Participation in diving as an adaptive recreational sport has increased significantly along with innovations of viable options for people who want to explore adaptive diving. One of the biggest concerns is how to provide these individuals with safe access to diving. As the dive industry welcomes new programs developed for adaptive diving, more dive businesses should get training in adaptive diving and create conditions to accommodate these divers.
Numerous medical and physical conditions such as limb amputation, paralysis from a spinal cord injury and neurological conditions that impede lower-limb mobility can restrict the person’s ability to perform all the skills required for open-water certification. Certified dive instructors and medical professionals should evaluate individuals for their ability to function safely, given their condition and current medications.
As the dive industry explores ways to improve the safety of adaptive diving, let’s look at the current challenges and possible solutions.
Adaptive Diving Equipment
A dive business may need to make accommodations and devote additional dive staff to ensure the safety of an adaptive diver. Some individuals will require extreme measures to allow them to experience scuba diving, so to determine if they fit into an adaptive diving program you may need to do research and consult with medical professionals to make a sound determination regarding an individual’s safety and abilities. The dive industry can also support adaptive divers by continuing to develop more specialized gear.
The first consideration for an adaptive diving program is providing access to the water. For training, a pool should have a properly maintained chair lift or a wheelchair ramp to assist with the safe entry and exit of an adaptive diver. Trying to carry, lift or pull an adaptive individual out of a pool could seriously injure the adaptive diver and the assisting dive training staff. Making transportation easier for these divers can include access ramps in place of steps, vehicle modifications for wheelchairs and boat-mounted cranes to assist with dive boat entry and exit. An adaptive diver can also wear a specialized body harness under their buoyancy compensator that has chest-mounted lift rings that allow staff to lift the diver on and off of dive boats while in a sitting position for easier placement into a wheelchair or other special seating.
Adaptive diving gear also includes specialized personal equipment, which has improved over the years. With appropriate and correctly utilized equipment, an adaptive diver can obtain neutral buoyancy and experience a newfound sense of freedom. The pressing need for specialized equipment for amputees has resulted in the development of dive gear for single, double and quadruple amputees, allowing individuals to experience the freedom and ability to dive without additional outside assistance for propulsion.
Specially designed and manufactured arm fins for upper-limb amputees allow for additional propulsion and protect the residual upper limb. The scar tissue on a residual upper limb is fragile and easy to injure if not protected during a dive; such injury could cause an infection on the end of the amputation that could require many months of recovery. Specialized adaptive arm fins are also available for individuals with spinal cord injuries or others who need additional assistance with using their arms to move through the water. These fins allow adaptive divers to independently propel themselves and provide a much larger area of resistance in the water than webbed gloves, allowing many divers to keep pace with others.
Many returning military veterans and individuals who have lower-limb amputations due to sepsis or diabetes are looking for ways to stay active. Diving helps them regain a sense of self-confidence and experience freedom from their prosthetics or wheelchairs.
The use of standard medically available prosthetic limbs, even specially fitted ones, presents several problems in adaptive diving. A standard dive fin attached to these prosthetics is not efficient, and in many cases these rigid pocket-style limbs fall off at depth. A residual limb retains limited dense muscle tissue and compresses at depth. When this happens, the rigid socket of the prosthetic limb cannot compress to maintain a sufficient connection for a secure attachment.
A recent development is a uniquely designed fin for lower-limb amputees that is fully adjustable to fit a wide range of leg amputations without the need of a prosthetic fitting. It can be attached to the lower limb with adjustable straps, and it provides propulsion in both the up and down motion, which is far superior to a standard dive fin that provides thrust only on the downstroke. This lower-limb fin can also provide twice the propulsion of a prosthetic leg fitted with a standard dive fin.
Many divers have experienced the weight of a cylinder on their backs causing a tendency to lean or roll. For an adaptive diver, this situation creates yet another stressful issue to overcome. Cylinder flotation pods are an innovative way to tackle this issue. This small flotation device attaches to the outside of the cylinder opposite the diver, and its design eliminates most of the cylinder roll tendencies and allows the adaptive diver to concentrate on enjoying their dive.
Development of adaptive diving equipment will evolve further as new technologies become available. All these endeavors will create a refined and improved adaptive diving experience.
Kenneth J. Hoser is the founder and executive director of the Adaptive Diving Association, a nonprofit organization in Montgomery County, Pennsylvania. Learn more at AdaptiveDivingAssociation.org.
Recreational Scuba Diving and the ADA
In “The Right to Refuse Service” (Expert Opinions, Winter 2019), it was stated that the Americans with Disabilities Act (ADA) does not obligate a dive operation to make special accommodations for handicapped divers. We have learned this is not correct. Sections of the ADA apply to recreational diving; dive professionals and dive shops should seek legal advice if they have questions or concerns.
The Americans with Disabilities Act of 1990 (42 U.S.C. § 12101) is a civil rights law that prohibits discrimination based on disability. The ADA does not provide an exception for dive operators and requires that businesses make “reasonable accommodations” to provide people with disabilities an opportunity to participate in the programs and services they offer. This may include retail operations, diving, training and other services.
What constitutes a reasonable accommodation has been the subject of significant litigation, and DAN legal experts are preparing a follow-up article to further address this issue. If you need information now, call the ADA Disability and Business Technical Assistance Centers at +1 (800) 949–4232, which can help you understand your obligations under the ADA.
— William Ziefle, J.D., DAN president and CEO
© Alert Diver — Q3/Q4 2020