TRANSCRIPT
The word 'can't' or giving up is not in Gabby Vassallo's [[Vah-sah-loh]] vocabulary.
"There is not much that I can't do. I just may need some assistance whether it is a modification or something. So the c-word - the 'can't do it' - is not a word I really like to use because it is limiting. Whereas I don't mind saying my limitations because it may mean I can't do something as well as I used to. I may need to do it slightly different. But to me, the end goal should be the same."
Fifteen years ago, she was hit by a car while riding a bike during her training for a triathlon.
It resulted in a traumatic brain injury and a spinal injury that took her months and years to recover from.
During the acute stage of recovery, she knew movement would be a big part of her healing and ultimately her independence.
She found a supporter in her rehab physiotherapist Leanne Hassett - and it was the confidence boost she needed.
"You know with someone like Leanne who recognised early days, I wanted to get back into (sports) and how important that physical activity was for me - not just for the physical benefits. But also for the mental health. It allowed me to go on to feel that anything was possible. If I could achieve those little physical goals, why can't I take the next step to the next level - maybe not running, but doing more physical activity - or going into getting a job. Do you know what I mean? It gives you the confidence to do achieve in other parts of your life."
Finding the modifications that would enable her to continue to play sports was challenging at the time, but using her networks she found solutions.
Using a modified bike, Gabby went on to achieve her goal to complete a triathlon in France.
"Most of my activity is modified. So I ride a modified bike. If I play sports, it is using modified equipment. Wheelchair basketball or something like that. So I have done a triathlon since my accident. I have done a couple actually. But I have also gone back and ironically riden in the Pyrenees. I have gone and done that again on a modified bike."
These days, she moves about an hour a day - whether it is getting from place to place with her modified bike or attending a Pilates class. When time permits, she will sign up for the wheelchair basketball team.
She knows her quality of life would be vastly different without the regular physical activity.
"I really think I would be probably, I would say morbidly obese. Doped up to the eyeballs on medication, drugs because I would probably be in a lot of pain. For me in a way, I have said to people since the pandemic, actually it is frustrating but you have got an idea what it is like for people who have a disability - that is their life potentially all the time, not when we've got a pandemic. So anyone who hasn't done exercise for a while - or at all - doesn't realise the benefit. I jokingly call the endorphins, the dolphins. Chasing that great feeling that you can get when you're active."
Those benefits have been documented in the first systematic review and meta-analysis of the impacts of regular physical activity on people with physical or intellectual disabilities.
Associate Professor Leanne Hassett - at the University of Sydney's School of Health Sciences - says substantial barriers exist: adults with disabilities are at least twice as likely to be physically inactive as the general adult population.
That got Hassett thinking - what is the evidence base on the topic and can it be synthesised to help find solutions?
"Our idea was to look more broadly. Regardless of what health condition you have, to look at the benefits for sport and physical recreation for people living with any type of physical disability or intellectual disability. And we're interested in that because really if we want to think about sort of scale-up and for there being lots of opportunities in the community, we probably need to think more broadly about people living with disability - as opposed to having specific activity for people with particular health conditions as such. So yes, it is a first (systematic review)."
The review examined 74 randomised control trials, involving 2,954 individuals. The most common recreational activities evaluated included yoga, dance and Tai Chi - conducted on average twice a week - for between six and 52 weeks.
The gender split was roughly equal (54 per cent women) and the average age was 55. Most participants had a physical disability versus an intellectual disability.
Those with a physical disability had impairments that could be modified for participation in parasports. Those with a intellectual disability had impairments eligible for Special Olympics.
Hassett says using the Cochrane gold standard approach for systematic reviews and meta-analysis, common conclusions can be drawn.
"We were able to look across a range of different outcomes. So you know people's mobility levels, their ratings of quality of life, fatigue, depression, anxiety. So we're able to look across a range of those. And we really found benefits across all those different outcomes when people participated in recreation activities. We were able to show that overall; and then we were able to break it down to look at the different health conditions. And also to look at the different types of recreation activities to give it a little bit more indication where the evidence is strongest."
She says there are scaleable strategies that could be implemented to boost the lower physical activity rates among the disability population - and it will require multiple professions and sections of the community to work together - as well as funding support in the NDIS system.
"I think if we want it to be scaleable then there needs to be opportunities out in the community. So a yoga program. How can we make the local neighbourhood yoga program. How can we make sure that is accessible for someone with a disability to go and join. We found a lot of really important information around the types of ways that the class was modified, or the extra equipment needed was really minor. So they might have held a pose for a shorter period of time. Or they might have needed a chair next to them. It was really little things that only need to be changed."
Across Australia, there are organisations working to promote grassroots participation through training and resources in adaptive or disability sports.
Sport Inclusion Australia works primarily with athletes with an intellectual disability.
Disability Sports Australia works with athletes in wheelchair sports, including those with spinal cord injuries and amputees.
Ayden Shaw is the organisation's general manager.
He says post-pandemic and with the Paralympics coming up this year - there has been a surge of interest in boosting disability inclusion and grassroots participation, but there is apprehension about how to go about it.
"We saw it during COVID that disability participation was one of the first things that went away. And justifiably because there were a lot of people with chronic health conditions that needed to be protected in that time. But in that return to sport, what we've seen is that a lot of sports have been prioritising mainstream participation; and not necessarily disability participation. It is a really interesting period of time in the sector because we're coming into this Paralympic year that is going to be talked about a lot over the course of the next 12 months. But how do you translate that mass awareness of disability sport into grassroot participation."
He says the organisation has seen success with training resources on how to start for sporting clubs and recreation providers, including their free online Accessibility Champion course.
Since it's release in December, 508 people - mostly coaches - have participated, boosting their confidence in the area from as low as 20 per cent up to 90 per cent.
"What we are seeing though is a lot of sporting organisations have realised the benefits of when they do have an adaptive program. I think for a very long period of time, adaptive sport involved either - the individual was told they can go to a mainstream club or have to play separately. Whereas now the focus is on just the experience participating in sport, not necessarily whether it is a segregated or non-segregated program. And what that has meant is that coaches are becoming increasingly more confident when they understand that. That engaging a person with disability in adaptive sport is no different to anyone else. It is just that additional support might be required to allow them to participate. And it actually becomes more of a coaching challenge rather than what it was previously, where it was the societal attitudinal issue."
Sports management professor Simon Darcy at the University of Technology Sydney is a quadriplegic and a power wheelchair user.
He says there are more options now than ever before - but challenges to getting on the sport pathway include access to inclusive training spaces - and equipment cost like a competition wheelchair in some cases.
"People when they can get the right equipment and the right support to participate - it can be really lifechanging because we're so sport-obsessed. People want to belong. And they want to belong in the sport that they want to follow. And that belonging might be as a participant. But it also might be as a part of the sporting family. Officiating, getting involved as a volunteer. Whatever it happens to be that you want to do brings that sense of belonging; and that you are with your flock."
He participates in an exercise therapy program NeuroMoves that is run in affiliated gyms, via telehealth or through home visits.
He says in all disability sub-groups he researched, including children and those with intellectual disabilities, the need was the same.
"And it also extends the circle of friends. It means that parents of children with disability also don't feel isolated because there have been many times when we did some of the research that we did. I had people in tears saying they are just trying to get their kids an opportunity at the school they're going to. And the headmaster will use safety and other things as an issue, which isn't true. And we're seeing big changes in that space with new programs that are coming in to break down some of those barriers. And support people who need the support to participate in whatever it happens to be."
Wheelchair Sports NSW/ACT set up a website in July 2022 to list more than 150 adaptive activities.
As an ambassador for the website - theadaptivemovement.com - Gaby says it gives people ideas about how to research what options are available.
"This website allows you to see what organisations out there have some kind of sport or activity that is modified. So it is about considerations that you're not as mobile as you were. But you can still do that sport. That is something really good. And I wish I had that - that that was available when I had my accident. It wasn't, but it is now. I would say start small because again it is the basis of something is better than nothing. So if you weren't doing any activity last week - one walk this week is more than you did last week. That is great and then you slowly increase it."
