Around the concept of classification in para sport: Involvement of physical and rehabilitation medecine (close-up on athletics)

Abstract

The Para-sport Movement aims to offset the restriction of sport participation by offering fair competition and rules. As such, the classification process is fundamental and unavoidable. It determines who can compete. Following the International Classification of Functioning Disability and Health, classification groups athletes with similar activity limitations in classes depending on how their impairments impact their ability to produce the core activities in each sport. Ten physical, sensory, or intellectual impairments, are recognised and minimum impairment criteria are defined. Certain diseases or health conditions are excluded. (Ehlers Danlos, conversion disorders, fibromyalgia, pain…). Physical impairments taken into consideration are reduced muscle power, reduced passive range of movement, loss of limb or limb deficiency, leg-length difference, short stature, hypertonia, ataxia or athetosis. Physicians and Physiotherapists form panels with technical experts evaluating athletes and assigning classes following a specific procedure. The medical diagnosis has to be sent prior to the competition. Then, classifiers assess the impairment and its impact on the activity in three steps, physical and technical assessments, and if needed observation during the competition. Different issues are developed in the presentation: – evidence-based classification: most valid, reliable and reproducible tests are needed to make the decisions; – ethical aspects and controversies with potential cheating called Intentional Misrepresentation. (I.M.); – specific cases of dysautonomia for high level of Spinal Cord Injuries and Maximum Allowed Standard Height for bilateral lower limbs amputees; – training to improve expertise and develop classifiers’ skills; – problems of data protection; – status (New, Confirmed, Review, Classification Not Completed…); – non-eligible and borderline cases.