Field: Rehabilitation program
Target group: Patients/clients in rehabilitation with lower extremity impairments (mostly amputees)

Purpose:

• Improve the patients’/clients’ physical activity and physical fitness level.
• Promote an active lifestyle after rehabilitation.
• Prepare patients/clients for reintegration into society after rehabilitation.

Programme:
Sitting volleyball is a Paralympic team sport to involve persons with locomotor disabilities, predominantly on the level of lower extremities. The main contingent for sitting volleyball are traumatic leg amputee – whether, mono- or bilateral. A sitting volleyball game is played as well by polio, CP and by the other persons with a variety of the permanent impairment of the musculoskeletal or nervous systems. Sitting volleyball has his roots in Europe and it is now a worldwide developed sport. 71
Historically, sitting volleyball is one of the oldest sports within a scope of the Paralympic family. The roots are going back to the fifties of the last century. The research data are showing that sitting volleyball is a safe sport; there is a little possibility of injury or the secondary, sport related health pathology.
Health related quality of life of sitting volleyball players is higher comparing to their non physically active counterparts with a disability. Sitting volleyball promotes many modalities of the overall health, not only the physical functioning. Sitting volleyball can be used as a means of physical rehabilitation for a wide spectrum of persons with predominantly leg’s impairments.
Sitting volleyball is a cheap sport. Sitting volleyball can be played in the ordinary sports hall or even outside. Only the ordinary net and volley balls are necessary to start playing. Sitting volleyball is played without the prostheses. There is no sophisticated equipment like the wheelchairs to be used.
When playing sitting volleyball, the sport specific biomechanical potential of the athletes with a disability is the same as for the able bodied ones. Because the game is played in a sitting position it makes the persons with a scope of disabilities even to the able-bodied peers. This fact, along with an attractively active game itself, gives a good reason for the able bodied players to be included into the sitting volleyball teams on a national level. Sitting volleyball is a fast and specific sport of its own. Normally, the able bodied volleyball teams are losing to their counterparts with a disability when playing sitting volleyball.
Being an attractive, simple, cheap and safe kind of sport for the persons with a disability, sitting volleyball can be widely advised as a mean of adapted physical activity. The main contingent comprises the traumatic amputee; therefore sitting volleyball is especially suitable, though is not limited to, for the post war countries to involve a wide spectrum of the persons with a disability.
This programme with international impact of scope helps the miscellaneous type of impairment. It requires mainly knowledge in:

• To understand the impact and risks of physical activity.
• To know the impact of medication on exercise performance.
• Understand indications and contra-indications of sports and adapted physical activities in the rehabilitation of specific populations.
• Understand the major components influencing the process of adapting activity situations.
• Understand the various community based physical activity and sports organisations eligible for patients/clients in the Adapted Physical Activity programme.

Skills are equally important:

• Master the ability to safely apply the Adapted Physical Activity programmes, including regular evaluations, using risk stratification and pre-programme screening.
• Master teaching, training and coaching skills (didactical skills), needed for a well-balanced approach in a therapeutic environment.
• Understand the principles of adapting activities, games and sports.
• Be able to adapt activities to the functional potential of the participants.
• Master the professional skill to initiate and effectively process adaptation.
• Master those skills which are necessary in the preparation of a strategic policy for management and integration of Adapted Physical Activity programmes within the multidisciplinary character of rehabilitation.

Example of good practice was described by Aivars Vetra and Pavel Mustafin from Riga Stradins University.