Introduction to Sport for People with Disabilities

Original Editor - Wanda van Niekerk based on the course by James Laskin

Top Contributors - Wanda van Niekerk and Jess Bell  

Introduction

One in five people lives with a disability. Physical activity, which may include sports participation, has significant benefits for everyone. However, people with disabilities are often at risk of not engaging or having low engagement in physical activity. Despite the barriers to sports participation, many athletes living with disabilities have experienced the benefits of sport and aim to reach the highest level of their sporting abilities.

Benefits of Sports Participation for People Living with Disabilities

Table 1. Experiences and perceived health benefits of participating in sport for people with a disability

Children and Adolescents	Adults	Elite Athletes
Opportunity to socialise and create a sense of belonging Team culture experience Cultivating friendships Increased physical and emotional wellbeing Ability to show off achievements and prove others wrong Creating a sense of pride Happiness and enjoyment Improved fitness, functionality and confidence	Experience camaraderie through being part of a team Equality and togetherness Breaking stereotypes and society-imposed limitations Manage stigma, defy expectations and challenge people's perceptions Provision of a sense of purpose and meaning Liberation in feeling free from impairment and not being restricted by perceived limitations Independence Empowerment Acceptance and adaptation of disability can be achieved through sports participation Improved fitness, functionality, strength and self-confidence	Support from teammates Creating strong interpersonal relationships Development and growth in dedication, mental toughness Funding opportunities Recognition Improved self-confidence Improved self-esteem

Barriers to Adaptive Sports Participation

Barriers to adaptive sports participation include:

• accessibility
• cost
• transportation
• variety of activities available
• dependency on others
• degree of impairment
• lack of energy
• lack of equipment
• pain
• comorbidities
• general health
• risk of injury
• lack of time
• lack of knowledge of opportunities
• lack of interest and/or motivation
• lack of social support
• inequity in financial support

Recreational and Non-Para Sports

The word “Paralympic“ derives from the Greek preposition “para“ (beside or alongside) and the word “Olympic“, meaning that Paralympics are parallel to the Olympics. Some examples of recreational and non-Paralympic sports include:

• wheelchair dance
• baseball
• ice-hockey
• watersports
• golf
• power football
• extreme or adventure sports

Paralympic sports are listed below.

Special Olympics

Mission:

• Provision of year-round sporting activities and athletic competitions in a variety of sports for people with intellectual disabilities
• Providing continuing opportunities to:
  • develop physical fitness
  • demonstrate courage
  • experience joy
• Participate in the sharing of gifts and friendships with their loved ones, other athletes and the community

Read more: Special Olympics

Paralympics

The Paralympics are the ultimate competition for world-class, elite athletes with physical disabilities. Athletes with disabilities should have opportunities to:

• pursue their goals
• dream of winning a gold medal
• commit to strenuous training regimes
• meet strict qualification standards
• exist in an environment of excellence and personal best performances

The four core values of the Paralympic movement are:

• Courage – “It encompasses the unique spirit of the Paralympic athlete who seeks to accomplish what the general public deems unexpected, but what the athlete knows as a truth.”
• Determination – “The manifestation of the idea that Paralympic athletes push their physical ability to the absolute limit.”
• Inspiration – “When intense and personal affection is begotten from the stories and accomplishments of Paralympic athletes, and the effect is applying this spirit to one's personal life.”
• Equality – “Paralympic Sport acts as an agent for change to break down social barriers of discrimination for persons with an impairment.”

Current Paralympic Sports

Currently there are 28 Paralympic sports (22 summer sports and 6 winter sports):

Table 2. Paralympic Sports

Summer Sports		Winter Sports
Para archery Para athletics Para badminton Blind football Boccia Para canoe Para cycling Para equestrian Goalball Para judo Para powerlifting	Para rowing Shooting Para sport Sitting volleyball Para swimming Para table tennis Para taekwondo Para triathlon Wheelchair basketball Wheelchair fencing Wheelchair rugby Wheelchair tennis	Para alpine skiing Para biathlon Para cross-country skiing Para ice hockey Para snowboard Wheelchair curling

Classification

Classification is an integral part of sport for people with disabilities. It provides structure to competition and ensures fair and equitable competition at all levels of sport. Specific criteria are established to ensure that winning is determined by skill, fitness, power, endurance, tactical ability and mental focus.

Read more: International Paralympic Committee Classification Code

How Does Classification Work?

Athlete evaluation focuses on three fundamental questions:

1. "Does the athlete have an eligible impairment for this sport?"
2. "Does the athlete's eligible impairment meet the minimum impairment criteria of the sport?"
3. "Which Sport Class should the athlete be allocated in based on the extent to which the athlete is able to execute the specific tasks and activities fundamental to the sport?"

The IPC athlete classification code supports and coordinates the development and implementation of "accurate, reliable, consistent and credible" classification systems in parasport.

Download the IPC Athlete Classification Code from here.

The International Standards provide technical and operational standards for specific aspects such as eligible impairments, athlete evaluation, protests and appeals, classifier personnel and training and classification data protection.

Find the International Standards in the IPC Handbook

Eligible Impairment Types

There are ten eligible impairment types in the Paralympic movement:

Table 3. Eligible impairment types and their description

Impairment Type	Description
Impaired muscle power	Athlete has a health condition that reduces/eliminates the ability to voluntarily contract muscles in order to move or generate force Examples of conditions: spinal cord injury, muscular dystrophy, post-polio syndrome, spina bifida
Impaired passive range of movement	Athlete has a restriction/lack of passive movement in one/more joints Examples of conditions: arthrogryposis, contractures from chronic joint immobilisation or trauma affecting a joint
Limb deficiency	Total or partial absence of bones or joints from trauma, illness or congenital limb deficiency Examples of conditions: traumatic amputation, amputation due to cancer, dysmelia
Leg length difference	Athletes with differences in the length of their legs Examples of conditions: disturbance of limb growth, trauma
Short stature	Athletes with reduced length in bones of the upper limbs, lower limbs and/or trunk Examples of conditions: achondroplasia, growth hormone dysfunction, osteogenesis imperfecta
Hypertonia	Athletes with an increase in muscle tension and reduced ability of a muscle to stretch due to damage to the central nervous system Examples of conditions: cerebral palsy, traumatic brain injury, stroke
Ataxia	Athletes with uncoordinated movements due to damage to the central nervous system Examples of conditions: cerebral palsy, traumatic brain injury, stroke, multiple sclerosis
Athetosis	Athletes have continuously slow involuntary movements Examples of conditions: cerebral palsy, traumatic brain injury, stroke
Vision impairment	Athletes have reduced or no vision due to damage to the eye structure, optic nerves or pathways or the visual cortex of the brain Examples of conditions: retinitis pigmentosa, diabetic retinopathy
Intellectual impairment	Athletes have a restriction in intellectual functioning and adaptive behaviour which affects conceptual, social and practical skills necessary for everyday life. Intellectual impairment must be present before the age of 18.

More information on Classification by Sports and Classification

Examples of classification classes for people with and without disabilities are shown in Table 5.

Table 5. Examples of classification classes for people with and without disabilities

Sport for people without disabilities	Sport for people with disabilities
Weight Biological sex Age	Weight Biological sex Age Type of disability Functional mobility Mixed

Members of the Classification Team

• Medical
  • Physician
  • Physiotherapist
  • Occupational therapist

• Sport Technical
  • Coach
  • Official
  • Former athlete

Main Organisations

• International Paralympic Committee (IPC)
• International Committee of Sports for the Deaf (CISS)
• International Blind Sports Federation
• World Abilitysport (The International Wheelchair and Amputee Sports Federation (IWAS) and the Cerebral Palsy International Sports and Recreation Association (CPISRA) joined forces)
• Virtus: World Intellectual Impairment Sport (Previously the International sport federation for persons with intellectual disability)
• Special Olympics International

Doping and Cheating in Paralympic Sport

Adaptive sports provide a platform for athletes with disabilities to perform at the highest level. With this, there is the added benefit of financial gain through winnings and sponsorships, leading to a more competitive environment and athletes wanting to achieve the highest levels of performance and skills. Similar to sport for people without disabilities, this improvement in performance is not always achieved ethically. Some methods used by athletes with disabilities are:

• doping by taking prohibited substances
• boosting - a special form of doping specific to athletes with spinal cord injury
• techno-doping - the use of advanced adaptive technology or equipment

Another method is cheating on classification and athletes feel strongly that this issue should be handled as a serious issue in integrity in sport.

Research on Classification

The IPC developed a conceptual framework for evidence-based classification. Read this position statement here: International Paralympic Committee position stand—background and scientific principles of classification in Paralympic sport. In this position stand, it is stated that each sport should develop its own classification system based on evidence. The empirical evidence needs to show the link or association between impairment and performance in that specific sport.

A five-step process has been proposed to describe the research needed to develop an evidence-based classification system in Para sports. These five steps are:

1. Identify the sport and eligible impairment types
2. Develop a theoretical model to identify the determinants of performance in a specific sport
3. Develop ways to measure impairment and determinants of performance in a specific sport
4. Use the tests designed and developed in step 3 to assess the relationship between impairment and performance in a specific sport
5. Develop a minimum impact criteria and class profiles for each sport

In addition, a translational phase is key wherein the implementation of a new classification system is being addressed and a monitoring phase wherein periodic monitoring of the classification system is necessary to evaluate if change is necessary or not. This conceptual framework for Paralympic classification should aim to:

• be consistent with the taxonomy and terminology of the International Classification of Functioning, Disability and Health (ICF)
• be based on scientific evidence
• define eligible impairment types by sport
• define the minimum impairment criteria
• classify impairments according to the extent of activity limitation caused

Read more: Classification Research and Research needs for the development of evidence-based systems of classification for physical, vision, and intellectual impairments (Chapter 7) in Training and Coaching the Paralympic Athlete

Articles on classification discussed by Dr. James Laskin in the course video:

• Game efficiency of wheelchair rugby athletes at the 2008 Paralympic Games with regard to player classification.
• Relationship between functional classification levels and anaerobic performance of wheelchair basketball athletes.