Currently, one in ten people in the Netherlands have a movement-related disability, with 21% of them participating in sports. Despite this, little is known about how to prevent injuries and illnesses among this group. This needs to improve, in order to lower the barrier to sports participation, according to Sietske Luijten, who is completing her PhD with the Tailored Injury Prevention in Adapted Sports (TIPAS) project at Amsterdam UMC.
Friction from prosthesis
In the online tool developed for her PhD research, athletes with physical disabilities fill out a short weekly questionnaire about their status. “For example, are you training less than usual? That could indicate an injury or illness,” explains Sietske. “If something is wrong, additional questions clarify the situation, and the person receives tailored advice. Athletes with a prosthesis may encounter issues at the stump, often due to friction. They then receive advice on how to keep their skin clean.”
The online tool is as comprehensive as possible, covering all complaints. The advice considers the type of sport (sitting or non-sitting) and all types of physical disabilities, divided into five categories: spinal conditions (such as spinal cord injury), limb abnormalities, brain disorders, neuromuscular disorders and restrictions in movement. The tool is designed for all sports levels, from recreational to high performance.
Though the advice is always tailored, one topic is universal: the balance between strain and capacity. “For someone in a wheelchair, the strain on the shoulders is different from others,” Sietske explains. “The tool provides advice on how to distribute the strain throughout the week. Do you have complaints? Then it might be better to avoid both heavy grocery shopping and sports on the same day, for example.”
Three years of preparation
It took a lot of work to make the tool as comprehensive as possible, Sietske says. “We spent three years on preparation.” During those three years, she read up on the literature and made an inventory of the problems faced by athletes with physical disabilities in the Netherlands. She discussed injuries and limitations with athletes and medical experts, and finally tested the tool over the course of a sports season.
Difference of opinion between doctors and athletes
Interestingly, doctors and athletes view injuries differently. “Medical experts see an injury as physical damage, whereas athletes think more in terms of consequences: if I’m injured, I can’t do my regular activities.” This insight helped translate the tool for athletes – the end users.
Fewer severe illnesses when you’re more aware
The tool proved effective: athletes using it had fewer injuries. They also experienced fewer severe illnesses, and less often. “Being aware of your physical condition helps with other complaints too,” Sietske suspects. “It keeps you healthier overall. For instance, people with spinal cord injuries are slightly more prone to bladder infections. And if you’re tired and act on it in time, you catch issues earlier.” This is also useful advice for the 4,400 athletes participating in the 2024 Paralympic Games in Paris from 28 August to 8 September.
“Athletes with physical disabilities helped me rethink”
Sietske (1996) has been competing in gymnastics at national level for 20 years. “I’ve had injuries all my life: a severe neck injury and multiple ankle injuries. Helping someone else with this is my drive behind injury prevention.”
The athletes she interviewed not only helped her develop the tool, but also her attitude to sports. “Their perspective on living with a physical disability helps me view my own situation positively.”
The TIPAS project's tool will soon be available on the Uniek Sporten (Disabled Sports Fund) platform. Sietske will defend her dissertation at the end of 2024 or the beginning of 2025.
