Winter Sports Clinic Experience Maura Nee NP Beth Tammaro RN, CRRN VA Boston Healthcare System Spina

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Winter Sports Clinic ExperienceMaura Nee
NPBeth Tammaro RN, CRRNVA Boston Healthcare
SystemSpinal Cord Injury Service
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HISTORY OF ADAPTIVE SKIING

• 1942, adaptive skiing first identified after WW2
  by German and Austrian veterans
• Amputees attached axillary crutches to skis,
  first mention of three track skiing
• 1947, first handicapped ski school in Austria,
  specifically for amputees
• Gretchen Fraser, a skier and rehabilitation
  volunteer at army hospitals during WW2, first
  American involved in adaptive skiing

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HISTORY OF ADAPTIVE SKIING

• 1953, Jim Winthrus, a WW2 veteran advanced
  adaptive skiing in northern CA
• Mid 1950s, first adaptive ski school in the US
  was established
• 1960s, Viet Nam Veterans founded National Amputee
  Ski Association
• 1972, became National Inconvenienced Sportsmens
  Association which became National Handicapped
  Sports and then Disabled Sports USA

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HISTORY OF ADAPTIVE SKIING

• Adaptive sports including skiing remained
  primarily recreational throughout the 1960s and
  70s with goals of improving strength,
  flexibility, balance, endurance and general well
  being
• First competitive adaptive winter sports event in
  US was in Winter Park, Colorado, 1972
• First US team competed in Paralympics in Norway
  in1980
• Sit down skiing first identified in 1970 in
  Europe

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CLOTHING

• Clothing for skiing should keep skier warm and
  dry.
• Ideally, skier wears three layers
• Innermost layer keeps skier dry. Avoid cotton,
  use polypropylene which wicks perspiration
• Second layer should insulate or keep skier warm.
  use wool, deep pyle or synthetics
• Third, outermost layer should protect from wind
  and snow, should also be vented to allow for heat
  and moisture release if needed
• Hat, goggles and sunscreen should also be used at
  all times

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UPRIGHT ADAPTIVE SKIING

• Stand up adaptive skiing categorized as 2, 3 or 4
  track skiing (based on how many tracks the skier
  leaves in the snow)
• Other Equipment includes
• Outriggers
• Prosthetic adaptations

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Outriggers

• Used to steer while skiing
• Stand up or sit down lengths

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Sit Ski

• Contained steel edges which allowed skiers to
  move by shifting their center of gravity
• Disadvantages
• Poles were either picks or Kayak poles
• Loading unloading were completely dependant
• Ski did not provide trunk stability

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BI-SKI

• Utilizes shock absorption and custom shaped skis
  to accommodate skiers with significant mobility
  impairments (usually T4 and above)
• High backs and several significant strap systems
  provide stability while maximizing mobility
• Can be utilized with or without hand held
  outriggers, fixed outriggers or handle bars to
  accommodate skiers disability and facilitate
  turns when skier cannot
• Seat and foot plates made of fiberglass shell
  which can be padded to relieve or support body
  weight as needed

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BI-SKI COMPONENTS

• Seat/bucket
• Footrest
• Ski angulation system
• Handle bar
• Fixed outriggers
• Hand held outriggers
• Shocks/suspension
• Straps
• Assistance bar

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BI-SKI
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DUAL SKI

• Requires good balance and strength
• Dual articulating skis (standard skis, step in
  type binding)
• Hand held out riggers
• No fixed outriggers available, can be fitted with
  a teaching handle
• Articulating seat hinged so skier can adjust
  forward lean
• This ski is very high to mimic standing

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MONO SKI

• Seat (snug fitting bucket or shell) mounted on a
  single ski via a shock absorbing suspension
  system
• Advanced binding systems
• Requires good balance and upper body strength
• Mono skis allow for maximum independence
  including self loading
• Skier must use handheld outriggers

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MONO SKI
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MONO SKI

• Improvements include
• Bringing skiers weight over center of the ski
• Inclusion of shock suspension
• Binding systems which now mimic a ski boot in
  order to take advantage of the new ski
  technologies
• More anatomical position of hips and knees over
  feet

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MONO SKI

• Basic design hasnt changed since original in
  early 1990s, however, improvements made in
  several areas
• Durability
• Weight
• Frame construction
• Seat ergonomics
• Instructor assistance
• Evacuation system

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Mono Ski
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National WSC Participants2005

• Number registered 322
• Number of women 37
• Veterans involved in combat 134
• 82 of these were injured in combat
• Vietnam 51
• Korea 6
• WW II 4
• Gulf War 27
• Bosnia 1
• Grenada and Panama 24

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National WSC Participants2005

• Participant Disabilities
• Paraplegia 84
• Quadriplegia 49
• Amputees 77
• Visually Impaired 54
• Brain Injured 28
• MS 22
• Other neurologic impairment 13
• Branches of Service
• Army 166
• Navy 58
• Air Force 45
• Marine 56
• Coast Guard 2
• National Guard 2

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Participant Quotes National WSC

• The WSC has permitted me to accomplish things I
  never thought I could. Disability is not the end
  of ones life, it is simply a new way to live.
• If I can ski down a mountain, I can face many
  more challenges.
• Skiing is not only proven to be very physically
  therapeutic, but it was also emotionally
  therapeutic for me.
• With a wheelchair, youre always thinking about
  your constraints, when youre skiing, all those
  issues disappear.
• Skiing promotes exercise, freedom, self esteem
  and a can do attitude.
• The clinic helps people with disabilities find
  their abilities

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Ski Docks
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BI-SKI OFF LOAD
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Chairlift
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HAVE FUN!!!
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THANKS!!!

• Original Presentation Randi Woodrow, PT VA
  Greater Los Angeles
• Healthcare System
• National Disabled Veterans Winter Sports Clinic
  Staff
• Sandy Trombetta, Carl Desrosiers, Richard Wright,
  Ralph Marche
• Disabled Sports USA/Hartford Ski Spectacular
  Kirk Bauer
• Rad Ventures (Yetti) Jeff Goodman
• WEBSITES
• http//www.dsusa.org/about.html
• http//miracles.dav.org/
• http//www.wintersportsclinic.org/