title: Independent sailing with high tetraplegia using sip and puff controls: integration into a community sailing center.
abstract: We are continually rediscovering how adapted recreational activity complements the rehabilitation process, enriches patients' lives and positively impacts outcome measures. Although sports for people with spinal cord injuries (SCI) has achieved spectacular visibility, participation by high cervical injuries is often restricted due to poor accessibility, safety concerns, lack of adaptability, and high costs of technology.
  
  
  
  We endeavor to demonstrate the mechanisms, adaptability, accessibility, and benefits the sport of sailing creates in the rehabilitative process. Our sailor is a 27-year-old man with a history of traumatic SCI resulting in C4 complete tetraplegia.
  
  
  
  The participant completed an adapted introductory sailing course, and instruction on the sip-and-puff sail and tiller control mechanism. With practice, he navigated an on-water course in moderate winds of 5 to 15 knots.
  
  
  
  Despite trends toward shorter rehabilitation stays, aggressive transdisciplinary collaboration with recreation therapy can provide community and natural environment experiences while inpatient and continuing post discharge. Such peak physical and psychological experiences provide a positive perspective for the future that can be shared on the inpatient unit, with families and support systems like sailing clubs in the community.
  
  
  
  Rehabilitation theory directs a team process to achieve patient self-awareness and initiate self-actualization in spite of disablement. Utilization of local community sailing centers that have provided accessible assisted options provides person-centered self-realization of goals as assisted by family and natural supports. Such successful patients become native guides for others seeking the same experience.
authors.affiliation: a Department of Physical Medicine & Rehabilitation , The Johns Hopkins School of Medicine , Baltimore , MD , USA.
authors.forename: Solomon
authors.initials: S
authors.lastname: Rojhani
authors.affiliation: b Department of Rehabilitation Medicine , University of Washington, VA Puget Sound Health Care System , Seattle , WA , USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Stiens
authors.affiliation: c International Center for Spinal Cord Injury , Hugo W. Moser Research Institute at Kennedy Krieger & Department of Physical Medicine & Rehabilitation, The Johns Hopkins School of Medicine , Baltimore , MD , USA.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Recio
mesh_terms: D000328:Adult; D062309:Community Integration; D006801:Humans; D008297:Male; D000066530:Neurological Rehabilitation / Q000379:methods; D011782:Quadriplegia / Q000473:pathology / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000473:pathology / Q000534:rehabilitation*; D064846:Sports for Persons with Disabilities; D000073678:Water Sports
keywords: Adaptive sailing; Community reintegration; Nature; Recreation therapy; Spinal cord injury; Tetraplegia