Enhanced Physical and Mental Function and Promotion of Social Participation in a Cerebral Palsy Patient Through Participation in Para-Jujutsu

While sports participation for individuals with disabilities is promoted by the Basic Act on Sport and policies for the promotion of parasports, the actual participation rate remains low (32.8% for individuals with disabilities compared to 52.5% for able-bodied individuals), and many challenges exist in continuing competitive sports. While international reports highlight the physical and mental benefits of Jujutsu participation for individuals with disabilities, there are few practical reports on this topic in Japan. This report aims to elucidate, from an occupational therapy perspective, the changes in physical function and quality of life (QOL) experienced by an adult male with cerebral palsy-induced motor paralysis who continuously engaged in Brazilian Jujutsu (BJJ), a combat sport. The subject was a right-handed male in his 30s with motor paralysis in his left upper and lower limbs due to cerebral palsy. He had prior experience in disabled professional wrestling and Judo from age 17, and began BJJ at age 22. We collected initial assessment data (Fugl-Meyer Assessment, Modified Ashworth Scale, range of motion, etc.) and qualitative data based on his narratives, documenting changes gained through BJJ practice and competition participation. During BJJ training, he received technical guidance tailored to his disability characteristics and diligently practiced with an occupational therapist, confirming body movements and techniques. His narratives revealed increased intrinsic motivation, stating things like, "It became easier to move by devising ways to use my left hand and foot", and "I started wanting to compete in matches". Twenty years after starting sports, in addition to improvements in physical function (Fugl-Meyer Assessment (FMA) upper extremity 20 points → 59 points, lower extremity 27 points → 47 points, increased range of motion (ROM), and reduced Modified Ashworth Scale (MAS)), the patient experienced an enhanced sense of fulfillment in life due to interpersonal interaction and a sense of achievement in competition. Furthermore, he competed not only in para-jujutsu but also in able-bodied divisions, progressing to the point of winning against able-bodied opponents in the purple belt category. This suggests that the benefits extended beyond mere physical improvement, contributing to the acquisition of psychological fulfillment, such as enhanced self-esteem and the formation of social connections. This case suggests the potential for multifaceted physical, psychological, and social benefits when individuals with disabilities proactively engage in combat sports like BJJ. Moreover, the style of support provided by an occupational therapist who actively participates in the sport alongside the individual is considered effective as a practice that goes beyond mere exercise instruction, closely aligning with the individual's life and values. Moving forward, it is necessary to accumulate more diverse case studies and research on the potential of disabled sports, including combat sports like Jujutsu, and explore how health support can contribute to the independence and social participation of people with disabilities.