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It’s not the disability that defines you, it’s how you deal with the challenges the disability presents you with. We have an obligation to the abilities we do have, not the disability.

Jim Abbott, former one-handed baseball pitcher,


Participation in sports by people with disabilities increased significantly over the latter half of the last century. In 1948, 16 competitors took part in the first Stoke Mandeville Games, a sporting competition for people with disabilities. Today, almost 4000 athletes from more than 146 countries compete in the summer Paralympic Games.


In this chapter we:


  • provide a brief history of how people with disabilities have gained opportunities to be physically active

  • discuss the challenges that people with disability face to achieve the benefits of physical activity

  • discuss common clinical concerns of the person with various major physical disabilities (e.g. spinal cord injury, limb deficiency, cerebral palsy, visual impairment, Les Autres)

  • introduce recent events to promote sport among people with intellectual disability

  • outline the classification system that categorizes persons with disabilities to permit fair competition

  • provide practical tips relating to

    • winter sports for disabled persons

    • anti-doping

    • travel with teams.


Historical perspective


At the start of the 20th century, sports participation among people with disabilities was very limited. A most significant figure in the history of disability sport was Sir Ludwig Guttman, who ran the Spinal Injuries Unit at Stoke Mandeville Hospital in England. He introduced sporting activity as part of the rehabilitation process for those with spinal cord injury. On the opening day of the 1948 Olympic Games in London, he arranged an archery contest on the lawns of the hospital between two spinal injury units. Thus began the Stoke Mandeville Games; four years later, the games became the International Stoke Mandeville Games with the inclusion of a team of spinally injured patients from Holland.


Guttman believed that “by restoring activity in mind and body—by instilling self-respect, self-discipline, a competitive spirit and comradeship—sport develops mental attitudes that are essential for social reintegration.” The inclusion of other sports such as athletics, swimming, table tennis, and basketball increased the diversity of opportunities for people with disabilities. Participation improved slowly, and in 1960 the International Stoke Mandeville Games were held in Rome after the Olympic Games, with a plan to hold these quadrennial games in the Olympic Games host city where possible. In 1976 people with vision impairment and limb deficiencies were included and those with cerebral palsy joined in 1980.


Initially the term “Olympics for the Disabled” was used, but this was not acceptable to the International Olympic Committee (IOC), and in 1985 the term “Paralympic” was devised to describe a games “parallel to the Olympics” (not “paraplegic,” a common misconception). In 1989, the International Paralympic Committee (IPC) was formed, and since then the games have truly been the Paralympic Games; cities bid to ...

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