Abstract
Many Paralympic sports classification systems use unspecified manual muscle testing (MMT) methods to assess impairment of muscle strength. This is a potential source of inconsistency in classification, and could be eliminated by nominating a single, published set of MMT methods. Additionally, four modifications can enhance the validity, reliability and utility of conventional MMT methods for classification: 1) limiting assessment to movements that are important to performance in the sport concerned; 2) specifying a single preferred technique for assessment of movement strength; 3) changing the reference range of movement from normal anatomical range to the maximum range of movement required in sport; and 4) adjusting testing techniques so that they are relevant for the sport. This brief communication may improve classification in established sports, and provide guidance for emerging sports that are developing classification systems.
Highlights
The recently published IPC Position Stand on classification in Paralympic sport states that the purpose of Paralympic systems of classification is to promote participation in sport by people with disabilities by minimizing the impact of impairment on the outcome of competition (Tweedy & Vanlandewijck, 2010), where impairment (World Health Organization, 2001) is any problem with body structure or body function
In many current systems of classification, a multiprofessional team estimates the extent of activity limitation resulting from impairment through assessment of four principal areas: a) impairments of structure and function; b) activity limitation experienced in motor tasks that are novel, yet biomechanically related/similar; c) assessment of activity limitation in sport specific motor tasks; d) assessment of factors other than impairment that will affect activity limitation (Tweedy, 2002)
The purpose of this paper is threefold: to illustrate that specification of the MMT methods used is an important means of minimizing potential sources of variation in classification outcome; to evaluate which of the MMT methods currently utilized in Paralympic classification is better suited to the purposes of Paralympic classification; and to describe how MMT methods can be modified so that their validity, reliability and utility in Paralympic sports classification can be optimized
Summary
The recently published IPC Position Stand on classification in Paralympic sport states that the purpose of Paralympic systems of classification is to promote participation in sport by people with disabilities by minimizing the impact of impairment on the outcome of competition (Tweedy & Vanlandewijck, 2010), where impairment (World Health Organization, 2001) is any problem with body structure or body function (e.g., paresis, hypertonia or decreased range of movement). MMT methods, in which the strength of a muscle, or group of muscles, is assigned a grade according to its capacity to overcome gravity and / or manual resistance, were first described in 1912 (Wright, 1912). These original methods have been adapted and modified since they were first published and current publications that describe methods for MMT include, but are not limited to, those authored by Clarkson (Clarkson, 2000), Cutter and Kevorkian (Cutter & Kevorkian, 1999), Hislop and Montgomery (Hislop & Montgomery, 2007), Guarantors of Brain (Guarantors of Brain, 2000) and Kendall (Kendall, 2005). In nine of the 14 Paralympic sports that employ MMT, it is quite likely that classifiers use various MMT methods, depending on their original professional training
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