UAB Sports & Exercise Medicine has developed the nation’s first training video on how to perform CPR and defibrillation on athletes with disabilities. The video and accompanying tools are designed for medical professionals and others who provide sideline coverage for adaptive athletes, offering detailed guidance on performing CPR both in and out of a wheelchair.
These resources, created in partnership with the Lakeshore Foundation, fill a critical gap for medical teams and sideline staff supporting adaptive sports.
“Shifting the focus of sports and exercise medicine toward groups like para-athletes and providing the right training tools is essential for ensuring these teams are prepared to respond effectively in emergency situations,” said Irfan Asif, M.D., chair of the Department of Family and Community Medicine and team physician for USA Wheelchair Rugby. “Sudden cardiac arrest is the leading cause of death on the playing field. I was surprised at the lack of available training resources to guide sideline medical providers on correctly administering life-saving CPR to athletes who require certain adaptations.”
Paralympian Bob Lujano, MS, who won bronze with the U.S. Wheelchair Rugby team in 2004, echoed the importance of addressing the unique health concerns of people with disabilities (PWD), who are three times more likely to experience secondary health concerns such as obesity, diabetes, cancer, and heart disease
“It is essential to build programs specifically for athletes with a disability because for decades people with disabilities have been excluded from sport participation or have limited recreation opportunities,” said Lujano. “With health disparities being so extreme for PWD, specifically creating programs geared toward fitness and wellness can address secondary health concerns, as well as provide social interaction.”
Designing effective emergency protocols for athletes with disabilities requires a deeper evidence base than what currently exists, making tailored research, training programs, and clinical resources essential.
“Because of so many vast disability types, it can be difficult for trainers or health care professionals to be aware of the many health issues that derive from having a physical disability,” said Lujano. “This can make treatment options limited for para-athletes.”
While CPR training is broadly standardized, performing effective chest compressions and emergency procedures on athletes in wheelchairs requires tailored approaches, modified positioning strategies, and sometimes adapted equipment. Wheelchair users may experience unique cardiovascular risks based on disability type, training load, autonomic function, and secondary medical conditions.
Until now, no nationally recognized training resource existed to guide clinicians, athletic trainers, and sideline responders specifically on emergency care for this population. This video is part of UAB Sports & Exercise Medicine’s continuing effort to close gaps in emergency preparedness for para-athletes.
This milestone aligns with the department’s broader leadership through the Para-Athlete Research for Wellness, Injury Prevention, and Sports Medicine Excellence (PARAWISE) Registry. This multi-institution collaboration was designed to build the first nationwide network dedicated to tracking para-athlete injuries, wellness, and training patterns. PARAWISE uses weekly online questionnaires over a three-month period to collect longitudinal data on injuries, illness, training load, and quality of life—data essential for developing sport-specific injury prevention strategies.
Researchers say the CPR video and the PARA-WISE project share a common goal: improving safety and evidence-based care for athletes with disabilities.
“Historically, many injuries among athletes with disabilities go unreported in traditional hospital or emergency department data, making it difficult for clinicians to design prevention and response protocols,” explained Asif, the study’s co-principal investigator. “PARA-WISE is addressing this gap by creating a nationwide network of adaptive athlete injury data, informed not only by clinical insight but also by the guidance of an advisory council composed of world-class para-athletes.”