ABC | Volume 113, Nº3, September 2019

Special Article Paralympics – Addendum to the Update on the Guidelines for Sport and Exercise Cardiology of the Brazilian Society of Cardiology and the Brazilian Society of Exercise and Sports Medicine Japy Angelini Oliveira Filho, 1 A ntônio Claudio Lucas da Nóbrega, 2 Luiz Gustavo Marin Emed, 3 Marcelo Bichels Leitão, 4,5 Roberto Vital 6, 7 Universidade Federal de São Paulo - Escola Paulista de Medicina, 1 São Paulo, SP – Brazil Universidade Federal Fluminense, 2 Niterói, RJ – Brazil Hospital Cardiológico Costantini, 3 Curitiba, PR – Brazil Sociedade Brasileira de Medicina do Exercício e do Esporte, 4 São Paulo, SP – Brazil Universidade Federal do Paraná, 5 Curitiba, PR – Brazil Comitê Paralímpico Brasileiro, 6 São Paulo, SP – Brazil Universidade Federal do Rio Grande do Norte, 7 Natal, RN – Brazil Keywords Sports; Athletes/history; Athletes/legislation &jurisprudence; Disabled Persons; Physical and Rehabilitation Medicine; Hearing Loss; Vision Disorders. Mailing Address: Japy Angelini Oliveira Filho • Universidade Federal do Rio de Janeiro - Av. Pedro Calmon, 550. Postal Code 21941-901 Rio de Janeiro, RJ – Brazil E-mail: japyoliveira@uol.com.br DOI: 10.5935/abc.20190194 Para-athletes or athletes with disabilities Paralympic sports include a wide group of athletic activities for individuals who have disabilities and who participate in diverse levels of competition. The Paralympic Movement began in 1888 in Berlin with the founding of the first sports clubs for people with hearing impairments. In 1922, the International Committee of Sports for the Deaf (CISS) was founded and the First International Silent Games were organized. In 1989, the International Paralympic Committee was founded in Dusseldorf (http://www.paralympic.org) , related to diverse federations connected to athletes with disabilities. In1945, LudwigGuttmann, adoctor specializing inneurological surgery, initiated rehabilitation programs forWorldWar II veterans with special needs at the National Spinal Injuries Centre of the Stoke Mandeville Hospital, in England. The first competition took place with 16 war veterans, on July 29, 1948, during theOpening Ceremony of the 1948 Summer Olympics in London. In 1960, the first Paralympic Games took place in Rome, with 400 athletes from 23 countries; on that occasion, Pope John XXIII referred to Guttmann as “the de Coubertin of the paralyzed.” Since the Summer Games of 1988 and the Winter Games of 1992, the Paralympics have been held in the same city as the Olympics. In Brazil, Paralympic sports began in 1958, when the wheelchair user Robson Sampaio de Almeida and the physical trainer Aldo Miccolis founded the Clube do Otimismo. Shortly thereafter, Sérgio Seraphin Del Grande, an athlete with a disability, founded the Clube dos Paraplégicos de São Paulo. The National Association for Parasports (Associação Nacional de Desporto de Deficientes [ANDE]) was founded in 1975. In 1995, the Brazilian Paralympic Committee (http:// www. cpb.org.br ) was founded. Its headquarters, initially located in the city of Niterói, Rio de Janeiro State, moved to Brasília in 2002. The Brazilian Paralympic Committee has the following vision, mission, and principles: “1 – Vision: to represent and lead the Brazilian Paralympic Movement, seeking to promote and develop high-performance sports for people with disabilities; 2 – Mission: To exercise the legitimate representation of Brazilian Paralympic sports; To organize Brazil’s participation in continental and worldwide competitions and in the Paralympic Games; To promote the development of diverse Paralympic sports in Brazil, in conjunction with the respective national organizations; To promote universal access of people with disabilities to athletic practice on their diverse levels; 3 – Principles: To work in full partnership with technical areas of national associations and confederations affiliated and connected to the Brazilian Paralympic Committee, valorizing the convergence of objectives in favor of the development of every segment of Brazilian Paralympic sports.” Paralympic Medicine deals with healthcare related to athletes with disabilities. 1 As of 1994, the International Paralympic Committee, aims to bring scientific support to the Paralympics, without interfering with athletes, training , and organization of the games. 2 There are 4 core Paralympic values established by the International Paralympic Committee. They are courage, determination, inspiration, and equality. 3 The development of specialized prostheses and equipment, such as specific wheelchairs is essential for the optimized use of parathletes’ residual mechanical function. 4,5 Two-dimensional kinematic analysis of athletic gestures may be useful, given the broad diversity of parathletes’ residual functional capabilities. 6 Furthermore, sports psychologists should assist parathletes in developing mental skills for stress management and consequent improvements in athletic performance. 7 Cardiological evaluation: pre-participation and re-evaluation All Paralympic athletes should undergo evaluation, regardless of age, sex, and associated disability; pre‑participation 339