieved its own American identity in 1978, when a U.S. National Sports organization, the National Association of Sport for Cerebral Palsy, was formed, facilitating regional and national competitions. This in turn led to the creation of a national team, which competed internationally for the first time in 1978. In 1987, cerebral palsy sports were reorganized as the U.S. Cerebral Palsy Athletic Association (USCPAA). More recently, in 2001, this organization broadened its mission to include other disability groups, and has been renamed the National Disability Sports Alliance (NDSA).

Amputee sports developed through several separate pathways. Winter sports offered the opportunity for unilateral amputees to ski, using some simple pole modifications, usually
not using a prosthesis. In more recent years, technical developments led to the participation of bilateral lower limb amputees in sled, and mono-skiing downhill events (12). Summer sports for amputees developed differently in Europe than in the United States. In Europe the emphasis was on the use of prostheses in sports as much as possible in field and track events, whereas in the United States, initially, amputees participating in sports favored the wheelchair route to competition. The development of technically more sophisticated prostheses, such as energy storage foot and ankle systems, has resulted in significantly more amputees participating in sports with their prostheses (e.g., in track events). Bilateral above-knee amputees, who represent a higher degree of impairment, usually continue to compete in wheelchair sports such as track and field and basketball. Disabled Sports USA, formerly National Handicap Sports U.S.A., is the U.S. organization that represents amputees in competitive sports activities.