Can Sports Save Lives?

By Laura Phelps

Most people don’t think twice about the little things they do each day. Getting out of bed every morning. Making breakfast. Taking a shower. Driving to work.

Then there are the activities we do for fun. Getting together with friends for happy hour. Going to the gym. Taking an evening walk around the block with the family.

However, for more than 61 million disabled people in the U.S., these little things aren’t little. They’re big.

Whether someone was born with their disability or they experienced a life-changing event like a stroke or car accident, simple activities like eating, showering and leaving the house present barriers to living a full life. As a result, many disabled people become isolated and immobile, sending them into an unhealthy spiral that impacts their physical, mental and emotional well-being.

Alice Krauss, who’s worked as an occupational therapist at Brooks Rehabilitation for more than 40 years, has seen this happen to patients after leaving the hospital. They would return home and never leave. They gained weight, which led to heart disease, diabetes and other life-threatening conditions. Some abused alcohol and other substances. Marriages ended, splitting families apart. Depression was rampant — and some patients experienced suicidal thoughts.

“My premise was that social isolation and the lack of physical activity are the key factors that lead to these negative health outcomes,” said Krauss.

“I had a mother of a 20-year-old quadriplegic tell me once … the only time her son had been out of the house was on a stretcher,” as an ambulance took him to the hospital to treat an infection, Krauss recalled.

“Once I see a problem, I can’t unsee it,” she said. So in 2007, she launched an adaptive recreation program rooted in occupational therapy principles that incorporate physical, mental and spiritual well-being. 

For 16 years, the Adaptive Sports and Recreation program at Brooks Rehabilitation has offered a wide range of activities and sports, including yoga, bowling, wheelchair basketball, kayaking, archery, cycling, dance, surfing and more. The program is entirely free for participants and provides equipment and transportation, which have been key to its success.

With the motto “Fun, Fitness and Friendship,” the program not only provides an outlet for physical activity but a chance to connect with others and create a sense of belonging. 

“Community is the number one indicator of longevity and quality of life,” Krauss said. “It’s not just about helping them recover function, but it’s as much about introducing them to people who have similar stories. They can look across the table and not feel so alone.”

In 2019, before the coronavirus pandemic, the program served about 800 people with more than a dozen activities each week and 20--30 special events each year, according to Krauss. Each year, dozens of Jacksonville University occupational therapy students volunteer and intern with the program, which serves as a hands-on learning lab. Through this partnership with Brooks Rehabilitation, students not only apply OT principles to improve performance in these personally meaningful daily “occupations,” but they learn that these same occupations help to increase health, well-being and quality of life.

Krauss constantly receives comments and letters from people who say their lives have been changed for the better. However, results of informal surveys that attempted to quantify the impact of the program somehow didn’t reflect that transformational improvement in quality of life that she was seeing.

So she reached out to Dr. Sandra Brown and Dr. Megan Bewernitz, two faculty members within Jacksonville University’s Occupational Therapy program.

Instead of quantifying the data, they suggested a qualitative study.

“We wanted to hear the voice of the people,” said Brown. “That’s the power of qualitative research. It really talks to you.”

Brown and Bewernitz reviewed more than 700 pages of testimonials from 92 participants, including emails, letters, social media posts and newspaper articles that had been collected over the course of roughly 10 years. They asked Krauss and her team to remove any identifying information to prevent any inherent bias.

Brown and Bewernitz also consulted with Dr. LaTonya Summers, assistant professor of clinical mental health counseling at JU and an expert on qualitative research, to help identify themes in the data and categorize the results using a grounded theory methodology.

“With grounded theory, you don’t go in with any preconceived notions and the data speaks for itself,” Bewernitz said. “You develop a theory based on the data; it’s grounded in the data.”

After analyzing all the data, their conclusions were clear. The program was not only accomplishing its intended purpose to improve health and quality of life for disabled people, but in some cases, it really was saving lives.

After joining the program, many individuals said they were able to do the activities they did before they were disabled, and many said they tried new activities they had never experienced in their lives. They engaged more with other people socially and made new friends. Many said they felt normal again, and some felt they had been given a second chance at life

“Not only have I lost weight, but my self-esteem is better and I have a sense of purpose in life,” one participant wrote.

“This program makes it possible to accomplish your mission in life,” another patient shared. “My life has opened to realms I never imagined. Family and friends can’t believe what I’ve been doing.”

“It’s not about your disability and what you can’t do. It’s about your ability and what you can do,” another person shared.

Brown and Bewernitz found the program had a positive impact in all areas of participants’ lives.

“They not only participated in sports and recreation, but they found more independence and autonomy in their everyday lives,” said Bewernitz. “They made more social connections outside of the adaptive sports and rec group … We saw people had an easier time advocating for themselves.”

Brown, Bewernitz and Krauss presented their findings at the American Occupational Therapy Association national conference and at the World Federation of Occupational Therapy Conference in Paris, France. Their abstract was published in the American Journal of Occupational Therapy.

They say occupational therapy should play a more significant role in adaptive recreation programs. They believe the program at Brooks Rehabilitation is so successful because it’s rooted in OT principles that aim to improve all aspects of health. The physical activities serve as a gateway to social connection that helps build positive identities focused on what people can do, rather than what they cannot do.

“I think the takeaway is that other programs could also add that extra piece and that sense of belonging and that sense of community,” Brown concluded.

Bewernitz added, “These types of efforts need to be supported because they’re so incredibly valuable to so many people.”