The history of disabled people participating in sport is closely allied with modern thoughts and techniques of rehabilitation and recovery from injury. In the 1940’s one of the earliest pioneers of disabled sports, Sir Ludwig Guttmann, observed that the enjoyment and motivation of competition could drive much better levels of achievement and recovery than just hours of working away in a physio gym.
Swimming has always been a useful adjunct to rehabilitation and physiotherapy. Early swimming races were one of the first sports in which participants were able to compete against others of similar impairment and succeed due to training or technique. Gradually basketball, handball and table tennis became the main sports of the ‘Disability Games’ (later the Stoke Mandeville Games and in 1988 the Paralympics).
In the 1950s, questions it was suggested that “consideration must be given to whether it would not be fairer to divide sports into classes,” to ensure equal competition opportunities for – at that time – athletes with higher and lower spinal cord lesions.
The huge growth in the participation in all manner of sports by disabled people has meant that as competitions have grown and become more fiercely contested, it has become necessary to classify competitors according to their ability or impairment in an attempt to make competition fair. In the 1980s, supported by the demands from Games organising committees to reduce the number of sports classes, classification transitioned from medical to functional classification.
Functional classification is sport-specific because any given impairment may have a significant impact in one sport and a relatively minor impact in another. For example, the impact of a below-elbow amputee in swimming is far greater than in running.
All athletes with a disability who intend to compete at a national or international level must produce a certificate stating their medical diagnosis. Their impairment is then assessed by a trained classifier, often a physiotherapist, and classified into a grading system.
The Meaden system of classification has been used since 1992. Developed by UK physiotherapist Dr. Chris Meaden, it was originally for use in dressage but has since rolled out to triathlon, athletics, sailing, and some other sports (basketball and tennis have their own system). Swimming has a very similar system developed by Birgitte Blomquist.
The International Paralympic Committee has established ten disability categories, including physical, visual, and intellectual impairment. Athletes with one of these disabilities can compete in the Paralympics though not every sport can allow for every disability category. Visual impairment and intellectual disability account for two categories whilst the eight different types of physical impairment include:
- Impaired muscle power – The force generated by muscles, such as the muscles of one limb, one side of the body or the lower half of the body is reduced, (e.g. spinal cord injury, spina bifida, post-polio syndrome).
- Impaired passive range of movement – Movement in one or more joints is reduced in a systematic way. Acute conditions such as arthritis are not included.
- Loss of limb or limb deficiency – A total or partial absence of bones or joints from partial or total loss due to illness, trauma, or congenital limb deficiency, e.g. dysmelia.
- Leg-length difference – Significant bone shortening occurs in one leg due to congenital deficiency or trauma.
- Short stature – Standing height is reduced due to shortened legs, arms and trunk, which are due to a musculoskeletal deficit of bone or cartilage structures, e.g. achondroplasia, growth hormone deficiency, osteogenesis imperfecta.
- Hypertonia – An abnormal increase in muscle tension and reduced ability of a muscle to stretch. Hypertonia may result from injury, disease, or conditions which involve damage to the central nervous system, e.g. cerebral palsy.
- Ataxia – An impairment that consists of a lack of coordination of muscle movements, e.g., cerebral palsy, Friedreich’s ataxia, multiple sclerosis.
- Athetosis – Characterized by unbalanced, involuntary movements and a difficulty maintaining a symmetrical posture, e.g. cerebral palsy, choreoathetosis.
The second element is to determine the athlete’s class within the sport. Sports such as swimming have developed a functional classification system, whereby every eligible athlete with a physical impairment is classified into one of ten classes (S1 to S10). This is based on the limitation their level of impairment places on their capacity to swim. This means that athletes with a spinal cord injury can swim in the same race as athletes with cerebral palsy or limb deficiencies.
Inevitably there is a range of impairment within a single classification class and it is an advantage for any athlete to be among the less impaired athletes in the same class.
In team sports like wheelchair basketball athletes are classified according to their level of impairment within the wheelchair and given a point rating. Players with the least impairment receive the most points (4.5) and the most impaired players are low pointers (down to 1.0). To prevent the game from being completely dominated by the high pointers, a team is limited to a total of 14 points on the court at any time.
Wheelchair rugby has a similar system, with points ranging from 0.5 to 3.5 and a maximum of 8 points across the four players on the court. The high pointers are the glamour players, but everyone has their role on the court.
References:
Explainer: How the paralympics classification system keeps things fair. The Conversation, September 6, 2016. Accessed online at https://theconversation.com/explainer-how-the-paralympics-classification-system-keeps-things-fair-64826 on 27 August 2021.
Leigh, J. 2012. Disability sport and the paralympics: The physiotherapists role in ensuring fair competition. Morecambe Bay Medical Journal, 6(8), 222 – 224.
International Paralympic Committee. History of Classification. Accessed online at https://www.paralympic.org/classification/history on 27 August 2021.
