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Disability Sports:From Rehabilitation to Paralympics – the Evolving Nature of Classification Systems
A/Prof Jagdish MaharajDSM, DCH, MPH, MMed, FAFRM (RACP) Hon, PhD
Head of Classification, IPC Sports Technical CommitteeIPC International Classifier for Athletics and Shooting
Treasurer, Oceania Paralympic CommitteeFounding President, Fiji Paralympic Committee
•Stoke Mandeville Spinal Injury Rehabilitation
•Beginnings of Paralympic Movement
•Evolution of Classification in Paralympics•Medical Classification• Functional Classification• Sport specific Classification
•Classification research
•Future of Paralympic Classification
Overview
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Historical Profile
www.thelancet.com/neurology Published online September 7, 2016 http://dx.doi.org/10.1016/S1474-4422(16)30228-9
“a great believer in the power of sport and competitionin physical, psychological and social rehabilitation”
“a Neurologist, Spinal injury rehabilitation specialistand founding father of Paralympic Movement”
‘From Spinal Injury to the Paralympics’
AFRM e-Bulletin 23 September 2016
https://www.racp.edu.au/news-and-events/newsletters-and-communiques/afrm-e-bulletin/afrm-e-bulletin-23-september-2016
“1943 Guttmann was invited by British Government to set up spinal injuries unit at Stoke Mandeville Hospital”
1948 Wheelchair Games
On 28th July, the day of the opening of Summer London Olympics Dr Guttmann hosted sports competition for British WWII SCI veterans
1952 Dutch veterans joined in alongside the British, making it the first internationalcompetition of its kind
1960 First ‘Paralympic Games’ in Rome
• 23 countries and 400 athletes
History of Paralympic Games
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Chronology of EventsYear Event
1944Dr Ludwig Guttmann established Spinal Injuries Centre at Stoke Mandeville Hospital
1948
On 29 July, the day of the Opening Ceremony of the London 1948 Olympic Games, Dr Ludwig
Guttmann organised the first competition for 16 ex-servicemen and women wheelchair
archery, which he named the Stoke Mandeville Games
1952
Dutch ex-servicemen compete against British athletes in England and this led to the
establishment of the International Stoke Mandeville Games
1955International Committee of Sports for the Deaf (CISS) officially recognized by the IOC
1960
18 – 25 September - Rome Summer Paralympics - 400 athletes from 23 countries ; 57 events in
8 sports. These Games became known as the 1st Summer Paralympic Games and were the 9th
International Stoke Mandeville Games - followed the Rome Olympics and used same venues
1960International Stoke Mandeville Games Committee (ISMGC) established
1989 International Paralympic Committee (IPC) established
•1964 - International Sports Organization for the Disabled (ISOD)
•1982 - International Coordinating Committee of World Sports Organizations for the Disabled (ICC)
• ICC IOC cooperation 1988 Seoul Paralympics
•1989 - International Paralympic Committee (IPC)
- Global governing body of the Paralympic
Movement with Headquarters in Bonn
Forerunners of IPC
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• IWAS was formed in 2005 by a merger of the International Stoke Mandeville Wheelchair Sports Federation (ISMWSF) (which was formerly known as the International Stoke Mandeville Games Federation (ISMGF) and the International Sports Federation of the Disabled (ISOD). ISOD had been founded by the International War Veterans Association in 1964
IWAS (2005) = ISMWSF (ISMGF) (1952) + ISOD (1964)
Four International Sports Organisations for the Disabled
Medical Classification – beginning to 1980s
Consisted of –
Medical evaluation and diagnosis of impairment
As an example - low spinal cord injury and double
above knee amputee with similar activity limitation
will compete in different ‘medical’ classes
When views on disabled (patient)/athlete shifted from
a form of rehabilitation the classification system
changed from medical diagnosis to functional ability
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•Amputee
•Cerebral Palsy
•Intellectual Disability
•Wheelchair
•Visually Impaired
•Les Autres (Others)
Medical Classification- six disability groups
Classification in sports
•Paralympic Sports aims to minimise the impact of impairment on outcome of competition
•Classification groups different types and severity of impairments to allow for comparable competition
•Classification to minimise the impact characteristics such as body weight, gender & age have on outcome of competition exists in many sports
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Medical-Based Classification System
Functional Classification Systems
Evidence-Based and Sport-Specific Systems
1948 1988 1992 2003
Classification Strategy
2007 2015
Tweedy, Vanlandewijck (2011), Hart (2014), IPC (2015c), Reina (2016)
Evolution of Paralympic Games & Classification
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•Archery •Athletics • Boccia • Equestrian • Football 5-a-side • Football 7-a-side •Goalball • Judo • Para-Canoe • Para-Cycling• Para-Triathlon • Powerlifting• Rowing• Sailing
• Shooting
• Sitting Volleyball
• Swimming
• Para-Table Tennis
•Wheelchair basketball
•Wheelchair Dance
•Wheelchair Fencing
•Wheelchair Rugby
•Wheelchair Tennis
23 Summer & 5 Winter Paralympic Sports
• Alpine Skiing
• Biathlon
• Cross-Country Skiing
• Ice Sledge Hockey
• Wheelchair Curling
•Archery •Athletics • Boccia • Equestrian • Football 5-a-side • Football 7-a-side •Goalball • Judo • Para-Canoe • Para-Cycling• Para-Triathlon • Powerlifting• Rowing• Sailing
• Shooting
• Sitting Volleyball
• Swimming
• Para-Table Tennis
•Wheelchair basketball
•Wheelchair Dance
•Wheelchair Fencing
•Wheelchair Rugby
•Wheelchair Tennis
Tokyo 2020 - 22 Summer Paralympic Sports
• Badminton• Para-Taekwondo
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IPC Athlete Classification Code
•New version published in 2015
• Core document for Athlete Classification
• Sets International Standards to be adhered to by IPC, IFs,
NPCs, NFs, LOCs, athletes, coaches and officials.
•Guidelines for all classification processes for all IPC Sports
• Sets timelines for competition organisers
•Outlines responsibilities for all levels of the IPC family
Classification Code
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1. Impaired muscle power
2. Impaired passive range of movement
3. Limb deficiency
4. Leg length difference
5. Short stature
6. Hypertonia
7. Ataxia
8. Athetosis
9. Visual impairment
10. Intellectual impairment
Ten Eligible Impairments for IPC Sports
•Medical Model• Bench Testing
• Manual Muscle Testing
• Joint ROM
• Amputation
• Limb Length
• Impairment
• Vision Impaired
Classification systems process
Sport Functional
Model
Observation of
athlete in training
Looks at specific
sport functions
E.g. W/Basketball
Hybrid Bench Test
Functional sports specific observation
E.g.
Athletics, Shooting, Swimming, Wheelchair Rugby, etc.
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1. Does the athlete have an eligible impairment for this sport?
2. Does the athlete’s eligible impairment meet the minimum impairment criteria (MIC) of the sport?
3. Which sport class describes the athlete’s activity limitation most accurately?
NE, CNC, R or FRD (Review), (C) Confirmed
Three steps of Classification
• Archery – W1-2
• Athletics – T/F11-13, T/F20, T/F32-38,
T/F40-41, T/F42-47, T51-54, F51-57, T/F61-64 (new)
• Boccia – BC1-4
• Paracanoe – KL1-3
• Cycling – H1-5, T1-2, bicycle – C1-5, TB
• Equestrian – Ia, Ib, II, III, IV
• Football 5-a-side – B1
• Football 7-a-side – FT5-8
• Goalball – B1-3
• Judo – B1-3
• Sailing – Sport class 1-7
• Shooting – SH1, SH2, SG-U, SG-L, SG-S, (SHVI)
Paralympic Summer Sports Classes
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Scientific background
10.2 Classification Research
10.2.1 International Sport Federations must develop sports-specific Classification Systems through multidisciplinary scientific research. Such research must be evidence-based and focus on the relationship between Impairment and key performance determinants. Athlete input must be solicited to assist in research and improvement in Classification Systems.
10.2.2 Classification research must comply with internationally recognised ethical standards and research practices.
Evidence-based Classification
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In January 2013 the IPC Governing Board approved the
concept of Classification Research & Development Centres,
which aims ”to develop methods of evidence-based
classification systems through a strategic long-term research
and development program that will guide the sport-specific
classification procedures for sports on the Paralympic Games
programme, and to develop assessment tools and methods”
IPC Classification Research
IPC signed agreements with three universities that became
official IPC Classification Research & Development Centres
University of Queensland (Brisbane, Australia)
Catholic University of Leuven (Belgium)
Free University of Amsterdam (Netherlands)
IPC Classification Research Centres
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Classification Research
Evidence Based Classification
Current research at University of Queensland
Standardized objective measurements
London to Rio to Tokyo
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•Current Classes SH1 & SH2
•Participate in Pistol & Rifle events
Classifications under development • Clay Target Para Trap introduced 2017
Classes SG-U, SG-L, SG-S for review in 2 years
• Visual Impaired Shooting Classification – coming soon
IPC Para Shooting Sport
Assessment of a “Classification Model”
for Athletes with motor impairment competing in
Clay Target Shooting (CTS)
Project Index & Outcome:
1. Background of Para CTS
2. Literature review of physiology and biomechanics of shooting sports
3. 3D Kinematics analysis of 5 able-bodied
4. Motor impairment score and performance score
5. Proposal of classification model
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VI Shooting Classification Research
Medical-Based Classification System
Functional Classification Systems
Evidence-Based and Sport-Specific Systems
1948 1988 1992 2003
Classification Strategy
2007 2015
Evolution of Paralympic Games & Classification
2018
Future of Classification
IF & NPC meeting July 2018
IPC Membership Gathering & IPC Governing Board
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Rapid pace of development in technology, training methods and medical advances
• Harmonisation of Classification• Classifier education• Code interpretation & compliance• Resources
• Optimization of athlete evaluation• Bring classification to athletes
• How, where, when and by whom• Creating the right environment
• Accessible to general public
Future of Classification
Must be -
sport specific evidence-based
Must have -
objective measurement methods
Should it be conducted during competition as now?
or
Should it be ‘laboratory’ based out of competition?
Within Universities / institutions?
Thank you