Sports and Recreation for Those with Lower Limb Amputation or ...

Scuba Diving
Fig . 41 . Webbed gloves to facilitate upper
limb power during scuba diving . (Photo
courtesy of Bernice Kegel)
He or she must be comfortable in
the water, know how to swim, and
be dedicated to the sport . Every
scuba diving student comes face
to face with certain fears . Whether
it is the fear of being without air
while underwater or the fear of
encountering sharks, the anxiety
for some is part of the excitement
that this activity offers. Another
important requirement is the opportunity
to dive . Once a disabled
person is certified, diving opportunities
can be hard to come by.
Beach diving, although required
for certification, is not practical on
a day-to-day basis.
A major challenge for the disabled
person is getting oneself
and one's equipment to the water.
In most cases, this requires assistance,
although some individuals
with amputation can manage
alone by diving from a boat . When
returning to the boat, the diver
removes the gear in the water so
that people on board the boat can
pull it back. They then assist the
diver into the boat . In either case,
the basic wetsuit should be individually
modified, which is a relatively
uncomplicated task that most
wetsuit repair facilities can handle.
Skin Care
Skin protection is a major concern
to all divers, especially those
with amputation . Skin breakdown
can result from abrasions inflicted
while transferring to a pool deck,
while underwater, and from equipment
pressing on various bony
structures of the body. Skin selfexamination
in the shower following
each diving session is recommended
for all divers.
Underwater Locomotion
Methods of locomotion vary
with the specific disability. Forexample,
the individual with unilateral
lower limb amputation generally
finds that progressing from a
dolphin kick into a modified flutter
kick works well with the aid of
specifically designed fins that will
fit over a prosthesis.
The Veterans Administration's
Prosthetics Center (VAPC) in New
York has developed axvate p resistant
prosthesis with attachable
fins . This device provides superb
mobility for the individual with
bilateral lower limb amputation
who wants to scuba dive (Figs. 42a
and 42b) . (For additional information,
see Swimming section .)
The scuba diver's arm stroke,
which begins with both arms extended
forward, is a modified
breaststroke similar to that used in
swimming competition . The hands
are pressed outward, downward,
and toward the chest, while the
elbows remain out to the sides . As
the hands pass the chin, they are
quickly pulled back in a deep,
short, and quick movement . A protracted
pu!l rn*anoa longer recover'
which is a negative effect . Once
pulling efficiency is achieved, the
diver with limb amputation can
participate authoritatively with
able-bodied companions.
Stability
A problem frequently encountered
by divers with disability is
that of limited ability to use the
lower limbs to balance the body
in a vertical position . One of the
most valuable tools for overcoming
this problem is the automatically
inflated buoyancy compensator
(BC), which allows the diver
to control buoyancy by just touching
a button. An inflatable bladder
is connected to a low-pressure
hose coming from a regulator. The
diver ascends by pressing a button
to fill the BC with air from the
tank.
To slow the ascent rate, the hose
is held overhead and the exhaust
valve button is depressed to purge
the air. Thus a diver can ascend,
descend, or attain neutral buoyancy
at any depth by merely pushing
a button.
The buoyancy compensator
comes in three configurations.
The first is the old horsecollar
type, which the diver wears on the
front of the chest . Since this interferes
with arm action it is not
usually recommended for divers
with limb disability who depend
on their arm strength . The second
configuration is the back inflation
unit (BIU), which is a horseshoeshaped
bag attached to the tank's
backpack . Although this type
leaves the arms free for pulling, it
does not provide frontal buoyancy,
so it is not generally recommended
either. The third type of BC is a
buoyancy jacket, which is a combination
of the other two . It attaches
to the backpack, has armholes like
a vest, and effectively distributes
buoyancy. The BC jacket also allows
the diver to maintain vertical
posture without relying heavily
upon the lower limbs for balance.
In addition, the buoyancy jacket is
easier than other BCs to put on
and take off. Either in or out of the
water, it provides excellent buoyancy
control and can be easily
inflated, automatically or orally.
Weight Distribution
Another concern to the diver
with disability is weight distribution
. Placing greater weight over
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