Advancing Paralympic Classification Through Science
The Paralympic games is organised by the International Paralympic Committee (IPC) and is the 3rd largest sporting event in the world after the Olympic Games and the FIFA World Cup. At the elite level of Paralympic sport, it is sometimes perceived that classification can play a major role in deciding the medals. With Paralympic athletes receiving increasing international recognition and commercial sponsorship, it is becoming more important than ever that classification decisions are defensible and based on sound evidence. In the lead up to the 2016 Rio Paralympic Games, this article will provide coaches with 1) an explanation of the vital importance of classification in Paralympic sport and an overview of the current classification methods, 2) an indication of the IPC’s commitment to classification research programs and strategies for improving classification systems, and 3) information on the role that coaches can play.
WHY IS CLASSIFICATION SO IMPORTANT TO COMPETITION OUTCOMES?
Classification systems are not unique to Paralympic sport. In fact, they are central to most modern sports. Combat sports classify variables such as body mass, sex and age, and athletics events classify age and sex. In Paralympic classification, the variable of interest is impairment. Sport classification systems increase the prospect of close competition which in turn increases the motivation to participate. Therefore, when a valid classification system is introduced, it will lead to a tangible increase in sport participation. For example, in rowing, the competitiveness of lightweight rowers is limited against rowers with greater body mass. Hence the introduction of lightweight rowing classes now provides opportunities for people who have a relatively lower body mass to participate at all levels of competition, thereby increasing participation in rowing among a group of people who would otherwise not be competing. Other sport classification systems operate in a similar way, including Paralympic classification.
22 Paralympic sports will be represented at this year’s Rio Games. Each sport’s classification system provides a structure for competition by 1) defining who is eligible to participate, and 2) defining the classes in which eligible athletes compete. Paralympic classification systems promote participation in sport by people with disabilities, by offering competitions that control for the impact of impairment on the outcome of competition.
Without classification, athletes who have impairments that negatively affect sport performance would be competitively disadvantaged in sporting competitions against their non-disabled counterparts. In addition, athletes with more severe impairments would be competitively disadvantaged against athletes with less severe impairments. Classification systems that adequately control for the impact that impairment has on the execution of sport skills will ensure that the athletes who win the medals will be those who are the most talented and best trained. Athletes will not succeed just because their impairments cause less difficulty in sport than the impairments of their competitors.
CURRENT SYSTEMS OF CLASSIFICATION
There are 8 physical impairment types that are eligible in Paralympic sport – impaired muscle strength, impaired range of movement, hypertonia, athetosis, ataxia, limb deficiency, leg length difference and short stature. In addition to these physical impairments, Paralympic sport provides competitions for athletes with visual and intellectual impairments. For the purposes of this article we will consider only the physical impairments.
Current methods for classifying physical impairments are conducted by a classification panel, comprising a medical classifier (a doctor or physiotherapist) and a sports technician (i.e. a sport scientist). They obtain a detailed sports training history via interview, assess relevant impairments (e.g. impaired strength and range of movement etc.) and evaluate the athlete’s ability to perform novel and sport-specific activities. The classifiers then amalgamate this information and use their combined clinical expert opinion to match the athlete profile to one of the class profiles which are described in the classification rules for each sport.
WHAT ARE THE LIMITATIONS OF CURRENT SYSTEMS OF CLASSIFICATION?
Current classification systems represent the best way to classify physical impairments – they are considered to be better than the previous system which was based on medical diagnosis – and are based on expert assessment of the key areas required for valid classification (i.e. impairment severity, type and location, the impact on sports activity and the training status of the athlete).
However, one of the most important limitations of the current system is that there is very little scientific evidence to support their use. Furthermore, because the decision-making process is inherently subjective, there is no scientific way to objectively evaluate classification decisions. This is often not a problem because when an athlete’s impairment profile matches one of the class profiles correct decisions are relatively easy.
However, there are many situations where decision-making is more difficult. Consider for example, the sport of wheelchair track racing. Athletes with impaired muscle strength compete in one of four classes from T51 containing athletes with the most severe impairments to T54 containing athletes with the least severe impairments. A hypothetical wheelchair track athlete with an incomplete spinal cord injury who has partial trunk function and partial arm function could be allocated to a number of classes because the athlete would have less arm strength compared to the T53 and T54 profiles but more trunk strength than T51, T52 and T53 profiles. Because the athlete profile does not directly fit a class profile, the decision becomes nuanced.
To classify these athletes, the classifiers must decide, “to what extent does the advantage of increased trunk strength outweigh the disadvantage caused by lower arm strength?” and determine the most appropriate class. This decision-making is the basis of current Paralympic classification systems. Since there is no scientific evidence on which to base such decisions, the problem is currently resolved by relying on the experience and judgment of the classifiers – the decision is inherently subjective. While there is no doubting the integrity or expertise of Paralympic classifiers, there is no objective way of assessing the validity of these decisions and inevitably this will sometimes lead to the perception that a given athlete is either at a competitive advantage or disadvantage compared to others in their class.
In the case of the hypothetical athlete with an incomplete spinal cord injury, impaired arm strength might be perceived as a disadvantage if they are allocated to the T54 and T53 classes, but because the athlete has some trunk strength they might be perceived to have an advantage in the T52 class. The IPC realises that these are critical issues and to address the limitations of current classification systems, the IPC mandated the development of evidence-based classification systems in the 2007 and the recently updated Classification Codes.
WHAT ARE EVIDENCE-BASED PARALYMPIC CLASSIFICATION SYSTEMS?
The advance towards evidence-based systems represents an important shift in the evolution of Paralympic classification systems. Evidence-based systems will ensure that, as far as possible, classification decisions have a sound scientific basis, increasing the precision of measurements and the objectivity of decisions. This will reduce (but not completely eliminate) reliance on personal opinion and increase the transparency of decision-making. Evidence-based classification will provide stakeholders in the Paralympic Movement with the best possible guarantee that the athletes who win the medals will be those who are the most talented, determined and well trained rather than those who are the least impaired.
THE IPC CLASSIFICATION RESEARCH AND DEVELOPMENT CENTRES
In 2013, after the IPC mandated the development of evidence-based classification and the conceptual model for how to develop evidence-based systems was introduced in the IPC Position Stand on Classification, the IPC opened three international centres for Paralympic classification research and development. One for physical impairment, one for visual impairment and one for intellectual impairment. The remit of the centres is to translate the theory of evidence-based classification into practice by taking a lead role in the development of evidence-based systems.
The centres are based at The University of Queensland (physical impairments), the University of Leuven, Belgium (intellectual impairments), and Vrije University Amsterdam, The Netherlands (visual impairments). While the centres are based in 3 countries, all of the centres collaborate with organisations and universities internationally. For example, our research centre in Australia has collaborated with organisations and researchers from universities in Africa, the Middle East, Europe, North America and Asia. Furthermore, elite and novice athletes from across the world have participated in our research.
WHAT RESEARCH IS REQUIRED TO DEVELOP EVIDENCE-BASED CLASSIFICATION SYSTEMS?
There are five fundamental steps to develop evidence-based classification systems:
- Step 1 involves identification of the sport and the impairment type(s) that research will focus on.
- Step 2 requires identification of the performance determinants in the selected sport. This is an important step because the outcomes will help to determine the muscle actions that must be evaluated in Step 3.
- Step 3 is concerned with developing objective and precise measures that reliably evaluate the impairments of strength, range of movement and coordination that are likely to affect sport performance. In addition, Step 3 involves developing measures to evaluate the determinants of sport performance. For example, because the effects of impairment on acceleration and top speed in sprinting might differ, the effect of impairment on these activities should be evaluated separately.
- Step 4 involves validating the impairment measures identified in Step 3. In order to validate the measures, a sample of athletes from a given sport performs the impairment and performance measures developed in Step 3. Statistically it is then possible to quantify the effect that different levels of impairment severity have on sport performance. For example, a valid impairment measure will permit a comparison of the relative effects of severe and mild arm strength impairments on accelerating a wheelchair.
- Finally, Step 5 uses outcomes from Step 4 to inform development of a scientific method for setting the minimum impairment criteria, the number of sport classes, as well as methods for allocating athletes to classes based on how much their impairment is likely to affect performance in the sport of interest.
These new systems of classification will provide a valid and reliable way of achieving the aim of classification – to minimise the impact of an eligible impairment on the outcome of competition – and will make classification decisions more defensible, objective and transparent. There are two further classification issues that are of importance to athletes and coaches which can be addressed through scientific research. First, in the current system many athletes and coaches are concerned about the possibility that high-levels of prolonged training will place the athlete in a class for athletes with less severe impairments. The perception is that this would constitute a competitive disadvantage. Secondly, there is concern that some currently competing athletes intentionally exaggerate their impairments in order to deliberately obtain a more favourable class. This is a form of cheating called intentional misrepresentation which can carry a 2-year ban from competing in IPC events.
Overcoming these issues is critical to the long-term success of any classification system. While the current system has processes and procedures to address these issues, improvements can be made by applying the scientific method to physiological and biomechanical principles which permits investigations into finding more objective solutions to these important issues. Our centre has several ongoing research projects that aim to develop defensible and robust methods to address these important challenges in classification.
COACHING, CLASSIFICATION AND RESEARCH
As key stakeholders in the Paralympic movement, it is important that coaches stay up-to-date on the latest developments in classification. A coach’s understanding of classification is important to the athlete for appropriate goal setting, interpreting qualifying times and for talent identification because these are all contextualised by the classification of the athlete. Furthermore, coaches who understand classification are well placed to assist athletes to choose a sport and classification system that suits their impairment profile.
Coaches can contribute to the integrity of classification in several ways. They can familiarise themselves with the testing procedures to ensure that the athletes understand the task requirements and to ensure that the athlete performs tests to their full capacity. In addition, coaches are in an ideal position to encourage athletes to take part in scientific research developing evidence-based classification systems that will benefit the whole Paralympic Movement.
Mark Connick, Ph.D BIO
Mark completed his PhD in Sport and Exercise Sciences at The University of Birmingham, England, and joined the School of Human Movement and Nutrition Sciences at the University of Queensland in 2009. Currently Mark is a Postdoctoral Research Officer in the IPC Classification Research and Development Centre which is located in the School of Human Movement and Nutrition Sciences at the University of Queensland. Mark’s primary research interest is the development and evaluation of evidence-based classification systems in Paralympic sport. Mark’s other research interest is the biomechanics of running and cycling including factors that are associated with performance and injury.
Emma Beckman, Ph.D BIO
Emma has a Bachelors degree in Human Movement Studies (Exercise Science) and an Erasmus Mundus Masters degree in Adapted physical activity from Katholieke Universiteit of Leuven, Belgium. Continuing with her interest in Disability sport, Emma returned to the University of Queensland to complete her PhD in classification in Paralympic Athletics. She is an internationally accredited classifier in Paralympic athletics. Emma’s research interests relate to the development of evidence-based classification in Paralympic sport, primarily athletics. Specifically Emma is working to develop assessment methods that can be used to classify the degree to which an athlete’s impairment impacts on their athletic performance.
Sean Tweedy, B.H.M.S, M.H.M.S., Ph.D BIO
Sean Tweedy has held the MAIC Research Fellowship in Physical Activity and Disability in the School of Human Movement Studies, University of Queensland since 1997. He conducts a teaching, research and community service program in adapted physical activity. One of Sean’s primary research interests is classification in Paralympic sport and he works with the International Paralympic Committee (IPC) in a number of capacities: as Principal Investigator for the UQ-IPC Paralympic Classification Research Partnership for Physical Impairments; as a Classification Educator for IPC Athletics; and a member of the IPC Classification Committee. Sean’s other research interest is in promotion of physically active behaviour among community-dwelling people with disabilities.
All authors of this article write in a personal capacity and not on behalf of any organisation/s. Sean Tweedy, Mark Connick and Emma Beckman are members of the IPC Classification Research and Development Centre (physical impairments). Sean Tweedy is also appointed to the IPC Classification Committee and the IPC Athletics Classification Advisory Group.
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