This literature review on Adaptive Sports Training Center started with Internet searches for

credible, peer-reviewed sources. Review of secondary sources led to primary sources. There was

also a review on the topic of the different types of disabilities found in recommended peer-

reviewed articles and books. This established a foundation concerning the history of Paralympics,

adaptive sports, and its effect to disabled people. Further examination into the topic broadened the

research to adaptive sports and recreational activities and the community benefits of differently-

abled athletes. Additionally, Google Scholar and Academia were used to find grounded theory

analysis of theoretical frameworks to be used, as well as case studies and scales that would assist

in developing the methodology for the current research. The international Paralympic guideline

was used to establish the sport categories that are included in adaptive sports. A Google search

was used to assist in finding procedures and policies related to healthcare and rehabilitation

associated with adaptive sports.

History of Adaptive Sports Programs

Adaptive sports began as a means to rehabilitate veterans of World War II, the Korean

War, and the Vietnam War (Disabled Sports USA, 2014). The first sport used in this context was

skiing, with veterans learning how to ski with crutches (O'Leary, 1995). Burke (2010) defined

adaptive sports as a way to promote change in an individual and in the community. ASPs “offer

avenues for the healthy development of both identity and quality of life” (Zabriskie, et al., 2005,

p. 180).

Defining Sports Categories for Adaptive Sports

 Adaptive sports are also divided into different sports activities which are winter and

summer sports respectively. However, in this project the researcher’s focus is the summer sports

due the climate and the sports opportunities in the Philippines.

A. Archery

Para archery was the first sport where wheelchair athletes had organized competition and

was one of the original Paralympic sports at Rome 1960. It is open to athletes with physical

impairments who may shoot with assistive devices allowed under classification rules. The sport

tests accuracy, strength and concentration. It includes specific competition categories for

athletes with certain classifications: W1, compound open and recurve open.

In Para archery, the target size and distance archers stand from the target differs based on

the competition category. In individual events, archers shoot 72 arrows at the 10-circle target,

divided into 12 ends of six arrows each. Each athlete is allowed four minutes per round. The

top-scoring athletes advance to 15-arrow head-to-head matches, which are single-elimination.

Figure 2.1. Para Archery

 An archer using a recurve bow shoots at a target 1.22m in diameter, 70m away from the

shooting line. A compound archer shoots at a target 80cm in diameter and stands 50m away.

B. Boccia

Boccia was practiced for many years as a leisure activity until it was introduced at the New

York 1984 Paralympic Games as a competitive sport. It is one of only two Paralympic sports

that do not have an Olympic counterpart (goalball being the other) and is governed by

the Boccia International Sports Federation (BISFed).

Boccia is a game of strategy and accuracy that was originally designed to be played by

people with cerebral palsy. Now, the sport includes athletes with impairments that affect motor

skills.

Figure 2.2. Boccia

 The sport is played on a flat, smooth surface, where players must throw or roll colored balls

as close as possible to a white target ball, known as the “jack.” The player, pair or team with

the most balls near the jack is the winner.

The individual and pair matches consist of four ends, while team matches have six ends. After

each end, the athlete, pair or team with the ball closest to the jack receive one point, and an

additional point for every ball that is closer to the jack than the opponents. Each athlete, pair

or team “throws” six balls per end.

C. Equestrian

Equestrian became a part of the Paralympic Games for the first time in 1996 in Atlanta. It

is open to athletes with any type of physical or visual impairment. Events are mixed and

grouped according to their functional profiles.

Athletes can compete in dressage events, a championship test of set movements and a freestyle

test to music. There is also a team test that involves three to four members.

Riders are judged on their display of horsemanship skills and are permitted to use devices such

as dressage crops, connecting rein bars, rubber bands and other aids.
 Figure 2.3. Equestrian

Eleven gold medals were up for grabs at Rio 2016 – an overall team medal and 10 from

individual competitions in both the individual and freestyle tests across the five sport classes.

D. Judo

Paralympic judo follows the same rules as Olympic judo, with the difference that judokas

shall start and remain during the combat holding each other’s suits.

Only athletes with visual impairment are eligible to compete, with all the sight classes (B1, B2

and B3) competing together and divided according to the judokas’ weight.

Combats last for five minutes for men and four for women. The aim is to either gain more

points than the rival by skillful attacks or score the “ippon” by throwing the opponent with

their back on the ground, immobilizing them or forcing a submission.

Figure 2.4. Para Judo

Judo made its Paralympic debut at Seoul 1988 and has been contested at every Games

since. Women’s events were added at Athens 2004. The sport is the only martial art on the

programmed. At the Rio 2016 Paralympic Games, there were seven different male weight

divisions and six female weight divisions: -48kg, -52kg, 57kg, -63kg, -70kg and +70kg.

Athletes compete in a series of tournaments along the year, including World Cups and world

and regional Championships.

E. Rowing

Rowing made its Paralympic debut at Beijing 2008. Athletes race over 2,000m on flat

water in boats that vary in length and crew size.

Rio 2016 featured four medal events: LTAMix4+ (LTA mixed coxed four), TAMix2x (TA

mixed double sculls), ASW1x (AS women's single sculls) and ASM1x (AS men's single

sculls).
Para rowing classes were renamed:

 PR1 men's single sculls (PR1M1x)

 PR1 women's single sculls (PR1Wx)

 PR2 mixed double sculls (PR2Mix2x)

 PR3 mixed coxed four (PR3Mix4+)

Figure 2.5 Para Rowing

The 2,000m course is raced head-to-head with the winner progressing to the next round.

Depending on the competition and number of entries, boats ranked second and third in the

initial head-to-head heats may progress to repackages and then finals. The exact format for the

progression of boats from head-to-head heats is decided at each competition based on entries.

The sport is governed by the International Rowing Federation (FISA)

F. Para swimming
 Figure 2.6. Para Swimming

G. Triathlon

Para triathlon was contested at the Paralympic Games for the first time at Rio 2016.

Athletes race in three disciplines: 750m of swimming, followed by 20km of cycling and 5km

of running.

Competition categories are based on specific physical impairments. Athletes may use a

hand cycle, tandem bicycle or bicycle in the cycling portion and wheelchairs are permitted on

the running portion of the course.

 Figure 2.7. Triathlon

The sport is practiced in 37 different countries, and 27 different nations will have held

national championship events by the end of 2011.

H. Wheelchair rugby

Wheelchair rugby was developed in Canada in the 1970’s by athletes with quadriplegia,

and after being presented as a demonstration sport at the Atlanta 1996 Paralympic Games, it

made its debut as a medal sport at the Sydney 2000 Paralympic Games.

Wheelchair rugby is a mixed-team sport for male and female athletes. Originating from

Winnipeg, Canada, the sport was created by athletes with an impairment and combines

elements of rugby, basketball and handball.

 Wheelchair rugby players compete in manual wheelchairs specifically designed for the

sport. Players must meet minimum disability criteria and be classifiable under the sport

classification rules.

Figure 2.8. Wheel Chair Rugby

Wheelchair rugby is now an established Paralympic sport, with 28 countries having

competed in international competitions and listed on the world ranking list, while more than

10 others are developing national programmers.

The International Wheelchair Rugby Federation (IWRF) is the global governing body of the

sport.
 I. Para Athletics

Figure 2.9. Para Athletics

J. Canoe

The two main boats are the kayak and va’as boats. Whilst the kayaks are the main Para

canoe boats and are propelled by a double-blade paddle, the latter are outrigger canoes

propelled by a single-blade paddle. Only kayaks were contested at Rio.

Athletes are put into one of the three categories – KL1, KL2 or KL3, according to the

abilities they have. The larger the number, the less severe an impairment an athlete has.

Athletes will race against each other on kayaks over a 200m course for both men and women

in KL1, KL2 and KL3classes.

Para canoe is a young sport which developed during the start of the century thanks to big

efforts of the sport’s governing body International Canoe Federation (ICF) and the

International Va Federation (IVF), who both pushed for the inclusion of Para canoe within

abled-bodied competitions.
 Figure 2.10. Para Canoe

In 2009, the ICF organized the first Para canoe showcase event, which was a big success.

One year later, Para canoe had its first World Championships and was included into the

Paralympic programmed at the IPC Governing Board meeting in Guangzhou, China.

K. Football 5-a-side

Football 5-a-side, also known as blind football, is an adaptation of football for athletes with

a visual impairment. The sport has been governed by the International Blind Sports

Federation(IBSA) since 1996 and it is played with modified FIFA rules.

It featured at the Paralympics for the first time at Athens 2004, and has been contested at

every Games since. Brazil have won gold at every Paralympics. World Championships take

place every four years in between the Paralympics.

 Figure 2.11. 5A Side Football

Football 5-a-side teams are made up of four outfield players and one goalkeeper.

Outfield players must be classified as completely blind (B1 category), which means they have

very low visual acuity and/or no light perception, whilst the goalkeeper must be sighted or

partially sighted (B2 or B3 category). To ensure fair competition, all outfield players must wear

eyeshades. Teams can also have off-field guides to assist them.

L. Para Dance Sport

 Figure 2.12. Para Dance sport

M. Shooting Para Sport

 Figure 2.13. Para Shooting

N. Table Tennis

Table tennis was included in the first Paralympic Games in Rome in 1960 and is now

estimated to have over 40 million competitive players and millions of recreational players.

Para table tennis is the third largest Paralympic sport in terms of athlete numbers and is

practiced in more than 100 countries. The sport is governed by the International Table Tennis

Federation through the International Para Table Tennis Committee (IPTTF).

Athletes from all physical impairment groups, aside from the visually impaired, are

allowed competing in standing or sitting classes. Intellectually impaired athletes can also

compete.
 Figure 2.14. Para Table tennis

Men and women can participate in individual, doubles or team events, and matches consist

of five sets of 11 points each, and are played in a best-of-five format.

O. Wheelchair basketball

Wheelchair basketball first emerged around 1946 in the USA, developed by injured

servicemen from World War II. Most were former able-bodied players who wanted to continue

playing the game. The simple adaptations and slight rule variations for people in wheelchairs

allowed the sport to spread across the US, and eventually worldwide.

The object of the game is to score the most points in the opposing team’s basket. The team

with the most points by the time the clock expires wins. As the name suggests, wheelchair

basketball is an adaptation of the able-bodied version.

 Figure 2.15. Wheelchair Basketball

P. Wheelchair Tennis

Wheelchair tennis was founded in 1976 due to the efforts by former US freestyle skier Brad

Parks. The sport grew in the 1980s as France became the first country in Europe to put together

a specific wheelchair tennis programmed. The sport made its first appearance at the Barcelona

1992 Paralympics. Today, wheelchair tennis is one of the fastest growing wheelchair sports in

the world and fits seamlessly with the able-bodied game. Opponents hit a tennis ball with a

racket back and forth over a .914-meter (three-foot) net in the middle of the court. The goal is

to hit the ball into the opponent’s half of the court without them being able to return it. There

are no modifications to the size of the court, rackets or tennis balls. The main differences are

the specially designed wheelchairs and the ‘two-bounce rule,’ whereby the ball can bounce

twice.
 Figure 2.16. Wheelchair Tennis

There are three categories athletes compete in: men’s, women’s and quads; each division

has singles and doubles tournaments.

Athletes compete in series of tournaments including Grand Slams: Australian Open, Roland

Garros, Wimbledon and US Open, plus the singles and doubles Masters.

Q. Badminton

Para badminton has been competed internationally since the 1990’s, with the first World

Championships taking place in Amersfoort, the Netherlands, in 1998. But it was not until 2011

that the sport was brought under the governance of the Badminton World Federation.
Figure 2.17. Badminton
There have been 10 World Championships to date, with the last taking place in Stoke

Mandeville, England in 2015, which saw a turnout of 232 athletes from 35 countries competing

in 22 medal events. Athletes compete in six different classes, with 63 countries across five

regions currently practicing Para badminton.

R. Cycling

Para cycling at the Rio 2016 Paralympic Games featured 230 athletes who competed in 18

medal events on the track and 33 medal events on the road. After athletics and swimming, it

was the sport with most medals up for grabs.

The Paralympics competition programmed includes sprints, individual pursuits, the 1,000m

time trial, road races and road time trials for both individuals and teams.

Road Para cycling made its Paralympic debut at New York/Stoke Mandeville 1984 and has

been contested at every Games since. Track Para cycling entered the Paralympic programmed

12 years after, in Atlanta.

The sport was developed in the 1980s, and was first open to visually impaired athletes who

competed in tandems with a sighted pilot.

Over the following years, Para cycling started to include those with cerebral palsy,

amputations and other physical impairments, who compete on bicycles, tricycles and hand

cycles.

There are five sport classes for hand cycling, two for tricycle and five for bicycle, whilst

the three sport classes for the tandem compete in one event.

Athletes participate in World Cups, World and regional Championships throughout the year.

Figure 2.18. Cycling

S. Goalball

Goalball is played exclusively by athletes who are blind or visually impaired. It was

invented in 1946 to help rehabilitate veterans who had lost their sight during the Second World

War.
 Players must wear opaque eyeshades at all times ensuring fair competition. All

international athletes must be legally blind, meaning they have less than 10 per cent vision,

and are classified as a B3, a B2, or a B1 – totally blind.

Teams are made up of six players, with three members playing at any one time.

Figure 2.19. Goalball

The object of the game is to throw a ball past the opponents and into their net to score

points. Players stay on their hands and knees to defend their net and score against their

opponents.

A goalball court measures 18 meters long and nine meters wide. It has goals at each end

covering the entire nine-meter back-line. String is taped to the markings on the court to allow

players to feel the lines and orientate themselves.

Goalball made its Paralympic debut in Toronto, Canada, in 1976, with the women’s event

being added at the 1984 Paralympic Games in New York, USA.

The first World Championships for goalball were held in Vocklamarck, Austria, in 1978. The

International Blind Sport Federation (IBSA) governs goalball and holds World Championships

every four years, in between the Paralympic Games.

 T. Para Powerlifting

Figure 2.20. Para powerlifting

U. Sitting Volleyball

Sitting volleyball is a team sport featuring constant motion, communication and bursts of

explosiveness. Two teams of six players are separated by a net and try to score points by

grounding the ball onto the other side’s court.

Sitting volleyball has many similarities to its stand-up version, but of course, with a few

modifications.

Whilst teams in the stand-up version are separated by a raised net, sitting volleyball is

played from a lower net. The court dimensions in sitting volleyball are also smaller.
The main difference between the two versions is that sitting volleyball, as its name implies, is

played from seated positions. At all times, the athlete’s pelvis must be in contact with the

ground, and service blocks and attacks are allowed.

Figure 2.21. Sitting Volleyball

It is played in a best-of-five set format, and the first to reach 25 points (with at least a two-

point lead) wins the set. Two medal events (men and women featuring eight teams each, total

of 192 athletes) were contested at the Paralympic Games in Rio de Janeiro. World Para Volley

is the global governing body of sitting volleyball.

V. Taekwondo

Taekwondo was introduced as a full member of the International Paralympic Committee

in 2015 and will make its Paralympic debut at Tokyo 2020.

World Taekwondo (WT), the sport’s governing body, began developing the kyorugi (sparring)

discipline for Para athletes in 2005. Since 2013, poomsae (martial art forms) is being developed

as a competition format for athletes of all impairments.

 Figure 2.22. Taekwondo

In the Paralympics, athletes will compete in kyorugi (limb impairments and athletes with

an arm amputation). In 2009, the first WTF Para Taekwondo World Championships were held

in Baku, Azerbaijan. The fifth edition of the World Championships held in 2014 in Moscow,

Russia, featured 120 athletes from 37 countries – its biggest championships. As of June 2015,

97 athletes from 23 countries and three regions have taken part in three world ranking

competitions, with expectations for the number of participants to rise with the four world

ranking tournaments remaining in 2015.

W. Wheelchair Fencing

Wheelchair fencing was developed by Sir Ludwig Guttmann at the Stoke Mandeville

Hospital and was introduced to the world at the Rome 1960 Paralympic Games. Men and

women with amputations, spinal-cord injuries and cerebral palsy are eligible to compete in foil

epee (men and women) and saber (men) events. Their wheelchairs are fastened to the floor

during competition.
 Figure 2.23. Wheelchair Fencing

X. Rowing

Rowing was added to the program in 2008. The 2012 Paralympic Games program included

20 sports and 21 disciplines. Canoe and triathlon made their debuts at Rio 2016. Badminton

and taekwondo are set to make their Paralympic debuts at the 2020 Games.
 Figure 2.24. Rowing

Goalball, Sitting Volleyball, and Wheelchair Basketball have men's and women's events.

Wheelchair Rugby is a mixed event, while the football event is only open to male competitors.

Definition of Disability

There are various words that are always incorporated to the concept of Disability. Words

like Impairment and Handicap are usually used interchangeably with disability. In order to

understand fully the concept of disability, defining impairment and handicap would be essential.

According to the Council on Tall Buildings and Urban habitat, Impairment refers to the loss of

abnormality of the structure or function of the body. Handicap refers to the impact of impairment

and/ or disability on the individual and on the wider community involved. When such impact

implies problems in relationships, limitations on life opportunities, with consequent disruption of

social integration into ordinary community life, then an impaired or disabled person is a

handicapped one. Disability refers to the limitations or lack of ability in performing activities that

are considered normal for a particular individual. It is normally a consequence of impairment.

(Council on Tall Buildings and Urban habitat, 1992)

The World Health Organization states that disability resulting from impairment is a

restriction or lack of ability to perform an activity in the manner or within the range considered

normal for a human being.” (World Health Organization, 2001) Disabilities can be permanent,

temporary, or episodic. They can affect people from birth, or be acquired later in life through injury

or illness.

Categories of Disability

According to the UN Convention on the Rights of Persons with Disabilities, “persons with

disabilities include those who have long-term physical, mental, intellectual or sensory impairments

which, in interaction with various barriers, may hinder their full and effective participation in

society on an equal basis with others.” (UN Convention on the Rights of Persons with Disabilities,

2006) The condition of the persons with disabilities is very broad and varying thus classifying

them according to the medical or functional basis can help in identifying their specific needs and

responding to these needs. Thus, the World Health Organization International Classification of

Functioning, Disability and Health formulated these categories of disability:

A. Impaired muscle power

 Impairments in this category have in common that there is reduced force

generated by the contraction of a muscle or muscle groups (e.g. muscles of one

limb, one side of the body, the lower half of the body). Examples of conditions

included in this category are para and quadriplegia, muscular dystrophy, post

poliomyelitis, spinal bifida.

B. Impaired passive range of movement

Range of movement in one or more joint is reduced in systematical way.

Note that hypermobility of joints, joint instability (e.g. shoulder dislocation), and

acute conditions of reduced range of movement (e.g. arthritis types of impairment)

typically will be excluded as ‘eligible impairment’.

C. Limb deficiency

There is a total or partial absence of the bones or joints as a consequence of

trauma (e.g. traumatic amputation), illness (e.g. bone cancer) or congenital limb

deficiency (e.g. dysmelia)

D. Hypertonia

A condition marked by an abnormal increase in muscle tension and a reduced

ability of a muscle to stretch. Hypertonia may result from injury, disease, or

conditions that involve damage to the central nervous system. When the injury

occurs in children under the age of 2, the term cerebral palsy is often used, but it

also can be due to brain injury (e.g. stroke, trauma) or multiple sclerosis.
E. Ataxia

Ataxia is a neurological sign and symptom that consists of a lack of co-

ordination of muscle movements. When the injury occurs in children under the age

of 2, the term cerebral palsy is often used, but it also can be due to brain injury (e.g.

stroke, trauma) or multiple sclerosis.

F. Athetosis

Athetosis can vary from mild to severe motor dysfunction. It is generally

characterized by unbalanced, involuntary movements of muscle tone and a

difficulty maintaining a symmetrical posture. When the injury occurs in children

under the age of 2, the term cerebral palsy is often used, but it also can be due to

brain injury.

G. Vision impairment

Vision is impacted by either an impairment of the eye structure, optical nerves

or optical pathways, or visual cortex of the central brain. Classification of visual

impairment are Partial Blind, Legal blindness, Travel vision, Motion perception,

Light perception, Total blindness.

H. Intellectual impairment

The Paralympic Movement identifies intellectual impairment as “a disability

characterized by significant limitation both in intellectual functioning and in

 adaptive behavior as expressed in conceptual, social and practical adaptive skills.

This disability originates before the age of 18” [American Association on

Intellectual and Development Disability, 2010]. The diagnostics of intellectual

functioning and adaptive behavior must be made using internationally recognized

and professionally administered measures as recognized by INAS (International

Federation for sport for para-athletes with an intellectual disability).

Effects of Adaptive Sports for the Differently-abled People

A. Therapeutic Effect

For the disabled, sports represent the most natural form of remedial exercise and can be

successfully employed to complement the conventional methods of physical therapy. It is

invaluable in restoring the disabled person’s physical fitness but the physically handicapped person

learns to overcome fatigue, a predominant symptom in the early stages of physical rehabilitation.

(Guttmann, L., 1976) Adaptive sports can increase cardiovascular fitness, muscular strength and

endurance to the person. It can also give additional benefits in perceptual motor development and

function plus a basic for life-long healthful activity

B. Psychological Effect

Sports for the disabled have a deeper meaning that being merely a form of physiotherapy.

The great advantage of sport over formal remedial exercise lies in its recreational value, which

represents an additional motivation for the disabled by restoring that passion for playful activity
and the desire to experience joy and pleasure in life. Recreation becomes an important factor in

promoting that psychological equilibrium which enables the disabled to come to terms with his

physical defect. The aims of the sport are to develop in the disabled activity of mind, self-

confidence, self-dignity, self-discipline, competitiveness and comradeship, mental attributes

which are essential for getting the disabled person out of the ghetto of self-centered isolation.

(Guttmann, L., 1976). Adaptive sports can be an instrument for positive emotional outlets,

improved self-image and opportunities for success.

C. Social Effect

The noblest aim of the sport for the disabled person is to help to restore his contact with

the world around him and to facilitate or accelerate his social integration. There are certain sports

and games where the disabled are capable of competing with the able-bodied which create a better

understanding between the disabled and the able-bodied and help the disabled in their social

integration through the medium of sport. (Guttmann, L., 1976). Sports can develop positive

emotional interaction and learning skills.

The Nine Mental Skills of an Athlete

What an athlete has in common is that their sport is important to them and they’re

committed to being the best that they can be when it comes in the world of sports competition and

scope of their limitation.

They set high, realistic goals for themselves to train and play hard. Their participation enriches

their lives and they believe that what they get back is worth what they put into their sport.

There are nine, specific mental skills that contribute to their success in sports. They are all

learned and can be improved with instruction and practice. Although each of the nine skills is

important, its primary importance will occur during one of three phases; long term development,

immediate preparation for performance and during performance itself.

Each of the following nine skills is related to each other, each of the higher levels

incorporates and is based upon the skills of the preceding levels.

Figure 2.25. Skills Relationship Pyramid

The nine mental skills associated with athletic success are the same mental skills associated

with performance in a wide variety of non- sport, performance situations.

Mental Toughness
 There are findings revealed that Paralympic athletes’ perceptions of MT can be seen as a

combination of characteristics (determination, defiance, pragmatic, optimistic, resilient, self-belief

and independence and autonomy), cognitions (normalization, sense of escape, non-acceptance of

constraints, influence perception and connection) and cognitive strategies (rational thinking, goal

setting, pain management and control).

Mental conditioning is a process of training your mind to modify your thoughts, attitudes,

and beliefs to accept thinking patterns, tendencies and/or mental states in order to optimize positive

thinking and ultimately optimize your performance. Mental conditioning focuses on increasing

self-awareness of your mental and physical states to allow you to best control and regulate your

body and mind. Mental conditioning helps you create a clear vision of what you want, know why

you want it, and develop mental fortitude to achieve it.

Much like physical conditioning, mental conditioning can be increased through education

and training. It involves learning a set of techniques designed to affect your thoughts, attitudes,

and beliefs in order to maximize your performance. Learning these techniques can help you

prepare and perform at your highest level on a consistent basis. Through this process you are able

to learn to condition and control your mind so you are able to perform at your best no matter the

circumstances. You learn how to maintain concentration, confidence, and motivation while in

challenging and stressful situations. Mental conditioning not only helps you deal with potential

obstacles in life, but is essential to reach your full potential.