ENDURANCE REDEFINED:
ADAPTIVE SPORTS FOR VETERANS WITH DISABILITIES
04/25/13
Crystal Black, MS, CTRS
VA EASTERN
COLORADO
HEALTH CARE
SYSTEM
ADAPTIVE CYCLING PROGRAM
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ENDURANCE REDEFINED
WHAT IT IS
Recreational Therapy Referral (Consult)
– Initial Assessment
– Treatment Plan
– Primary Care Clearance
– Program Enrollment
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3
ENDURANCE REDEFINED
WHAT IT IS
Program 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.
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4
ENDURANCE REDEFINED
WHAT IT IS
Program 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.
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ENDURANCE REDEFINED
WHAT IT IS
Program Design (Continued)
Interdisciplinary Approach
– VA PM&RS staff
• RT, PT, OT, SW, BRS, ATP, Psychology,
MD
– Paralympic Sport Club staff
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ENDURANCE REDEFINED
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WHAT IT IS
12-week Duration
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Goal Setting
Cycle Safety Assessment
Trail/Road Rating
Nutrition/Hydration
Equipment
Trail, Road & Race Skills
Progressive Independence
Community Discharge
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ENDURANCE REDEFINED
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WHAT IT IS
Reassessments
– Weekly
– Quantitative
– Qualitative
Program Evaluation
Risk Management
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8
ENDURANCE REDEFINED
WHAT IT IS
– Graduation Ride
– Veterans, family, Paralympic Sport Clubs,
VA staff, community members and
organizations
– Community Transition
– Independence
– Celebration
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ENDURANCE REDEFINED
HOW WE GOT HERE
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ENDURANCE REDEFINED
STEP 1
ECHCS Leadership Buy In:
• RT Supervisor
• PM&RS Department Supervisors
• Service Chief
• Chief of Staff
• Director
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11
ENDURANCE REDEFINED
STEP 2
US Paralympic Outreach:
• Susan Rossi, MNpS, CTRS
• Paralympic Sport Club Contacts
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ENDURANCE REDEFINED
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STEP 3
Develop Partnerships:
• Adaptive Adventures
– Handcycles, recumbent trikes, bicycles
– Safety Equipment (flags, helmets)
– Expertise
• Boulder EXPAND
– Handcycles
– Expertise
– Graduation Items
• USA Handcycling
– Jerseys
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ENDURANCE REDEFINED
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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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ENDURANCE REDEFINED
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STEP 4
Design Program Outline
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Weekly Schedule
Goals & Objectives
Graduated Skill Development
Progressive Independence
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ENDURANCE REDEFINED
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STEP 5
Enroll Veterans
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Maximum 6
Varied diagnosis
Varied ability levels
Equipment needs
Ratios
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ENDURANCE REDEFINED
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STEP 6
Begin Clinic: Week 1
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Nutrition education
Hydration education
Equipment education
Goal setting
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ENDURANCE REDEFINED
STEP 7
Begin Safety Assessment: Weeks 2-4 & 8-9*
(Adapted from Andy Duprey, RT - VAPAHCS)
• Everyone must successfully complete to progress
• Includes:
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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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ENDURANCE REDEFINED
STEP 8
Progressive 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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ENDURANCE REDEFINED
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ENDURANCE REDEFINED
STEP 9
Promotion, Marketing & Advancement
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Public Affairs Officer
Medical Media
“Ride for Freedom”
US Paralympics
Research
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ENDURANCE REDEFINED
STEP 10
Discharge
• 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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ENDURANCE REDEFINED
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ENDURANCE REDEFINED
IN THE WORKS
• Research with Indiana University
 Investigate Outcomes for this model
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ENDURANCE REDEFINED
QUESTIONS
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