By Dana Swarbrick & Bruna Seixas Lima
“And yet the menace of the years
Finds and shall find me unafraid.
It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate,
I am the captain of my soul.”Invictus – William Ernest Henley (1849–1903)
Growing up in Hamilton, Ontario, Christopher Klodt had some academic issues which led him to drop out of high school in grade 12. “I had trouble with English. I’m dyslexic,” he says. However, he excelled at sports and always dreamed of going to the Olympics. He started playing baseball at the age of six, and he played a little hockey, but his parents could not afford the equipment. At the age of 10, Klodt began playing football, and that was when he found the chance to showcase his abilities best.
“I was really good at football,” he remembers. “I was even asked to try out for U of T’s football team, the University of Halifax football team, [and] Laurier in Waterloo. I played rep until I was 19.”
Klodt was even invited to demonstrate American football in Europe, but by then, he had joined the Canadian Armed Forces. “I had already signed my life away, so that wasn’t an option,” he says.
In his twenties, Klodt had been in and out of jobs. His brother, a year younger, had joined the army when he was 18. “He was telling me about how much he loved it, and how much fun he was having,” Klodt says. So when he got laid off from another job, wanting a little security, Klodt decided to enlist. He served in the army for 13 years and was deployed twice. He was sent to Bosnia in 2003. Three years later, he was sent to Afghanistan. During this tour, at age 24, Klodt was shot. The bullet hit him in the throat and lodged in his spinal cord. Eleven years later, the bullet still lies where it landed. Klodt explains that this is how he became a C6 quadriplegic.
Returning to Canada, he began rehabilitation, where his physiotherapist introduced him to wheelchair sports. “[She] showed me the documentary Murderball,” he says. Murderball features the American wheelchair rugby team’s participation in the 2002 and 2004 Paralympics. Incidentally, the film documents how the American team was defeated by Canada. “That was one of our gold medal moments,” Klodt recalls. He began to contemplate joining a wheelchair rugby team. “[Murderball] inspired me into not having such a bleak outlook on this new situation.”
Wheelchair rugby is a high contact sport, so joining a team was not a decision to be taken lightly. Klodt’s wife was concerned that he would be injured again. “After watching it, my wife instantly said ‘no, you’re not playing that!’” Klodt says. “She’s seen me injured enough, so she was worried about that part of that, so I didn’t even push for it.”
Three years later, Klodt got a call from Soldier On, a sports program offered by the Canadian Armed Forces to veterans and serving members with physical disabilities or mental health challenges. They invited him to attend a sports camp. One of the track coaches at the camp had a son who played wheelchair rugby for the Ottawa Stingers. “Soldier On arranged for me to go see it and Bob’s your uncle, I haven’t stopped since,” Klodt recalls. Today, he describes himself as a retired corporal, happy husband, father of two, and a wheelchair rugby player.
In the summer of 2017, Klodt participated in the Invictus Games, held in Toronto, Ontario. The Invictus Games Foundation supports rehabilitation through sports and holds an international sporting event for wounded, injured, and sick servicemen and women.
Mark Parr was the manager of the 2017 Canadian Invictus team. To him, social belonging is one of the greatest benefits of participating in parasport. “Being part of a team again is huge,” says Parr. “Having the sense of purpose, and feeling the sense of belonging again. This is often missing after a veteran gets released from the military.”
Patrick Okens, chair of the Invictus Sport Work group, echoed the impact of the Invictus Games on social connectedness. “There’s a sense that this isn’t really about sport but about identity and community regardless of whether you were a competitor, family member, coach, volunteer, or spectator,” Okens says.
Beyond the social benefits, Parr also recognizes the health benefits of exercise: “The Invictus Games and the training leading up to the games are a significant form of rehabilitation.”
Athletes begin preparing a year before the competition begins. Klodt practiced three to four times a week leading up to the games. In addition to improving in rugby, Klodt reports he experienced other functional benefits. He says his training allowed him to perform floor to chair transfers, something that is difficult for most individuals with quadriplegia. The training and access to healthcare leading up to the games may also facilitate recovery from illness and injury.
Decades of research suggest that physical fitness is related to cognitive functioning throughout the lifespan (1,2). Exercise causes the release of neurochemicals including brain-derived neurotrophic factor which acts like a fertilizer, helping brain cells grow and connect to each other (3). This neurochemical release is likely the mechanism responsible for improved short-term (working memory) and long-term memory after exercise (4). Exercising over the long-term improves cognition through enhancements to attention, executive functioning, and processing speed (5). Exercise is also linked to improved mood, well-being, and quality of life (6). When compared to activities such as brain training games (e.g., crosswords, Sudoku, Lumosity, etc.) and socializing, exercise still finishes first for maintaining cognitive functioning during aging (7).
“Exercise is medicine” is an old adage that originated in 600 BC when Susruta, an Indian physician, first prescribed exercise as medicine (8). While its benefits for disease prevention are well known, many rehabilitation professionals also use exercise as an integral component in the treatment of chronic disease. Exercise has shown benefits in treating or coping with a plethora of disorders including depression and anxiety (9,10), Parkinson’s disease (11), fibromyalgia (12), cancer (13), chronic obstructive pulmonary disease (14), stroke (15), and cardiovascular disease (16). Physical activity has also been shown to slow neurodegeneration in disorders such as Alzheimer’s disease and dementia (17).
Dr. Sivakumar Gulasingam, physiatrist at the Toronto Rehabilitation Institute’s Lyndhurst Centre, developed the first classification system for the Invictus games. Parasport athletes undergo a standardized classification process based on their impairment levels to ensure that no competitor has an unfair advantage. During a recent public lecture, Gulasingam spoke about how he applies his expertise in sport assessments to his clinical practice to evaluate impairment in his patients. But, other aspects of parasport may also be applied in the rehabilitation clinic.
Competition distinguishes sport from exercise. Some research has explored whether this aspect of sport can be leveraged to enhance motivation and performance in rehabilitation settings. Competition is inherently motivating. Sport fosters intrinsic motivation which is associated with more enjoyment, whereas exercise may be motivated by extrinsic factors such as social pressures of body image (18). Researchers examined whether competition could increase the intensity and amount of self-directed training on a wheelchair-compatible bicycle trainer in stroke inpatients (19). Competition was an effective way of increasing motivation though it had no influence on ratings of perceived exertion. Stroke inpatients in the competition group demonstrated higher exercise intensity, showed improved performance after winning a competition, and worked particularly hard during rematch competitions. Another study examined three versions of an arm rehabilitation game: (a) competition against a friend; (b) cooperation with a friend; and (c) solo against the computer, and replicated the result that competition increases exercise intensity (20). Furthermore, those who preferred the competitive and cooperative games experienced greater motivation than those who preferred to play alone. More research is required to generalize these findings to other disease populations and to examine the effects of competition on functional outcomes.
According to Klodt, sport has provided him with life lessons and incredible experiences which he has applied both on and off the field. His advice to other people with disabilities is: “Never stop. Never quit. Yes, things are hard. Yes, they look bleak. All things are possible with the proper amount of force and determination.”
When asked what he would tell his younger self, he replied, “I wouldn’t tell myself anything. Surprise is a great part of life. I wouldn’t change anything that has ever happened to me. I have had such great experiences throughout my life both because of my injury and before my injury… Sport is such an incredible thing. It has so much power for healing… It will increase your mental health, your physical health… and all you are doing is playing a game.”
Sport wields the power of peer support, the intrinsic motivation of competition, and the physical and mental health benefits of exercise. Parasport is a full package in the rehabilitation sciences: it combines exercise, motivation, and social support into a single intervention that leads to so many health and functional outcomes. Few other interventions can remind people that “they are the masters of their fate and the captains of their souls” (21).
- Khan NA, Hillman CH. The Relation of Childhood Physical Activity and Aerobic Fitness to Brain Function and Cognition: A Review. Pediatr Exerc Sci [Internet]. 2014;26(2):138–46. Available from: http://journals.humankinetics.com/doi/10.1123/pes.2013-0125
- Voelcker-Rehage C, Godde B, Staudinger UM. Physical and motor fitness are both related to cognition in old age. Eur J Neurosci. 2010;31(1):167–76.
- Rothman SM, Griffioen KJ, Wan R, Mattson MP. Brain-derived neurotrophic factor as a regulator of systemic and brain energy metabolism and cardiovascular health. Ann N Y Acad Sci. 2012;1264(1):49–63.
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- Smith PJ, Blumenthal JA, Hoffman BM, Strauman TA, Welsh-bohmer K, Jeffrey N, et al. Aerobic exercise and neurocognitive performance: a meta- analytic review of randomized controlled trials. Psychosom Med. 2011;72(3):239–52.
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- Studer B, Van Dijk H, Handermann R, Knecht S. Increasing self-directed training in neurorehabilitation patients through competition [Internet]. 1st ed. Vol. 229, Progress in Brain Research. Elsevier B.V.; 2016. 367-388 p. Available from: http://dx.doi.org/10.1016/bs.pbr.2016.06.012
- Goršič M, Cikajlo I, Novak D. Competitive and cooperative arm rehabilitation games played by a patient and unimpaired person: effects on motivation and exercise intensity. J Neuroeng Rehabil. 2017;14(1):1–18.
- Henley, W E. “Invictus.” The Objective Standard, Summer 2017, p. 67. Academic OneFile, http://link.galegroup.com.myaccess.library.utoronto.ca/apps/doc/A503273348/AONE?u=utoronto_main&sid=AONE&xid=74b816df. Accessed 9 Jan. 2018.