The preamble of the IPC Medical Code details the responsibility of the Paralympic Movement to ensure athlete health in sport participation:
“The Paralympic Movement, in accomplishing its mission, should encourage all stakeholders to take measures to ensure that sport is practiced in a manner that protects the health of the athlete and respects fair play and sports ethics. To that end, it encourages those measures necessary to protect the health of participants and to minimise the risks of physical injury and psychological harm. It also encourages measures that will protect athletes in their relationships with healthcare professionals.”
(IPC Medical Code, Preamble, article 1).
The IPC Medical Code came into effect on 1 January 2013 and guides the work of the Movement in this area.
The IPC Governing Board has mandated the IPC Medical Committee to “advise the IPC Governing Board on all policy matters related to the medical care of Paralympic athletes.” In particular, the IPC Medical Committee shall:
• Promote the education of athletes and athlete support personnel on the impact of health and safety on Paralympic athletes and their performances, including the risks and consequences of the use of Prohibited Substances and Methods and the IPC TUE management for otherwise Prohibited Substances and Methods
• Serve as medical advisors to the IPC to develop and implement prevention programmes in areas that affect the health and safety of Paralympic athletes, and to develop and monitor the implementation of medical service programmes at IPC sanctioned events
• Review TUE applications submitted in accordance with the IPC Anti-Doping Code.
The IPC Medical Committee has translated this mandate into the following priorities for the 2014-2018 period:
• TUE Management. Under the IPC Anti-Doping Code, the IPC Medical Committee is responsible to assess or review each Therapeutic Use Exemption application submitted in accordance with the Code and to administer the requirements of article 4.4 of the Code. Additional detail on the TUE process is available from the anti-doping section of the IPC website.
• Medical Services in IPC Sports. The scope of medical services must be sport-specific. A systematic inventory of medical encounters at IPC Sport events provides input to the systematic review of sport-specific ‘Scope of Medical Services’ documents. In addition, sport-specific advices are formulated in response to questions raised by athletes or NPCs, or in response to situations occurring at events.
• Injury and Illness Surveys. Over the course of time, epidemiological studies to monitor injury and illness in Para athletes have been initiated at both Paralympic Summer and Paralympic Winter Games. More detail is provided on a separate page.
• Development of Paralympic-specific medical protocols. The population of Para athletes is an atypical gathering of a wide variety of medical conditions, but some common medical issues will prevail in relation to the impairment types that need to be considered as part of medical provisions at events. More detail is provided on a separate page.
• Monitoring Autonomic Dysreflexia and Boosting. Persons with cervical or high thoracic spinal injuries can suffer from an abnormal sympathetic reflex called Autonomic Dysreflexia. This reflex is caused by painful stimuli to the lower part of the body, particularly distension or irritation of the urinary bladder. The symptoms of dysreflexia are a rapid rise in blood pressure, headache, sweating, skin blotchiness and gooseflesh. In serious cases, confusion, cerebral haemorrhage and even death can occur. This reflex may happen spontaneously or may be deliberately caused (“Boosting”). As this is a health hazard, the IPC forbids athletes to compete in a hazardous dysreflexic state. More detail under Paralympic Specific Sports Medicine.
• Athlete Education. The IPC Medical Code directs the IPC to “ongoing education based on the ethical values of sport and on each individual’s responsibility in protecting his or her health and the health of others.”
• Ensuring Games operations in the medical area. The IPC Medical Committee is responsible to monitor the implementation of an effective and efficient medical programme at IPC sanctioned event.
The IPC Medical Committee works in close collaboration with the IPC Sports Science Committee and different world-leading authorities on athlete health and safety research. More detail is provided on the science page of the IPC website.
The contact person for medical matters in the Paralympic Movement is the IPC Medical Manager, Ms. Judith van der Veen: [email protected]