Since the London 2012 Paralympics captured the imagination and hearts of the world, there seems to have been a push to engage more disabled people in sport with the English Federation of Disability Sport (EFDS) in 2012 announcing a 5 year strategy to enhance health and wellbeing for all disabled people and around the same time the government announced that there would be a £10million boost of disabled sport projects. Sport England suggest there has been an increase in the amount of disabled people engaging in sport over the past decade, however the amount of people over the age of 16 with a life long illness, disability or infirmity who are engaging in a sports activity stands at just 17.2%. Similarly the EFDS also report that only 1 in 5 disabled people are engaging, with 7 out of 10 wanting to increase their amount of physical activity. This suggests that there are still barriers prevalent which prevents people with disabilities from engaging with sport.
There is one disability group which seems to be rising in prevalence; Acquired Brain Injury (ABI), from leading charity Headway. Headway have stated that in 2013-2014 there were 348,934 UK admissions to hospital with an ABI (Headway, 2014). There are many people who have sustained an ABI who may experience difficulties in returning to work and therefore seek to develop a weekly structure consisting of voluntary work and leisure activities, the problem is that the same barriers which prevent the individual from returning to work are still present when engaging in seemingly less pressured and less formal activities.
As well as physical difficulties these barriers can include:
• Cognitive deficits e.g. impaired problem solving, executive functioning, decision making etc.
• Social and behavioural difficulties such as establishing and maintaining relationships and inappropriate or disinhibited behaviours.
• Psychological barriers, including PTSD, depression and anxiety all of which could inhibit an individual’s motivation and desire to participate in sport.
Occupational therapy is a client-centred profession with the main aim of promoting health and wellbeing. The goal of occupational therapy is work with individuals to help them to engage in the occupations they want to do, either by modifying the environment or the task (WFOT, 2012).
Creek (2003) explores the core skills which are embedded in to occupational therapy practice, which includes:
• Building and maintaining therapeutic relationships to guide clients through the therapy process, by promoting reflection, autonomy and engagement.
• Assessing and observing functional potential and limitations.
• Promoting occupational balance between self-care, productivity and leisure.
• Identifying and solving occupational problems.
• Promoting health, wellbeing and function through the use of therapeutic activity.
• Planning, organising and leading therapeutic groups.
• Adapting environments to increase function and participation.
All things considered it would seem like occupational therapists are best placed professionals to help facilitate disabled people in engaging with sport. Here at Manchester Occupational Therapy Services, this is what we are trying to achieve. We have set up an Occupational Therapy Football Group for individuals with Acquired Brain Injuries (ABI), called ABI-lity OT FC.
The purpose of the group is to provide a meaningful and purposeful service for clients to engage in which has therapeutic value. The group will be led by a qualified FA football coach and a qualified occupational therapist with experience in working with individuals with ABI. The group will also be facilitated by volunteer occupational therapy students. The occupational therapist will be on hand to utilise the core occupational therapy skills to enable engagement, maximise potential and overcome any barriers. The sessions will be goal focused with goals collaboratively generated with the client and any other healthcare professionals who are involved.
Occupational therapy is beginning to become more popular within sports groups, with projects such as Sense Rugby in Australia and Sportsball in America enjoying the benefits of having occupational therapy input. Occupational therapy attempts to balance activities between self-care, productivity and leisure, however leisure often gets forgotten about. Leisure can often be viewed as an alternative to employment, which for many people with an ABI may be the case; however there are arguments to suggest that they can complement each other. The session can be used as a stepping stone or a means to acquiring the skills to prepare for work, for example goals can include; arriving on time for the session, being dressed appropriately, arranging transportation, and to demonstrate the appropriate social skills throughout, all of which are transferrable skills.
There are an array of benefits for individuals attending groups including building confidence, reducing anxiety and depression and developing cognitive, physical and social skills. The group would also create an opportunity for people who have similar experiences and passions to come together to form a support network in a bid to reduce isolation in what could be considered a marginalised group. There are many fantastic brain injury support networks out there but they are not always appropriate for the younger generation; with the main group of brain injured individuals being young males who are not always readily motivated by arts and crafts groups.
Sport is an important medium to help improve health, well-being, quality of life and social inclusion. Other benefits include improve mood, reduce anxiety, improve self-confidence, self-esteem, improved cognitive functioning. With more evidence emerging regarding the positive impacts of exercise following a brain injury, such as improved neuroplasticity and increased blood flow in to the hippocampus, is it time we consider incorporating more sport in to rehabilitation?
Find out more about ABI-lity OT FC and Manchester Occupational Therapy Service at www.manchester-occupational-therapy-services.co.uk, or by calling 0161 749 7727.
Writen by Ryan Price