ENDURANCE REDEFINED: ADAPTIVE SPORTS FOR VETERANS WITH DISABILITIES

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VA EASTERN COLORADO

HEALTH CARE SYSTEM

ADAPTIVE CYCLING PROGRAM

04/25/13Crystal Black, MS, CTRS

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WHAT IT ISRecreational Therapy Referral (Consult)– Initial Assessment– Treatment Plan– Primary Care Clearance– Program Enrollment

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WHAT IT ISProgram Design– Mission: Adaptive cycling program allows

individuals interested in beginning or resuming cycling after an injury or disability to develop and/or practice the necessary physical, psychosocial and cognitive skills in a safe environment.

– Vision: Adaptive cycling program is directed toward achieving and maintaining optimal levels of independence, productivity, and well being, as well as enter/re-enter the mainstream of community life.

ENDURANCE REDEFINED

4

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WHAT IT ISProgram Design Continued– Inclusion: physical, social, emotional

and/or cognitive barriers that prevent independent participation in community cycling. Must have PCP clearance.

– Exclusion: weight bearing, range of motion, physical activity and/or behavioral limitations that may exclude him/her from participating in the activity safely.

ENDURANCE REDEFINED

5

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WHAT IT IS

Program Design (Continued)

Interdisciplinary Approach– VA PM&RS staff• RT, PT, OT, SW, BRS, ATP,

Psychology, MD– Paralympic Sport Club staff

ENDURANCE REDEFINED

6

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WHAT IT IS12-week Duration– Goal Setting– Cycle Safety Assessment– Trail/Road Rating– Nutrition/Hydration– Equipment– Trail, Road & Race Skills– Progressive Independence– Community Discharge

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7

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WHAT IT ISReassessments–Weekly– Quantitative – Qualitative

Program Evaluation

Risk Management

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8

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WHAT IT IS

– Graduation Ride – Veterans, family, Paralympic Sport

Clubs, VA staff, community members and organizations

– Community Transition– Independence– Celebration

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9

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HOW WE GOT HERE

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10

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STEP 1ECHCS Leadership Buy In:• RT Supervisor• PM&RS Department Supervisors• Service Chief• Chief of Staff• Director

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11

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STEP 2US Paralympic Outreach:• Susan Rossi, MNpS, CTRS• Paralympic Sport Club Contacts

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12

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STEP 3Develop Partnerships: • Adaptive Adventures

– Handcycles, recumbent trikes, bicycles– Safety Equipment (flags, helmets)– Expertise

• Boulder EXPAND– Handcycles – Expertise– Graduation Items

• USA Handcycling– Jerseys

ENDURANCE REDEFINED

13

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STEP 3 CONTINUED• Primal– Water bottles– Discounted jerseys

• Paralyzed Veterans of America– Stationary trainers– Water Bottles– Training Opportunities

• Performance Bicycle Shop– Maintenance Gift Certificates

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14

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STEP 4Design Program Outline• Weekly Schedule• Goals & Objectives• Graduated Skill Development• Progressive Independence

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15

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STEP 5Enroll Veterans• Maximum 6• Varied diagnosis• Varied ability levels• Equipment needs• Ratios

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STEP 6Begin Clinic: Week 1 • Nutrition education• Hydration education• Equipment education• Goal setting

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STEP 7Begin Safety Assessment: Weeks 2-4 & 8-9* (Adapted from Andy Duprey, RT - VAPAHCS)

• Everyone must successfully complete to progress• Includes:

– Pre-trip inspection– Safety in a flat un-crowded area– On trail/road maintenance– Safety on the trail– Safety on the street– Emergency response*– Pre-arrangements*

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ENDURANCE REDEFINED

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STEP 8Progressive Independence• Leisure Ability Model• 4 weeks at Jewell Outpatient Clinic • 7 weeks on community trails– Destination based on Trail/Road Ratings– 2 weeks planned by Veterans

• 1 week independently in the community

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STEP 9

Promotion, Marketing & Advancement • Public Affairs Officer• Medical Media• “Ride for Freedom”• US Paralympics• Research

ENDURANCE REDEFINED

22

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STEP 10Discharge• Community Referrals & Resources• Referrals to Paralympic Sport Clubs• ECHCS Sports & Recreation Equipment

Committee• Independent Rides• Peer Networking• Alumni Rides• Peer Support/Mentor

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IN THE WORKS

• Research with Indiana University Investigate Outcomes for this

model

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QUESTIONS

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