SouthwesternYacht Club San Diego, CA

Roger Strube, MD

US Sailing National Classifier

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August 27-29, 2015

Classifier Training Seminar Preview

INTRODUCTION

• To ensure competition is fair and equal, all Paralympic sports have a system in place which ensures that winning is determined by skill, fitness, power, endurance, tactical ability and mental focus, the same factors that account for success in sport for able bodied athletes.

• This process is called classification and its purpose is to minimize the impact of impairments on the activity (sport discipline). Having the impairment thus is not sufficient. The impact on the sport must be proved, and in each Paralympic sport, the criteria of grouping athletes by the degree of activity limitation resulting from the impairment are named “Sport Classes.” Through Functional Assessment, Classifiers determine which athletes are eligible to compete in a sport and how athletes are grouped together for competition. This, to a certain extent, is similar to grouping athletes by age, gender or weight.

• Classification is sport-specific because an impairment affects the ability to perform in different sports to a different extent. As a consequence, an athlete may meet the criteria in one sport, but may not meet the criteria in another sport.

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Non-Governmental Organizations (NGO - International Federations) that Regulate and Sanction Sport

• International Olympic Committee• Organizing Authority / Event Planner for the Olympics

• International Paralympic Committee• Organizing Authority / Event Planner for the Paralympics

• International Sailing Federation (ISAF)• International Federation for Disabled Sailing (IFDS) (Disabled Sailing Admin)

• International Classifier Committee (Functional Assessment athletes)

• International Technical Delegates (measure, monitor, approve equipment)

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US Sailing is the National Governing Body Recognized by the IOC, IPC & IFDS to Regulate

and Sanction Sailing in America

• US Olympic Committee

• US Paralympic Committee

• US Sailing (National Governing Body for Sailing)• US Olympic Sailing Team• US Paralympic Sailing Team

• Classifier Committee

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Know the Players – Cooperative Delegation

IOCISAF

US Sailing

IPC

IFDS

Adaptive Sailing

Technical DelegateGene Hinkel

Classifier CommitteeThweatt, Leviton, Strube

USPCUSOC

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The History of Classification

• Paralympic Sport founded by Dr. Ludwig Guttmann in the 1940s• Founded as an extension of the Rehabilitation Process• Medical Model based Class on Diagnosis for almost 40 years

• The Diagnostic Class allocated by the Paralympic Movement Authority valid for all sports

• Athletes with similar Functional Limitation (amputation vs paralysis) were not in the same Class• Resulted in multiple Diagnosis Based Classes competing in the same Sport/Event

• Thirty years spent debating the transition from Medical Diagnosis to Function Based Classification

• Paralympic Sport Movement drove acceptance of Functional Classification• 1980s Transition to Function Based System driven by Olympic and Paralympic Organizing Committees

• Resulted in reduction in the complexity and number of Classes in different sports• 1989 Event Organizers for Barcelona ’92 Paralympic Games and ICC required Functional Classification

• The Functional Classification Systems required by the ICC (later the IPC) were sport specific

• This decision accelerated the transition from Medical to Functional Classification• Only residual Medically Based Classification System is for athletes with Visual Impairment

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The History of Classification

• Widespread adoption of Sport Specific Classification Systems• Questions raised because the athletes’ Functional Classification could determine success

• Classification revisited by the Governing Board of the IPC in 2003

• Approved a strategy to develop a universal classification code for future Paralympic games

• Paralympic Movement approved the IPC Classification Code in 2007

• The Code defines sports focused Paralympic Classification as: “accurate, reliable and consistent…”

• Future Outlook – Evidence Based Systems• Paralympic Movement committed to development of Evidence Based Classification Systems

• Effective training to improve performance will not change the athlete’s Classification

• All Paralympic sports must have Classification Rules that comply with the IPC Classification Code

• The IFDS and US Sailing Functional Classification System provides evidence based classifiction

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What is Classification?

• The Functional Assessment Process to establish the athlete’s level of disability

• Classification establishes the athlete’s “Eligibility to Compete” in major events:• US Disabled Sailing Championships (e.g., Galveston 2014)

• US Sailing sanctioned events that determine appointment to US Paralympic Sailing Team

• Classification for three keel boat classes used for Paralympic Competition:1. One person keel boat – 2.4mR (Class up to 7 – Minimally Disabled)

2. Two person keel boat – Skud (M/F crew – Skipper level 1 or 2 – Crew up to 7)

3. Three person keel boat – Sonar (Total disability points 14)

• Criteria used are based on the functions required to sail in competition

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Main Functions Necessary to Sail in Competition• Compensation for the movement of the boat (Stability).

• Operating the control lines and the tiller (Hand function).

• Ability to move about in the boat (Mobility).

• Ability to see while racing (Vision).

These Main Functions Further Refined to Test:

a) Tiller

b) Cleating

c) Sheeting

d) Transferring

e) Hiking

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No Objective Criteria to Classify Some Impairments

a) Minimal physical impairment of the hands or feet may not be significant enough to functionally impair a sailor.

b) Classifiers are not able to assess functional impairments due to pain, obesity, and hearing loss.

c) Classifiers have no criteria and are not qualified to assess disabilities resulting from emotional or intellectual impairment.

Individuals with these impairments cannot be classified and are not considered “Eligible to Compete” in US Sailing Championships or Sailing Team qualifying events.

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Benchmark Scoring Criteria

• Appendix A1 on page 29 of the US Sailing FCS & PM 2013-2016

• Benchmarks are the most Objective Classification Criteria

• Class assigned is categorized by specific amputations

• Class assigned based on degree amputation impacts sailing

• Assigned Classes range from 1 (severe) to 7 (minimal)

• Athletes with High/Low paraplegia not listed• Most high paraplegic athletes assigned Class 2

• Most Low paraplegic athletes assigned Class 3

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Functional Assessment – Three Categories

• Functional Anatomical Assessment (FA) - Grading Rules and Score Sheets• Grading Rules for Strength, ROM & Coordination• Graded 0 to 5• Only lowest score counts• Scoring chart defines joints/motions tested

• Functional Dock Testing (FD)• Testing done at a dock on a Sonar (or similar 3 person keel boat)• Static test of sailing functions: Tiller, Sheeting, Cleating, Transferring, Hiking• Graded 1 to 5 for “Expected” and “Observed”• All scores count• Scoring chart defines level of function at each task

• Functional Sail Testing (FS done at First Appearance Race or Practice)• Same elements listed above• Dynamic Test during practice or racing conditions (First Appearance)• Putting it all together – Do the FA & FD scores match Racing Reality?

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Muscle – ROM – Coordination Grading Chart

Muscle Gradations Description

0 — Zero No evidence of contractility

1 — Trace Evidence of slight contractility. No joint motion or incomplete range of motion with gravity eliminated.

2 — Poor Complete range of motion with gravity eliminated

3 — Fair Complete range of motion against gravity

4 — Good Complete range of motion against gravity with some resistance

5 — Normal Complete (available) range of motion against gravity with full resistance

Range of Motion

Scale Description

0 No movement possible

1 Less than 25% movement possible

2 25 — 49% range of movement possible

3 50 — 69% range of movement possible

4 70 — 89% range of movement possible

5 90 — 100% range of movement possible

Coordination

Scale Description

0 Activity impossible

1 Severe impairment; only able to initiate activity without completion

2 Severe impairment; able to accomplish the activity but in a very unorthodox way. Unable to move through the full range

3 Moderate impairment; able to accomplish the activity, movements are slow, awkward and unsteady through the full range

4 Minimal impairment; able to accomplish the activity with slightly less than normal speed and skill through the full range

5 Normal performance

Functional Anatomical Assessment Grading Chart

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Functional Anatomical Assessment (FA) Report FormClassification Report — To be completed by Classifier(s)

Right Side Left Side

Neck ROM Strength Co-ordination Lowest Right ROM Strength Co-ordination Lowest

Left Comment

Neck

Flexion Max 5 pts

Extension Max 5 pts

Rotation 5 pts each

Subtotal points (Max 20 pts)

Upper Limbs ROM Strength Co-ordination Lowest Right ROM Strength Co-ordination Lowest

Left Comment

Shoulder

Flexion

Extension

Abduction

Adduction

Ext. Rot.

Int. rot.

Elbow

Flexion

Extension

Pronation

Supination

Appendix A2.2.1 Functional Anatomical Text – Neck and Upper Extremity – Incomplete Example

US Sailing Functional Classification System & Procedures Manual – Page 33

Note: For each joint/motion tested during, only the lowest score of the three elements is counted toward the Functional Anatomical total. For example, an athlete may score 5 by 5 on strength and (passive) ROM but only 2 on the Coordination Scale. The points scored for that joint/motion are 2 (the lowest score).

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Functional Dock Test (FD) and Functional Sail Test (FS)Detail of Movement

Please

tick box

0 = Observed E = Expected FD SAIL

A. Tiller ROGER H STRUBE, MD O E O E 1. Only controls tiller with assistive device (i.e. ropes, blocks, mechanical or electrical device).

2. Does not move the tiller through the full range of movement. Or only controls the tiller with teeth or feet. Or controls the tiller by "tapping", due to coordination problems.

3. Let go of the tiller for >2 seconds while changing sides, or while handling sheets.

4. Only controls the tiller with one upper limb. Or uses one hand for support while tacking. Or controls the tiller with moderate difficulty

5. Controls tiller throughout tack or gybe normally

Comments:

B. Sheeting O E O E

1. Does not pull sheet in any way, or only with teeth or feet, or uses servo assistance.

2. Pulls sheet, but with severe difficulty, very slow, or cannot get proper sheet tension or has assistance from another crew member to get it.

3. Pulls sheet but with moderate difficulty, or slow

4. Pulls sheet with slight difficulty

5. Pulls sheet normally

Comments:

C. Cleating O E O E

Comments: SAMPLE FD FORM – CLEATING CRITERIA DELETED

D. Transferring O E O E

Comments: SAMPLE FD FORM – TRANSFERRING CRITERIA DELETED

E. Hiking ROGER H STRUBE, MD O E O E

Comments: SAMPLE FD FORM – HIKING CRITERIA DELETED

Total Number:

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Total the Scores to Determine the Class & Status

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The Olympic & Paralympic Quadrennium

• Yearly Events Hosting Classification

•Useful Information Internet Links• US Sailing Web Site

• US Olympic and Paralympic Sailing

• International Sport and Sailing

• International Olympic and Paralympic Information

• Wikipedia – Classification Information

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