Ebook: Amputee Sports for Victims of Terrorism

The present volume originated in an Advanced Research Workshop held at the Turkish Armed Forces Rehabilitation Center in Ankara, 7–11 May 2007. This was a workshop hosted by the Centre of Excellence – Defence Against Terrorism (COE–DAT), which was opened in Ankara in 2005 with the purpose of supporting NATO on defence issues related to terrorism. Turkey is the framework nation, and at present six other nations also contribute with staff and funds, namely the United States, the United Kingdom, Bulgaria, Romania, the Netherlands and Germany. Each year, COE–DAT organizes numerous workshops and courses, bringing academic rigour and institutional expertise in terrorism to NATO, Partnership for Peace (PfP), and Mediterranean Dialogue countries, Non-triple Nations and others.

As amputee sports gain worldwide recognition, it is natural that books and articles begin to be written about them. These would be from very different points of view because of the differing individuals and institutions which have an interest here. This book, Amputee Sports for Victims of Terrorism, is an almost entirely new departure, on the one hand because it takes as its topic these new sports, in particular amputee football, and secondly because the workshop which created it brought together the varied interest groups for the first time. The amputee sportsmen, trainers, administrators, medical professionals, social workers, not to forget the army, came together with the common aims of giving theoretical and practical information on amputee sports, promoting their international organization and regulation, and of increasing awareness of these sports which have been recognised as an effective means of rehabilitating amputees and promoting their well-being. The editors hope that this book will be a useful reference point for future work on amputee sports.

The diverse viewpoints of those who came were reflected in the structure of the workshop and the order in which the papers were delivered, and this structure remains in the collection of those papers in this book. The workshop began with contributions on ‘Sports for the Disabled’, which set the scene. In this session there were two papers, one on “The History of Disabled Sports” (see the chapter by Mr Demirhan Şerefhan), the other on “The History of ‘Modern’ Amputee Football” (see the chapter by Jim Frère). Jim Frère spoke of ‘modern’ amputee football because, as one of the photographs in his chapter proves, the sport was played in an informal way many decades ago.

The topic moved to the physiological background of amputee football. Prof. Dr Col. Kamil Yazıcıoğlu, in his chapter “The Anatomy of Amputee Players,” gives an introduction to anatomy, with an emphasis on terms which apply to one leg amputees. Here, for example, are found the names of the various degrees of leg amputation found among players of amputee football. Prof. Dr Col. Tunç Alp Kalyon (see his chapter on “Muscular Activity and Exercise”) also gives an overview, this time of the different muscle types and, crucial to any training programme, the different kinds of exercises and their effects. While the training programme must include different categories of exercise, for example anaerobic and aerobic, Assoc. Prof. Lt.-Col. Salim Göktepe introduces us to the energy systems of the body which are the reason why these categories of exercise are necessary (see his chapter “Energy Systems in Sports”).

Three other medicine-based topics were considered in the workshop, all of them essential information for those involved in sport. “Sports Injuries and First Aid” are considered by Assoc. Prof. Dr Col. Ali Şehirlioğlu, while “Doping – Drug Misuse in Sports” is the topic of Prof. Dr Aytekin Temizer. While those at the workshop had not come across a case of doping in amputee football, there is no doubt this topic is liable to affect all sports.

The next session of three papers at the workshop treated the subject of the benefits of sports for amputees, both physiological and psychological. Assoc. Prof. Lt.-Col. Ahmet Korkmaz spoke of “The Physiological Effects of Sports in Amputees,” both in terms of corporal and mental health. Fitness also helps to prevent or limit chronic or age-related disorders such as diabetes, cancer and atherosclerosis. Assoc. Prof. Turgay Biçer (see his chapter “Psychology in Sport”) emphasises the role that mental preparedness plays in sporting success, and suggests methods for mental training. Assoc. Prof. Veli Duyan looks at disabled sports from the viewpoint of social work, where sports can be an effective means of social inclusion. He argues for a ‘social model’, as opposed to ‘charity’ or ‘medical’ models, in our approach to disability (see his chapter “The Community Effects of Disabled Sports.”

Two chapters of this book are concerned with sports administration. Prof. Dr Diana Indjov notes some of the successes of the Disability Movement, in her chapter of the same title. However, the situation of the disabled in some countries is far behind that of other countries. Prof. Indjov argues for the need to lobby politicians and achieve changes in the law. Prof. Dr Ivan Kijanskiy, the Secretary-General of the Russian Disabled Football Association, has long experience in organizing this sport in Russia. He considers the importance of securing sponsorship and raising the profile of the game (see his chapter “The Role of Socially-Focused Marketing in the Development of Amputee Football in Russia”). In Russia the Federal Sports Ministry plays the main role in funding amputee football.

In a paper which also presents the history of amputee football in Russia, Mr Sergey Lisitsyn, the trainer of the Olympro team, emphasized the importance of “Coordination in Amputee Football.” He argues that “the purpose of the development of coordination in amputee football goes beyond the mere build-up of the bodily motor skills … to the establishment of a perfectionist psychological framework, and the formation of a vital need for coordination training throughout their lives.”

By this point the topics of the workshop had shifted from the theoretical to the practical, and the floor was open for the practitioners themselves to discuss and demonstrate aspects of the sport. Three sessions of the workshop were spent in the field, with demonstrations of the game from the Turkish National Amputee Team and their trainers. This section of the workshop was introduced by a summary of the rules of the game (see Prof. Dr Col. Kamil Yazıcıoğlu's chapter on “The Rules of Amputee Football”). Mr Fahir Genç, the Head Coach of the Turkish National Amputee Football Team, and the Turkish team showed the workshop the physical building blocks of the game; how an amputee prepares his equipment, runs, turns, shoots, etc. (see Mr Genç's chapter on “Techniques of Amputee Football.” Warm-up and training techniques were shown to the participants by Mr Steve Johnson, the present President of the World Amputee Football Federation, and by the Brazilian trainer Mr Ademir Cruz. Mr Genç and his team demonstrated some training techniques, especially for passing (see the chapter by Mr Fahir Genç on “Practice in the Field”). The final chapter of the book is on “Tactics in Amputee Football”, by Fahir Genç, who presented a paper on this subject at the workshop.

The book concludes with an account by Col. Mete Tahmisoğlu of the Sum-up Session, and some of the lessons learned from the workshop.

Kamil Yazicioğlu, Prof. Dr Col, Scientific Director

Mete Tahmisoğlu, Col. ARW Director

Sir Ludwig Guttmann organized a sports competition in 1948 which became known as the Stoke Mandeville Games, involving World War II veterans. In 1952 competitors from the Netherlands took part. The first Olympic-style games for athletes with a disability was in Rome in 1960, and since 1988 the Paralympics have been held in conjunction with the Olympics (1992 for the Winter Olympics). There are various categories of disability recognised by the Paralympic Committee. Since the 2000 Sydney Games the intellectual disabilities category has been suspended. There are currently twenty paralympic sports, and six winter paralympic sports. In 2000 Turkey sent an athlete for the first time, and the Turkish National Paralympic Committee was formed in 2002. At present amputee football is not recognised as a paralympic sport.

Don Bennett began modern amputee football in Seattle, USA, in 1980. Bill Barry created Amputee Soccer International, initially with tournaments between USA, Canada and El Salvador. Soon teams from other countries joined the World Cup. In the 1990s the international game had to be revived after frictions had led to the World Cup being suspended. In 1998 Rick Hofmann launched www.ampsoccer.org. Later that year, at a meeting in Moscow, the International Amputee Football Federation was established, with Georgy Lunarcharsky as its first president. The rules and constitution were drawn up. Further tournaments took place, but funding and international misunderstandings remain a problem. The name changed to the World Amputee Football Federation. In 2007 an All Africa Championships was held in Sierra Leone, and the Amputee Football Federation of Africa was formed. The next World Cup will be in Antalya, Turkey.

Anatomy is the study of body structure and function. It is also a science to understand biological and mechanical principles and processes. Biomechanical rules are applied to locomotion system. Amputation is the removal of a limb or appendage or outgrowth of the body. Disarticulation is the amputation through a joint. The portion of limb that remains after amputation is called as “residual limb”. The weight bearing from the inferior part of residual limb is impossible except disarticulations and partial foot amputations. Natural movements are accomplished by groups of muscles. The muscles are classified according to their actions: Prime movers, antogonists, fixators and synergists. The muscles that connect limbs to vertebral body are very important for amputee players. Latissimus dorsi muscle which covers from neck to gluteal area is a strong muscle for adduction, extension, medial rotation of the humerus. It is called as “climbing muscle”. In order to maintain hip stability and elevation of counter hempelvis, amputee players need strong hip abductors. The most important hip abductor is “gluteus medius”.

Definitions of muscle, the different muscle types and their fibres. Types and aims of exercise: muscle strengthening exercises, isotonic exercises, isokinetic exercises, flexibility and ROM exercises, endurance exercises, stretching exercises, plyometric exercises, kinetic chain exercises, relaxation exercises, balance and coordination exercises.

Energy is defined as the ability to do work or cause motion. It has different forms like heat, light, sound, electrical energy, mechanical energy, and chemical energy. Metabolic processes in the human body use chemical energy. Adenosine triphosphate (ATP) is used as the source of energy for muscle contraction. ATP has high energy phosphate bonds and each bond stores about 11,000 calories. There are three energy systems for muscular contraction: a) Immediate energy system (Anaerobic System): Phosphogen system, b) Short-term energy system (Anaerobic glycolysis): Lactic acid system, c) Long-term energy system (Aerobic glycolysis). Football is the most popular sport in the world. It is categorized as intermittent exercise (frequent periods of intense work followed by periods of less-intense recovery). Top level players travel approximately 11 km in a 90 minute match. The exercise intensity is reduced and the distance covered is 5–10% less in the second half. Football is mainly dependent upon aerobic metabolism. Aerobic energy production accounts for more than 90% of the total energy consumption. The average work intensity is close to the anaerobic threshold (normally between 80–90% of HRmax in football players). In football there are periods of high-intensity activity where accumulation of lactate takes place. There is a sprint bout every 90 seconds, lasting 2–4 seconds. Sprinting constitutes 1–11% of the total distance covered during a match, corresponding to 0.5–3.0% of effective play time. Anaerobic episodes constitute a small part of the match, but are very crucial. During recovery, oxygen uptake remains elevated. If recovery periods are relatively short, VO2 remains elevated and the aerobic contribution to ATP resynthesis increases. There are no published data about the energetics of amputee football. The following assumptions can be made: slow and fast episodes of amputee football are slower than regular football; the energy needed to accomplish the same task is higher in amputees; the energy profile is similar.

In recent years, increasing numbers of people of all ages have been heeding their health professionals' advice to get active for all of the health benefits exercise has to offer. But for some people, particularly those who overdo it, or who don't properly train or warm up, these benefits can come at a price: sports injuries. Fortunately, most sports injuries can be treated effectively, and most people who suffer injuries can return to a satisfying level of physical activity after an injury. Even so, many sports injuries can be prevented if people take the proper precautions.

This paper reviews many of the kinds of drugs misused to gain an advantage in sports. It introduces the Turkish Doping Control Center, which recently received accreditation. Aspects of the laws relating to doping in sport are highlighted. One of the difficult aspects of anti-doping measures is that there are drugs which are difficult to detect.

Due to a decrease in physical activity, in particular lower limb amputees experience a decline in physical fitness. However, apart from many other beneficial effects of being more active, amputee individuals may obtain impressive advantages if they regularly exercise. Human body systems, in particular cardiovascular, muscle and bone, respiratory and nervous systems, may readily react and adapt to exercise in order to serve the increased demands. The human body supports the more active systems through several neuronal, hormonal, and metabolic regulations. These actions may improve and become stronger if the exercise is performed regularly. Moreover, several structural adaptive changes, especially in the cardiovascular and muscle system, appear as the exercise is repeated. The adaptation capacity of human systems is great when the amputee individual lives a more active life-style. The latter may be achieved either through having a more active daily life-style and/or participating in a sport team or activity organization, such as walking club and others. In this way, amputee individuals may obtain health promotions affecting both body and mind. Furthermore, other preventive health effects, in particular against chronic or age-related disorders such as diabetes, hypertension, cancer, and atherosclerosis, may naturally occur in the amputee body.

Sport Psychology is the branch of Sport and Exercise Science defined as the scientific study of human behaviour in sport. Like the other disciplines within Sport and Exercise Sciences, Sport Psychology can be applied to varied skilled movements, physical activities and exercise programmes which incorporate fitness, exercise rehabilitation and health-oriented exercise programmes, as well as traditional physical education and competitive athletes (Gill, 1986). Another explanation of Sport Psychology is the study of individual and group human dynamics in the context of sport. As its name implies, it has its origins in both psychology, the study of human mind and behaviour, and sport studies, primarily physical education (Hill, 2001). While Sport Psychology draws on both physical education and psychology, it differs significantly from them. For example, physical education emphasizes bodily aspects of movement, while Sport Psychology emphasizes the mental, emotional, behavioural and spiritual aspects of the sport (Hill, 2001).

Disability takes various forms and is quite difficult to understand for both non-disabled persons and people with disabilities. The charity model sees people with disabilities as victims of their impairment. The medical model considers people with disabilities as persons with physical problems which need to be cured. The social model regards disability as the result of the way society is organized. Barriers faced by disabled people, and dimensions and functions of the community are mentioned in the article. Also, some information is given about sport as a means of social inclusion, empowerment, social interaction and integration, physical rehabilitation, and awareness-raising. In conclusion, we need to highlight the importance of approaching the issues of persons with disabilities from a positive perspective, and we need to raise awareness of the key issues and barriers to participating in sport activities.

10 to 15% of the world's population is affected by some disability. This may affect their ability to secure work, and other social activities. Whereas a medical model of disability sees disability as an impairment needing health care, the social model concentrates on correcting social attitudes and the tendency to label. Some of the fundamental rights are still inaccessible to Disability Movement: the right to education; the right to work; the right to private and family life; the right to protection of health and social security; the right to protection against poverty and social exclusion; the right to adequate housing, sport access etc. The right to receive support and assistance is not enough. Guaranteeing access to equal political, social, economic, sport and cultural rights is not a common political objective. Equal status, inclusion, and the right to choose is not promoted and implemented.

In this paper some aspects of the problem of developing amputee football in Russia as a means of social rehabilitation are considered. Insufficient state support for this kind of football, its low status in comparison with the recognized paralympic sports, and specific complexities in working with sponsors are a number of the basic difficulties. The decision-making process for this problem requires socially-focused marketing. This means that amputee football must have the components of a social programme, popular support, the active interest of the mass media, and commercial appeal to sponsors. It is proposed that the efforts of the various national associations must be united, paralympic status should be sought, and there should be an all-European association of amputee football.

The history of the foundation of amputee football in Russia. The definition of coordination. Criteria for the evaluation of coordination skills in an amputee football player. Principles for how to develop coordination and coordination skills. An account of game tactics in amputee football.

Amputee football's rules are adapted to the special needs of the sport. As the sport requires more intensive physical effort than mainstream football, the pitch is smaller, a team is made up of seven players, and playing time is fifty minutes. Where different rules are not stated in WAFF rules, FIFA rules apply.

The photographs in this chapter are from a training session of the Turkish national amputee football team. More clearly than words, they show many of the practical aspects of modern amputee football, from holding the crutches, and running (two methods), to how to turn, jump and shoot. Particular importance is given to balance when using the crutches.

This chapter contains diagrams and explanations of exercises for training sessions with amputee players. There are three warm-up exercises involving passing. Two more complex exercises combine running, dribbling, passing and shooting. Finally, a three-zone game which concentrates on passing skills is explained.

Tactics are ‘planned actions aimed at scoring a goal, or preventing an opponent's goal, taking into consideration the possibilities and strategies available to your team and to the opposing team (including weather conditions, the state of the field, the referee, the spectators, etc.).’ Game conditions will affect tactics. Attack and defence tactics may apply to the team as a whole, groups or one group of players, or to individuals. Beyond these criteria, we explain specific strategies, like pressure play, the use of set play, one-on-one defence, etc. Mental preparation is also important.

This is a brief look at the sum-up session which concluded the workshop. The session considered the administrative, practical and medical aspects of amputee sports. Regarding this last, discussion focussed on a concern that, for the health of the players, more attention should be paid to training the residual limb. Many participants expressed their satisfaction with the workshop.