Measures of impairment applicable to the classification of Paralympic athletes competing in wheelchair sports: A systematic review of validity, reliability and associations with performance

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ABSTRACT

A fundamental aspect of classification systems in Paralympic sport is having valid and reliable measures of impairment. However, minimal consensus exists for assessing impaired strength, coordination and range of motion. This review aimed to systematically identify measures of upper body strength, coordination and range of motion impairments that meet the requirements for use in evidence-based classification systems in wheelchair sports. Three electronic databases were searched from 2003 until 31 August 2019 for studies that assessed upper body function of participants and used a measurement tool that assessed strength, coordination or range of motion. The body of evidence for each identified measure was appraised using the Grading of Recommendations Assessment, Development and Evaluation framework. Twenty-three studies were included: ten measured strength and coordination, and six measured range of motion. There was “moderate” confidence in using isometric strength for assessing strength impairment. Tapping tasks for the assessment of coordination impairment received a “low” confidence rating. All other identified measures of coordination and range of motion impairment received a “very low” confidence rating. Several potential measures were identified for assessing upper body strength, coordination and range of motion impairments. Further research is warranted to investigate their use for classification in Paralympic wheelchair sports.

KEYWORDS:

• Strength
• coordination
• range of motion
• classification
• paralympics

Disclosure statement

The research was supported by funding from the International Tennis Federation and Institute of Advance Studies at Loughborough University. The authors have no conflicts of interest that are directly relevant to the content of this review.

Supplementary Materials

Supplemental data for this article can be accessed online https://doi.org/10.1080/02640414.2020.1815957.

Additional information

Funding

The research was supported by funding from the International Tennis Federation. We also thank the travel grant from the Institute of Advance Studies at Loughborough University for initiating the partnership between the institutes involved.