APTA President Sharon Dunn, PT, PhD (standing, left) and Vicki Tilley, PT, look on during a FUNfitness screening at the recent Special Olympics USA National Games. Tilley is co-global clinical advisor for the program.

Vicki Tilley, PT, and Donna Bainbridge, PT, ATC, EdD, wanted to make a difference in the lives of others by working with Special Olympics. Along the way, Special Olympics returned the favor.

"I have a different lens now," Tilley said. "Being able to engage, explore, and interact with the ID [intellectual disabilities] population in a way that's positive has changed the way I think about people in general, and about inclusion and access."

"My experiences with Special Olympics have shaped my entire career path in practice, research, and programming," Bainbridge added. "I have a better understanding of the health needs of individuals with ID, and what we as physical therapists can do to improve the lives and function of people with ID at all ages."

As Special Olympics celebrates its 50th year, Tilley and Bainbridge are marking their 19th year with the program, and their 18th with "Healthy Athletes," an initiative that brings health professionals and students from multiple disciplines to provide education, screenings, and other services to athletes. Both were instrumental in the creation of FUNfitness, the branch of Healthy Athletes responsible for screenings and education around balance, strength, flexibility, and aerobics fitness. FUNfitness is primarily performed by physical therapists (PTs), physical therapist assistants (PTAs), and students.

Officially, Tilley and Bainbridge serve as co-global clinical advisors for FUNfitness. Together, they help to guide not only the programs offered at every Special Olympics world and national event, but a worldwide outreach and education initiative that helps health care providers better understand the often-overlooked health needs of individuals with an intellectual disability. But both Tilley and Bainbridge are more than program managers—they're hands-on PTs who love being able to provide services at the games alongside other volunteers.

Over the summer, Tilley, Bainbridge, and a contingent of PTs, PTAs, and students brought their skills to the Special Olympics USA Games in Seattle, where they provided nearly 1,500 services to 761 athletes who visited the FUNfitness area of the Healthy Athletes program. Overall, Healthy Athletes provided 7,125 screenings to 1,762 athletes during the games. Physical therapy education programs that participated included those from the University of Washington, the University of Puget Sound, Pacific University, Touro University – Nevada, Eastern Washington University, and PIMA Medical Institute.

According to Bainbridge, the origins of the physical therapy profession's involvement with Special Olympics can be traced back to 1999. Back then, Bainbridge worked for APTA, serving as director of practice. The association saw an opportunity and seized it.

"The association's involvement with Special Olympics was and is a great fit that came at just the right time," Bainbridge said. "At the time, APTA was focused on changing the paradigm of the profession from just rehab and the medical model to health and wellness—our involvement with Special Olympics was one of our first steps in that direction."

Tilley's involvement came about the same year, when the world games came to her home state of North Carolina. Like APTA national, the North Carolina chapter of APTA saw an opportunity—to pilot the idea of providing a flexibility screen—and asked Tilley to help out. At first, Special Olympics organizers didn't quite understand the role that PTs and PTAs could play, Tilley said. "They understood the idea of an athletic trainer on the field to help with injury, but we had to show them that we could offer even more off the field to help with injuries and keep athletes injury-free," she explained.

After seeing the PTs and PTAs in action, Special Olympics didn't need much more convincing.

"After the games they liked it so much, when we met with Special Olympics about expanding to balance, strength, and cardiovascular fitness, they were on board," Tilley said.

Both FUNfitness and the larger Healthy Athletes program are helping to spread an important concept—that ongoing health matters.

"Healthy Athletes was in this nice little add-on space, in a sense," Tilley said. "It was originally thought of as add-on features—it wasn't something that coaches thought was really important. But then over time, the coaches began to connect the dots, and started to see that this isn't just a once-a-year thing, and that overall health is really important." Thanks to additional funding from the US Centers for Disease Control and Prevention, and subsequent donations from the Golisano Foundation, Special Olympics and the Healthy Athletes program is expanding efforts to promote community-based year-round health for individuals with ID around the globe.

"Special Olympics has also realized that the ultimate key to change lies in systems and policy change, so this has become a new focus," added Bainbridge. "We're now working with [the World Health Organization], [the Pan American Health Organization], and [the United Nations Educational, Scientific, and Cultural Organization] on efforts to expand services equitably to all."

Those efforts, both locally and globally, are at the heart of why, after years of more informal collaboration, APTA established a formal partnership with Special Olympics in 2017, according to APTA CEO Justin Moore, PT, DPT. This year, APTA established an even stronger presence at the games, with Moore, APTA President Sharon Dunn, PT, PhD, and the president of the APTA Sports Physical Therapy Section in attendance, along with the president and executive director of the Washington chapter of APTA.

Moore described the partnership as one that allows APTA to help live out its mission of building a community that advances the profession of physical therapy to improve the health of society. "What [Special Olympics is] doing in health care by trying to create a more equitable and inclusive health care system is truly incredible, and we are privileged to be in this partnership," Moore said in an interview. "What a great lasting legacy that Special Olympics is providing these athletes."

Particularly inspiring, Moore believes, is the way Special Olympics does its work through a strong commitment to collaboration. "It helps our profession understand—how do we work with dentists, podiatrists, dieticians, and others in collaborative ways and always put the athlete, the patient, first?" he said.

When it comes to collaboration, Tilley thinks that the physical therapy profession has much to offer other health care disciplines, if for no other reason than the variety of patients often seen by PTs and PTAs. "Dentists, optometrists, nutritionists, nurses…they don't necessarily get much exposure to people with ID," Tilley said. "For PTs, we learn how to work with different populations—it's just not as much of a reach for us."

"The importance of the contributions of PTs, PTAs, and students can't be overstated," Bainbridge said. "We could not stage FUNfitness in our US states without the help and support of these professionals—they are both our clinical directors and our volunteers, and nothing would happen without them."

But as Bainbridge points, out, it's not all about what PTs can do for Special Olympics—it's also about what Special Olympics does for the profession and for the person who volunteers.

"Involvement with Special Olympics is a critical value for physical therapy professionals," Bainbridge said. "It allows them to work with and find best ways of communicating with persons with cognitive impairment, a skill that will help them with many other types of patients as well. And it exposes them to a population that they might not usually see in their practices. Although we work with persons with developmental disabilities who might also have an intellectual disability, we much less frequently see those who only had ID unless they have another physical problem. So, this is a population that we do not see routinely, who obviously, from our data, have problems with fitness in all its components."

"Healthy Athletes and FUNfitness allow providers to see these athletes as part of the wider community," Tilley said. "They come to realize that individuals with ID are just people, with many of the same interests, challenges, and emotions they have—and that can have a big impact."

According to Tilley, that interaction and understanding can change entire outlooks. Thanks to her involvement with Special Olympics, Tilley explained, she now tends to look at any new physical therapy program, approach, or modality with an eye toward how it may or may not be able to be applied to the population of individuals with Id. Another impact is that she has made Special Olympics a part of her family: both her 18-year old daughter and 21-year-old son have been volunteering with Special Olympics for as long as they can remember. Tilley believes their participation has enriched her kids' lives immeasurably.

Bainbridge echoes Tilley's comments. "I have made so many wonderful relationships with athletes and their families and caregivers," she said. "Those relationships and experiences have contributed to who I am today, and have given me great understanding, patience, and a concern for equity that I bring to everything I do."