Shortly prior to Budrio festival, David Ramos of Ocabanda had an electric bike accident and broke / injured his arm. One of his arms was in a sling at the festival.
He was performing with Ocabanda by holding the ocarina at about navel level on his body, with the instrument oriented vertically, and was blowing it using a melodica tube, and a modified 'mr mute' to attach the tube to the mouthpiece.
I found this very impressive and inspiring that he was able to work around his injury and continue to participate in the septet, with no apparent impact on the musicality of his performance.
I can see this having wider applicability, as there are people who are unable to lift their arms into 'standard' playing position due to artificial shoulder joints that do not permit full range of motion. There is someone i know near Chepstow who isn't able to play ocarina for this reason.
The idea of playing ocarina with a tube may also be an ergonomic win for able bodied players as well, because it allows the instrument to be placed on a table or a stand. The ergonomic challenge of two thumb holes would be eliminated entirely were the instrument externally supported and moved away from the players face.
I'd like to open a discussion about adapting ocarinas to disabilities as a general topic, beyond just playing with a tube. In sone respects this instrument is uniquely suited to this because the finger holes can be placed anywhere.
Another player I'm aware of having adapted an ocarina to be playable with injury is Ostign Haga (spelling?), who lost fingers due to an accident, and developed a double ocarina playable with only one hand.