Prevention of secondary conditions

Reduction of health risks

Promotion of healthy behaviors

Increased physical activity

Improved overall attitude and outlook

Improved performance in activities of daily living

Gains in strength and mobility leading to increased participation in other leisure activities

Experiencing a sense of camaraderie from socializing with other SCI athletes and their families

Increased social participation; reintegration into the community

Decreased depression and anxiety

Increased life satisfaction

Increased opportunity for gainful employment

Having fun

Being involved in a competitive sport reigniting preinjury identity as an athlete

Regulation of mood and stress

Increased sense of belonging and purpose

Valuing one’s contribution to the education and training of future athletes

Broadened view of life while encouraging a sense of hope

Limited access to facilities, adaptive sports teams, and local training staff

Lack of financial resources to support costs for participation, transportation, and equipment needs

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  Sports participation for adults is more expensive than for children

Stress/pressure to perform in a competitive sport

Medical issues associated with

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  Baseline health

  
  
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  Pain/injury from sport

Accessibility problems

Time constraints

Transportation concerns

Caregiver/family burden

Lack of awareness of sports opportunities

Poor health care support/assistance

In adaptive archery, the target size and distance between the archer and target differ based on the competition category

Participants with physical or cognitive impairments, who may otherwise be dissuaded from participating in sports, can participate in archery alongside athletes without any disability

Individuals with impaired muscle power, athetosis, impaired passive range of movement, hypertonia, limb deficiency, and ataxia

Classification : 2 categories

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  Open class contains both standing athletes and those in a wheelchair. Archers position themselves at a 90° angle to the target and may use body support

  
  
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  W1 athletes may use either a bow limited to 45 lbs in draw weight and without magnifying sights

Para badminton is played on a 44 × 22 court with a net and follows the same rules as standard badminton

Amputee, spinal cord injury

Classification 6 divisions

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  Divisions differentiate wheelchair and standing divisions and severity of disability in each division

Only manual wheelchairs incorporated

Wheelchair basketball is an adaptation of the able-bodied version where the court dimensions, basket height, scoring structure, number of players on court, and playing time are the same

Adaptations are for dribbling, travel violations, and fouls

Adult and youth leagues

Amputation/limb loss, leg length discrepancy, spinal cord injury, spina bifida, post-polio syndrome, cerebral palsy, brain injury, stroke, and other orthopedic and locomotor disabilities with permanent joint disorders that severely limit the ability to jump, run or pivot

Manual wheelchair sport

Adapting billiards allows individuals to stay active recreationally or at a competitive level

Multiple levels of adaptive equipment available based on need

Spinal cord injury, amputees, cerebral palsy, low vision, multiple sclerosis, and neuromuscular disorder

Manual or power wheelchair

Like able-bodied bocce, a set of balls is thrown or rolled onto a court by opposing players, getting as close as possible to a target ball

In adaptive bocce, there are 6 balls per side, and athletes may use an aide to assist with specific tasks during competition, such as a ramp to propel the ball

Persons with conditions of a noncerebral origin that affect all 4 limbs such as high spinal cord injury, muscular dystrophy, arthrogryposis, multiple sclerosis, stroke, or ALS

Competitive boccia is open to persons with tetraplegia, cerebral palsy, and traumatic brain injury

Adaptive bowling is played on standard lanes and can be modified for varying skill levels

Adaptive equipment includes ramps, guide rails, ball pushers, and varying types of bowling balls and wrist supports

Physical and cognitive impairments

American wheelchair bowling has 4 divisions: Scratch, A, B, Novice

Adaptive canoeing and kayaking can occur at recreational level as well as competitive level using either kayak or Va’a

Adaptive equipment such as outriggers, double hull catamaran, seating or paddle adaptations can allow large variety of participants

Tetraplegia, paraplegia, cerebral palsy, amputees, multiple sclerosis, and neuromuscular disorders

Classification:

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  3 classes exist in competition that addresses abilities to use arms, legs, and trunk

Wheelchair curling occurs on same field of play and with same stones as well as many of the same rules as abled body curling

The differences are as follows: no sweeping in wheelchair curling; teams must be composed of male and female participants

Significant impairments in lower leg/gait function, spinal cord injury, cerebral palsy, multiple sclerosis, amputees, others

Both power and manual wheelchairs are allowed; if manual, brakes are necessary on wheelchairs

Para dance is an elegant, graceful, and stylish sport. Participants can have an able-bodied partner or duo dance for 2 wheelchairs together

Dance floor is minimum of 250 m ² (350 m ² for championships), with no side of the floor <10 m in length

Impaired muscle power, impaired passive range of motion, limb deficiency, leg length difference, athetosis, hypertonia, and ataxia

Classification:

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  6 sport classes in 4 competition classes

Utilizes power or manual wheelchair

Equestrian:

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  Equine-assisted therapy

  
  
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  Hippotherapy

  
  
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  Therapeutic riding

  
  
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  Para-equestrian

Para-equestrian (competitive) has 3 divisions: para-dressage, para-driving, and para-reining

There is a wide variety of adaptive equipment for mounting and securing riders in saddle

Spinal cord injury, cerebral palsy, amputees/limb loss, blindness/visual impairments, brain injury, stroke, and neuromuscular disorders

Wheelchair fencing has the same objective as standard fencing by earning points through touches to your opponent

The difference is that the participant is sitting in a wheelchair and is stationary

Amputees, spinal-cord injuries, and cerebral palsy

Classification: 2 categories of athletes:

Category A: good trunk control

Category B: athletes have an impairment that impacts their trunk or their fencing arm

Manual sports wheelchair with specialized playing surface system to lock chair in place

Adaptive fishing is an activity that people with various disabilities can enjoy

There is a host of adapted fishing equipment available that range from simple devices such as rod holders to more complex adaptive devices such as powered casting reels

Adaptations for boat controls and seating

All types of diagnosis, including physical and cognitive disabilities, can participate

Can participate from wheelchair level or standing

Floorball is played on an indoor court 26 m by 16 m with 5 players on court not to exceed 12 points

Of the 5 athletes: 3 have hand sticks, and 2 have T sticks

Goal is to shoot ball into goal

Original name was electric wheelchair hockey

Tetraplegia multiple sclerosis, muscular dystrophy, cerebral palsy, head trauma, or stroke

Floorball is a sport for those with very limited physical abilities

Wheelchair football can be played on an indoor basketball court or concrete/asphalt that is 60 × 25 yards divided into 15 yard segments with end zone 10 yards

There are two 20 min halves with 10 min half time. 7 players are on the field for each team

Permanent physical disability consistently reduces the function of the lower limbs to a degree where they cannot run, pivot, block, or tackle at the speed, control, safety, stability, and endurance required to play running football as an able-bodied player

Classification : Players are classified via a functional classification system comparable to wheelchair basketball

Manual sports chairs are used

Adaptive golf allows players the opportunity to enjoy golf independently or with friends and family by providing access to equipment and supplies

In adaptive golf, the golfer may adjust the ball’s position to allow the club to be swung and the ball to be hit

Participants with a physical disability who can move one or both arms and have at least minor trunk function

Many adaptive golf devices are available; however, it is important to ensure the course will allow adaptive golf devices such as a para golfer

Adaptive handcycling and off-road cycling allow individuals to enjoy the outdoors, improve cardiovascular fitness, and socialize with friends and family

Multiple sclerosis, stroke, spinal cord injuries, amputations, stroke, spina bifida, and cerebral palsy

The concept is to modify and adapt cycles to suit an individual rider. Many options are available to be inclusive to many

Wheelchair lacrosse is played on a roller hockey rink or box lacrosse pad, using a no-bounce ball. Gameplay is 8 vs 8 (including goalie)

Players use lacrosse sticks to scoop, catch, carry, pass, and shoot the ball into the other team’s goal

Amputees, spina bifida, spinal cord injury, cerebral palsy, congenital limb issues, leg length discrepancy, muscular dystrophy, Parkinson’s, multiple sclerosis, motor dyspraxia, and stroke

Manual wheelchairs are used, often the same sport wheelchairs that are typically used for wheelchair basketball are used for lacrosse

Marital arts

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  Judo

  
  
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  Karate

  
  
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  Kung Fu

  
  
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  Brazilian jiu-jitsu

Modifications to rules and techniques are made

Goal is to continue to offer physical strength, coordination, flexibility, mental focus, and discipline through martial arts

Physical and cognitive impairments of all levels

Incorporates manual and power wheelchairs

Wheelchair pickleball can have one or more players on the pickleball court who are in a wheelchair

The difference from able-bodied pickleball:

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  There is a larger court size

  
  
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  A wheelchair athlete can hit off double bounce

  
  
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  The wheelchair is considered part of player’s body, therefore:

  
  
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  Wheelchair player’s rear wheels must be in the correct serving area at the point of contact on the serve

  
  
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  On volley, zone faults are based on the back wheels of a wheelchair

Diagnoses not defined for this emerging sport. Participants must play using a wheelchair

Manual wheelchair sport: Players in a wheelchair must always be seated and cannot stand in the wheelchair

Para powerlifting focus is on the bench press—lower bar to chest, hold motionless, then press upward

In para powerlifting, athletes participate laying supine on para bench

Spinal cord injuries, spina bifida, congenital limb deficiencies, lower limb amputee, cerebral palsy, bone shortening, and multiple sclerosis

Classification: 10 different weight categories per gender exist in competitive para powerlifting

Power soccer is played in power wheelchairs with a specialty attachment in a gymnasium on a regulation basketball court

Two teams of 4 players attack, defend, and spin-kick a 13 in soccer ball in a challenging game like able-bodied soccer

Tetraplegia, multiple sclerosis, muscular dystrophy, cerebral palsy, head trauma, or stroke

Power soccer is a sport for those with very limited physical abilities

Participants 5 y and up can participate

Wheelchair racing includes the use of a racing wheelchair and occurs on a track or road

Racing wheelchairs are like a recumbent handcycle with 2 wheels in the back and one in the front, but no gear system exists

Athletes wear specialized gloves to help with pushing wheels and for use on the turning system of the racing wheelchair

Amputees, spinal cord injuries, and cerebral palsy

Divisions of racing are

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  those who have complete function from waist up only

  
  
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  those who have complete function in upper limbs but impaired in abdominals

  
  
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  those with upper limb restrictions

  
  
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  those with cerebral palsy qualify but have different division

Para climbing/adaptive climbing makes climbing accessible to people with any type of physical or cognitive disability

Specialized equipment is utilized during adaptive rock climbing that is customized to the individual

Physical and cognitive impairments; limb difference, amputees, spinal cord injury, those with visual impairments, autism, down syndrome, cerebral palsy, traumatic brain injury, multiple sclerosis; and epilepsy

Participants have the option to use a wheelchair depending on the activity

Adaptive rowing is a sport for sweeping, rowing, or sculling

Para-rowing can be recreational or competitive

Adaptations to boat, seat, and oars can be made to allow successful participation

Amputees, cerebral palsy, cognitive impairments, traumatic brain injury, autism, epilepsy, spinal cord injury, and hearing and visual impairments

Wheelchair rugby is a full contact sport that is played on a basketball court

There are 2 cones at baseline 24 ft apart at goal line

Teams are composed of 4 players who are permitted to be on the court at one time

The game’s objective is to take a volleyball and advance it from one end of the court to the other

Extensive gloves and taping system are used for skin protection; other equipment is specialized per impairments and athlete needs

Diagnoses include tetraplegia, cerebral palsy, muscular dystrophy, multiple sclerosis, lateral sclerosis, amputates, post-polio

Classification: players classed from 0.5 to 3.5 in increments of .05 (7 classes). 0.5 is lowest function, and 3.5 is highest function

Customized manual sport wheelchairs are required

Parasailing can occur with able-bodied and disabled sailors together

Sailing includes cruise, race, or potter in a variety of boats on sea or inland water

Adaptations can include but are not limited to special seating, electric power winches, electric starter motors, talking GPS, roller furling, davit Transfer system (like Hoyer lift), and joystick controls, like sip-and-puff systems

Both physical and cognitive impairments can participate. The sport is focused on variety, types, and degrees of disability

Classification focuses on 3 factors: stability, hand function, and mobility. Classification rating is from 1 to 7. Visual impairments have a separate process

Adaptive scuba diving is a method of training persons with various disabilities to participate in scuba diving as independently as their abilities allow them to do

Amputations, spinal cord injuries, those with hearing loss or vision impairment

Individuals must be able to meet the basic medical criteria for scuba diving.

Sled hockey is played with 6 team players (including a goalie). Sled hockey follows most of the typical ice hockey rules except for variability in equipment

Specially designed sleds that sit on top of 2 hockey skate blades

Two shorter sticks with metal picks on the bottom for players to propel themselves, similar to cross-country skiing

Goalies wear the same equipment but have metal picks sewn into the backsides of the gloves to allow the goalie to maneuver

Amputation/limb loss, spinal cord injury/wheelchair users, cerebral palsy, brain injury, and stroke

Snow skiing

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  Nordic skiing

  
  
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  Cross-country skiing

  
  
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  Snowboarding

Adaptive skiing enables skiers with disabilities to participate by using special equipment. Athletes combine speed and agility while racing down slopes

Types of skiing: downhill, slalom, giant slalom, super-G, super combined, and team events

There are many levels of equipment to allow for various participants. This includes monoskis, biskis, and outriggers

Spinal cord injury, cerebral palsy, amputation, limb deficiency, leg length difference, hypertonia, ataxia, athetosis, impaired passive range of movement, and blindness/vision impairment

Wheelchair softball is played with 10 players on field for one team not exceeding 24 classification points. The field is on hard surfaces, which include cement/blacktop fields

Players must tag the bases with their wheels. No running, hopping, or using the lower limbs to reach the bases is allowed

Tetraplegia, muscular dystrophy, multiple sclerosis, post-polio, amputation/limb loss, leg length discrepancy spinal cord injury, spina bifida, post-polio syndrome, cerebral palsy, brain injury, stroke, and other orthopedic and locomotor disabilities with permanent joint disorders

Classification: players must use wheelchair basketball or wheelchair rugby classification. One of 10 players must be tetraplegic

Participants play in manual sports chairs

Like standard surfing, adaptive surfing involves the surfer paddling away from shore and riding a wave toward the shore

Adaptive surfing can occur wherever there are suitable waves, this is mainly in the ocean; however, this can occur in lakes, rivers, and through artificial wave pools. Surfing requires the use of a surfboard

Amputations (upper and lower), visual impairments, and spinal cord injury

Adaptive surfing can occur in multiple positions, including upright and prone. There is also an option for assisted adaptive surfing

Adaptive swimming can utilize specialized devices and offers many benefits, including strengthening the cardiovascular system and major muscle groups of both the upper and lower body

Impaired muscle power, limb deficiency, leg length difference, short stature, hypertonia, ataxia, athetosis, impaired passive range of motion, vision impairments, and cognitive impairment

Classification: Competitive swimming has divisions based on diagnosis/impairments to create fair competition

Para table tennis can be played as singles or doubles

Table tennis can be played recreationally or competitively

Rules are the same as standard table tennis except in the severely limited division, where accommodations are made if the ball goes off-table or if the ball does not go over the net

Impaired muscle power, athetosis, impaired passive range of movement, limb deficiency, ataxia, leg length difference, short stature, and intellectual impairment

Classification for sport: 11 different classifications over 3 divisions: wheelchair level, standing, and intellectual impairment

Can compete in sitting or standing

Para shooting includes air rifles and air pistols. Participants shoot from distances of 10, 25, and 50 m.

There is a wide range of shooting equipment to improve a shooter’s stability and accuracy while reducing fatigue

Impaired muscle power, limb deficiency, hypertonia, ataxia, athetosis, and impaired passive range of movement

Can occur in wheelchair or standing

Wheelchair tennis is played on a standard tennis court and follows many of the same rules as standard tennis

In wheelchair tennis, a player is allowed to let the ball bounce twice, not once, before hitting a return shot

The athlete’s wheelchair is considered a part of the body, so rules applying to the player’s body apply to the chair

Participants can fit into 2 levels of play

Open: have permanent physical disability that results in a substantial loss of function in one or both upper extremities. Diagnosis: paraplegia or leg amputations

Quad: Impairment in arms as well as legs, which limits the ability to hold a racquet or move in a wheelchair

Diagnosis: tetraplegia, athetosis, impaired passive, hypertonia, limb deficiency, ataxia, and leg length discrepancy

Wheelchair tennis is played in a manual sports wheelchair

Adaptive track and field sports have multiple areas for participation:

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  Throwing disciplines in field competition: javelin, shot put, and discus. Each of these events aims to throw, hurl, or put an object over a distance as far as possible. All 3 sports can be done from an ambulatory or seated position

  
  
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  Races take place on the track

  
  
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  Throwing and jumping competitions take place on the field inside the track

Dwarfism, amputation/limb loss, blindness/visual impairment, spinal cord injury, cerebral palsy, brain injury, and stroke

Athletes can have physical disabilities and visual impairments that affect their ability to learn the running, pushing, and throwing techniques

Athletes can participate in stand-up events and racing chairs or field chairs

Para triathlons consist of 750 m swimming, 20 km cycling, and 5 km running

Spinal cord injury, amputees, cerebral palsy, low vision, multiple sclerosis, and neuromuscular disorder

Classification: 9 divisions with eligible impairment types including impaired muscle power, athetosis, impaired passive range of movement, hypertonia, limb deficiency, ataxia, and vision impairments

Handcycles or tandem bikes are allowed for cycling and wheelchairs for running

Adaptive water skiing is a subgenre of water skiing in which the equipment is modified—water ski known as a sit ski, special rope, or special handle, are incorporated to allow a person to enjoy the sport regardless of their level of mobility

The sport allows a skier to participate in a range of water sports, from skimming the surface in an inner tube to competitive skiing, including slalom, tricks, and jumping

Spinal cord injuries, amputee/limb loss, stroke, blind/low vision, muscular dystrophy, multiple sclerosis, and cerebral palsy

Sport is open, widely available for almost anyone regardless of mental or physical condition

Exclusionary diagnoses: brittle bones syndromes, uncontrolled seizures, hemophilia, and open tracheotomy

Adaptive yoga’s goal is to allow for increased flexibility, strength, focus, and clarity

Can include individuals with physical and/or cognitive impairment

Can use power or manual wheelchair