Measures of impairment applicable to classification of athletes competing in wheelchair sports.

Introduction:

A fundamental aspect of classification systems in Paralympic sport is having valid and reliable measures of impairment.

Each Paralympic sport requires its own classification system, which groups athletes according to the level that their impairment impacts on performance in that particular sport. This is to ensure that characteristics such as talent, volume and quality of training, and psychological factors are the determinants of success in Paralympic sport, rather than severity of impairment. However, minimal consensus exists for assessing impaired strength, coordination, and range of motion.

Study aim:

1) To systematically identify methods for assessing upper body (including trunk) strength, coordination and ROM impairment that could be used for the development of evidence-based classification systems in wheelchair sports (primary)

2) To investigate, for each identified method, the validity for it to measure impairment, the test-retest reliability and the association between impairment and sports performance (secondary).

Methods:

Three electronic databases were searched from 2003 until 31 August 2019 for studies that assessed upper body function of participants and used a measurement tool that assessed strength, coordination, or range of motion.

The body of evidence for each identified measure was appraised using the Grading of Recommendations Assessment, Development and Evaluation framework.

Twenty-three studies were included: ten measured strength and coordination, and six measured range of motion.

Main findings:

• There was “moderate” confidence in using isometric strength for assessing strength impairment.
• Tapping tasks for the assessment of coordination impairment received a “low” confidence rating.
• All other identified measures of coordination and range of motion impairment received a “very low” confidence rating.
• Several potential measures were identified for assessing upper body strength, coordination, and range of motion impairments.
• Further research is warranted to investigate their use for classification in Paralympic wheelchair sports.

Reference:

Hutchinson MJ, Phillips JK, Mason BS, Goosey-Tolfrey VL, Beckman EM. Measures of impairment applicable to the classification of Paralympic athletes competing in wheelchair sports: A systematic review of validity, reliability and associations with performance. J Sports Sci. 2021 Aug;39(sup1):40-61. DOI: 10.1080/02640414.2020.1815957. Epub 2020 Sep 10. PMID: 32912039.

Image credit: © Paralympics GB