Independent sailing with high tetraplegia using sip and puff controls: integration into a community sailing center

Background: We are continually rediscovering how adapted recreational activity complements the rehabilitation process, enriches patients’ lives and positively impacts outcome measures. Although sports for people with spinal cord injuries (SCI) has achieved spectacular visibility, participation by high cervical injuries is often restricted due to poor accessibility, safety concerns, lack of adaptability, and high costs of technology. Methods: We endeavor to demonstrate the mechanisms, adaptability, accessibility, and benefits the sport of sailing creates in the rehabilitative process. Our sailor is a 27-year-old man with a history of traumatic SCI resulting in C4 complete tetraplegia. Results: The participant completed an adapted introductory sailing course, and instruction on the sip-and-puff sail and tiller control mechanism. With practice, he navigated an on-water course in moderate winds of 5 to 15 knots. Discussion: Despite trends toward shorter rehabilitation stays, aggressive transdisciplinary collaboration with recreation therapy can provide community and natural environment experiences while inpatient and continuing post discharge. Such peak physical and psychological experiences provide a positive perspective for the future that can be shared on the inpatient unit, with families and support systems like sailing clubs in the community. Conclusion: Rehabilitation theory directs a team process to achieve patient self-awareness and initiate self-actualization in spite of disablement. Utilization of local community sailing centers that have provided accessible assisted options provides person-centered self-realization of goals as assisted by family and natural supports. Such successful patients become native guides for others seeking the same experience.

[1]  A. Cliquet,et al.  Physical activity and improved diastolic function in spinal cord-injured subjects. , 2014, Medicine and science in sports and exercise.

[2]  M. Dijkers Quality of life of individuals with spinal cord injury: a review of conceptualization, measurement, and research findings. , 2005, Journal of rehabilitation research and development.

[3]  M. Post,et al.  Community integration of wheelchair-bound athletes: a comparison before and after onset of disability , 1997, Clinical rehabilitation.

[4]  Norman R. Saunders,et al.  Use of a Virtual Reality Physical Ride-On Sailing Simulator as a Rehabilitation Tool for Recreational Sports and Community Reintegration: A Pilot Study , 2013, American journal of physical medicine & rehabilitation.

[5]  P. Kennedy,et al.  The association of sports and physical recreation with life satisfaction in a community sample of people with spinal cord injuries. , 2005, NeuroRehabilitation.

[6]  M. Carta,et al.  Sailing for Rehabilitation of Patients with Severe Mental Disorders: Results of a Cross Over Randomized Controlled Trial , 2014, Clinical practice and epidemiology in mental health : CP & EMH.

[7]  Samuel T. Moulton,et al.  An Outdoor Adventure Program for Young Adults with Cancer: Positive Effects on Body Image and Psychosocial Functioning , 2014, Journal of psychosocial oncology.

[8]  G. Whiteneck,et al.  Longitudinal outcomes in spinal cord injury: aging, secondary conditions, and well-being. , 1999, Archives of physical medicine and rehabilitation.

[9]  B. Brewer,et al.  Athletic identity, sport participation, and psychological adjustment in people with spinal cord injury. , 2011, Adapted physical activity quarterly : APAQ.

[10]  Paul M. Smith,et al.  The perceived benefits and barriers of sport in spinal cord injured individuals: a qualitative study , 2012, Disability and rehabilitation.

[11]  M. Nash,et al.  Circuit training and protein supplementation in persons with chronic tetraplegia. , 2014, Medicine and science in sports and exercise.

[12]  D. Walker,et al.  Therapeutic recreation camps: an effective intervention for children and young people with chronic illness? , 2009, Archives of Disease in Childhood.

[13]  M. Chung,et al.  The relationship between posttraumatic stress disorder following spinal cord injury and locus of control. , 2006, Journal of affective disorders.

[14]  Outdoor adventure camps for people with mental illness , 2013, Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists.

[15]  B. Kemp,et al.  Depression after spinal cord injury: relation to gender, ethnicity, aging, and socioeconomic indicators. , 2000, Archives of physical medicine and rehabilitation.

[16]  K M Stotts,et al.  Health maintenance: paraplegic athletes and nonathletes. , 1986, Archives of physical medicine and rehabilitation.

[17]  P. Foreman,et al.  Sports participation in individuals with spinal cord injury: demographic and psychological correlates , 1997, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[18]  L. McAllister,et al.  Wilderness adventure therapy and cognitive rehabilitation: Joining forces for youth with TBI , 2009, Brain Injury.

[19]  J. Cauley,et al.  Assessment of physical activity in inactive populations. , 1985, Medicine and science in sports and exercise.

[20]  K. Birkeland,et al.  Improved body composition after 8 wk of electrically stimulated leg cycling in tetraplegic patients. , 1997, The American journal of physiology.

[21]  R S Gibbons,et al.  FES-rowing in tetraplegia: a preliminary report , 2014, Spinal Cord.

[22]  S. Hitzig,et al.  Influence of Sport Participation on Community Integration and Quality of Life: A Comparison Between Sport Participants and Non-Sport Participants With Spinal Cord Injury , 2009, The journal of spinal cord medicine.

[23]  E. Garshick,et al.  Participation in Organized Sports Is Positively Associated with Employment in Adults with Spinal Cord Injury , 2013, American journal of physical medicine & rehabilitation.

[24]  M. Chung,et al.  Locus of control among spinal cord injury patients with different levels of posttraumatic stress disorder , 2007, Psychiatry Research.

[25]  P. Jacobs,et al.  Circuit training provides cardiorespiratory and strength benefits in persons with paraplegia. , 2001, Medicine and science in sports and exercise.

[26]  P. Jacobs Effects of resistance and endurance training in persons with paraplegia. , 2009, Medicine and science in sports and exercise.

[27]  R. Thietje,et al.  Influence of physical exercise on quality of life in individuals with spinal cord injury , 2010, Spinal Cord.

[28]  M. Carta,et al.  Sailing Can Improve Quality of Life of People with Severe Mental Disorders: Results of a Cross Over Randomized Controlled Trial , 2014, Clinical practice and epidemiology in mental health : CP & EMH.

[29]  R. Barros,et al.  Wheelchair Rugby Improves Pulmonary Function in People With Tetraplegia After 1 Year of Training , 2013, Journal of strength and conditioning research.

[30]  D. Dorstyn,et al.  Examining factors that contribute to the process of resilience following spinal cord injury , 2013, Spinal Cord.

[31]  A. Craig,et al.  A longitudinal investigation into anxiety and depression in the first 2 years following a spinal cord injury , 1994, Paraplegia.

[32]  Yvonne Tran,et al.  Relationship between quality of life and self-efficacy in persons with spinal cord injuries. , 2007, Archives of physical medicine and rehabilitation.

[33]  M. Gelkopf,et al.  Nature adventure rehabilitation for combat-related posttraumatic chronic stress disorder: A randomized control trial , 2013, Psychiatry Research.

[34]  M. Weiss,et al.  Sport as part of therapy and rehabilitation of paraplegics , 1973, Paraplegia.

[35]  S. Bergman,et al.  4. Individual experience, personal adaptation, and social perspectives , 1997 .

[36]  Brett Smith,et al.  The barriers, benefits and facilitators of leisure time physical activity among people with spinal cord injury: a meta-synthesis of qualitative findings , 2014, Health psychology review.

[37]  J. Zierath,et al.  Exercise‐induced overexpression of key regulatory proteins involved in glucose uptake and metabolism in tetraplegic persons: molecular mechanism for improved glucose homeostasis , 1998, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[38]  Brandon Irwin,et al.  Resilience in Competitive Athletes With Spinal Cord Injury , 2013, Qualitative health research.