The Impact of Physical Impairment on Motor Proficiency in Para-footballersEVIDENCE-BASED CLASSIFICATION IN PARALYMPIC SPORT

Raúl Reina

rreina@goumh.es

Functional Classification Systems Sport-Specific and Evidence-Based

Classification Systems

1948 1988 1992 2003

ClassificationStrategy

2007 2015

StokeMandeville

Games

SeoulParalympic

Games

Barcelona Paralympic

Games

IPC´sClassification

Strategy

Classification Code

Athlete´sClassification

Code

Model of Best

Practices

2017

Medical Classification Systems

Reina & Vilanova-Périz (2017; adapted from Hart, 2016)

1978 2015

Historical Overview: Research Problem

C1

C3

C2

C4

-

+ C5C8

C7C6

NE

FT8

FT5

FT7FT6

Historical Overview: The Cut-point Problem

A = Bilateral Spasticty

B = Athetosis / Ataxia

C = Unilateral Spasticity

FT5

FT6

FT7

FT8 MIC

“Grey Areas” of the Current Classification System

Reina (2016)

How can Decision‐Making be Improved?

Multi-Component

C

P A

BBalance

Coordination

Sprint

Power CODA

S

Performance Parameters in CP-Football

Reina (2014)Campayo-Piernas (2016)

0123456789FT5

FT6

FT7FT8

FNPC

HT_D

HT_ND

012345678FT5

FT6

FT7FT8

FNPC

0

5

10

15

20

25

30FT5

FT6

FT7FT8

FNPC

Rapid Heel-Toe (s) Running in Place (s) Split Jumps (s)

Performance Differences: e.g. CoordinationTesting

p < .001d = 1.34

% = 38.75

p < .001d = 1.85

% = 66.74D ND

p < .001d = 0.98

% = 17.36

p < .001d = 2.01

% = 71.17 Campayo-Piernas (2016)

a. Coordination, defined as the ability to voluntarily executefluid, accurate movements rapidly.

b. Balance, defined as the ability to maintain the line of gravity(vertical line from centre of mass) of a body within the base ofsupport with minimal postural sway.

c. Symmetry, defined as the correspondence and/or movementsimilarity on opposite sides of a dividing line or plane.

d. Range of movement, defined as the full movement or optimalpotential of a joint, usually its range of flexion and extension.

e. Arm impairment, defined as the contribution of the arms toperform the whole movement.

S

B

C

R

A

Reina, R., Sarabia, J., Sánchez, A., Beckman, E., Connick, M., & Tweedy, S. (2015)

Activity Limitation Observation Categories

Project supported by:

-0,5-0,25 0 0,25 0,5 0,75 1 1,25 1,5 1,75 2 2,25 2,5 2,75 3 3,25 3,5 3,75 4

CoordinationDist-ROMProx-ROM

CoordinationDist-ROMProx-ROM

CoordinationDist-ROMProx-ROM

FT5

FT7

FT6

-0,5 -0,25 0 0,25 0,5 0,75 1 1,25 1,5 1,75 2 2,25 2,5

CoordinationDist-ROMProx-ROM

CoordinationDist-ROMProx-ROM

CoordinationDist-ROMProx-ROM

FT5

FT7

FT6

Reina, R., Gómez, G., Sarabia, J., Roldán, A., & Tweedy, S. (in process)

Decision-Making using Effect Sizes

Dominant Side vs Non-Dominant Side

Rhea (2004)

MAT Test

Triple Hop

RHT

Limited ROM in hips (needed to turn the whole body.

Poor dynamic running pattern (particularly when running backward)

Presence of scissor running pattern:

Hip and knee flexion

Hip adduction and internal rotation

Performance:

Difficulty for stopping and accelerating

Difficulty assisting movements of the upper limbs when running

Poor agility level.

R

Qualitative Analysis of Activity Limitation

IFCPF (2017)

What determines Proficiency in Para‐footballers?

Data Envelopment Analysis (DEA): Classification tool.

Study the relative efficiency of some “Decision Making Units” (DMUs) using several inputs to produce several outputs.

DEA provides useful benchmarking information that can improve performance of inefficient DMUs

Charness et al. (1978)

Testing for Evidence-Based Classification

Reina et al. (2016)

Illinois with Ball 10m with BallBeckman & Tweedy (2009)**

4 Bounds Triple Hop ‐ NDMunro & Herrington (2011)

Standing Broad JumpBeckman & Tweedy (2009) Cámara et al. (2013)

8 FT8 players ranked in the first 14´s

N 56

DMU´s Outcomes

Reina, R., Pastor, D., Campayo-Piernas, M., & Pastor, J.T. (in process)

Reina, R., Sarabia, J.M., Caballero, C., & Yanci, J. (in Press)

N 60

Stop & Go (with and without the ball)

N 82

Within-GroupsComparisons p2 > 0.54, large; p < 0.01*

* Except Sprint 0-10 m

What is Next?

Game Analysis by GPS

Total Distance(m.min-1)

MaximumVelocity(km.h-1)

Distancecovered ≠ Intensities(m.min-1)

Acceler. / Deceler. (n.min-1)

Change of Direction(number.

min-1)

LowWalking

(< 4)

Walking(4 - 3)

Medium IntensityRunning(8 - 13)

Jogging (3 - 9)

Sprinting(> 18)

High IntensityRunning(13 - 18)

Game Analysis by GPS

Total Distance(m.min-1)

MaximumVelocity(km.h-1)

Distancecovered ≠ Intensities(m.min-1)

Acceler. / Deceler. (n.min-1)

Change of Direction(number.

min-1)

Mode-rate

(1–2.78)

High (> 2.78)

LowIntensity

Medium Intensity

High Intensity

Forward vs Back

Left vs Right

N 31

New Analysis may be Necessary…Notational

Analysis

New Statistics will be Necessary…

R&D Centre Physical

Impairment

R&D Centre Visual Impairment

R&D Centre Intellectual Impairment

IPC Classification Research Steering Group

IPC Classification Committee

IPC Management

Team

Athlete Representation

Interested sportInterested sportInterested sport

IPC Sports Science

Committee

Expr

essi

on o

f int

eres

t/D

ialo

gue

Advice & Support to initiate the work

Athletics

Interested sport

Athletics Swimming

SCIEN

TIFIC

AN

D

SPORT

S NET

WO

RK

S

Van de Vliet (2015)