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A class act

As a classifier for the International Paralympics Committee, physio Rob Kinder (below right) once had to tell an athlete he was too tall to compete. He speaks to Robert Millett

File 107832There’s one non-sporting hurdle that every athlete at the London 2012 Paralympics has had to face. It’s a rigorous classification system, designed by the International Paralympics Committee (IPC) to ensure that competitors in each sport are evenly matched – whatever their disability.

But how does the IPC ensure a fair and level playing field, when the range of physical impairments is so diverse and the stakes so high?

One man in the know is Rob Kinder, a full-time neuro-physiotherapist with Somerset Partnership NHS Foundation Trust. In his day-to-day role he’s a clinical specialist for stroke, but in his spare time he works as an IPC classifier.

The role takes him all over the world and requires him to assess athletes who apply to participate in the Games – clarifying the nature, extent and veracity of their disability.

‘My work involves classifying athletes with physical impairments, as opposed to visual or intellectual impairments,’ explains Mr Kinder.

‘I’m trying to find out how impairments impact on particular sports. So it ties in really well with my day job as a neurophysio, because in both cases I’m looking at how people’s impairments affect their daily function.’

Classification procedure

Before competing, every athlete is categorised by an expert panel and given an internationally-recognised class and a class status, which is either ‘confirmed’ or ‘reviewed’.

A confirmed class status is usually given to athletes whose condition is unlikely to change, Mr Kinder explains, whereas a reviewable class status is for athletes with a variable condition, such as multiple sclerosis, that could deteriorate,

The classification panel usually consists of a doctor, a physio and a coach.

‘The doctor is looking at the condition and the effect it has on them and making sure that whatever impairments we find are attributed to a condition,’ says Mr Kinder.

‘The coach is looking at how it affects them in the sport, and the role of the physio is to find the impairments and establish how they are limiting the athlete in their sport’

Each classification assessment has three stages. In the first, the classifier takes the athlete’s medical history and proceeds with some benchmark testing, such as muscle grading and measuring the person’s range of movement.

Next the athlete is observed while engaged in the activities involved in his or her particular sport, including warm-ups and training drills.

At this stage, Mr Kinder says, the classifier might be looking for co-ordination problems or an issue such as spasity in the calves.

In the final stage, the classifier watches an athlete perform during an actual competition; at a time when the competitor should be striving to perform at his or her best and is highly unlikely to exaggerate the impact of any impairment.

Borderline issues

Of course people do, on occasions, try to cheat the classification system, but it’s relatively rare says Mr Kinder. When it does occur it’s often motivated by dire financial circumstances.

‘For some countries the finances the athletes receive could be financing their family or home, so it is a very big deal.

‘Sometimes you get bad coaches who encourage a certain type of behaviour. They might convince young athletes that it’s a good idea not to show their best performance at an assessment. But I think we are pretty good at spotting people who aren’t trying their best.’

To be eligible to participate in competitions, all IPC athletics must have at least one of the following impairments: hypertonia; ataxia; athetosis; muscle weakness; loss of joint range; limb deficiency (amputee or abnormality); shortened leg length ; short stature; visual impairment or intellectual impairment.

However, as Mr Kinder explains, exhibiting one or more of these disabilities is not an automatic guarantee that an athlete will meet the strict classification criteria.

‘Having one of these impairments is not always enough, as it is the severity of the impairment and how much it impacts on the athlete’s performance that counts.

‘If somebody has lost a hand they obviously have impairment but when it comes to long distance running it’s not really a disadvantage.

Over shorter distances, however, the same disability could be considered a disadvantage because, in a sprint,for example, they wouldn’t be able to use a block start or balance well enough to get up and power through at the start.’

Offering an analogy, Mr Kinder compares the classification process to other class systems – such as the differing age ranges used for school sports or the weight distinctions in boxing.

However, assigning a boxer to a ‘featherweight’ or ‘heavyweight’ category is easy in comparison to the complexities that can arise from classifying a range of physical impairments and their impact on particular sports.

‘There are athletes who sit comfortably in a class and those who sit on a borderline. These athletes can be difficult to class - never more so than when they have a complex condition, such as an incomplete spinal injury or multiple pathologies,’ Mr Kinder explains.

He regularly finds the assessment process difficult, especially when making decisions that impact on the hopes and dreams of individuals.

‘One of the worst for me was when I had to tell a dwarf that he was too tall. But there are things put in place so we can manage problems as best we can, and seeing the rising numbers that can participate goes a long way to helping.’

Career route

Mr Kinder says science is helping to make his role easier and that, since its inception at Stoke Mandeville Hospital, Buckinghamshire, in 1948, the classification process has moved from being based purely on medical diagnosis to a system based on functional capabilities and physical impairments.

Mr Kinder says the process is still evolving, allowing more athletes to participate.

‘The classification rules are continually updated and revised and ongoing research studies aim to make the assessments as objective as possible,’ says Mr Kinder.

‘Other steps include having a panel of classifiers rather than an individual one. Naturally, there are various protest and appeal procedures.‘

Mr Kinder first became involved in IPC Athletics in 2005, while working in Cardiff.

‘As someone who has always enjoyed athletics, I voluntarily joined the Welsh National squad for training sessions.

Rather than taking a sports injury type role, I became interested in understanding the athletes’ physical impairments and started to help them and their coaches to structure their training,’ says Mr Kinder.

‘Through assessing them for their physical potential, I became increasingly aware of classification. In 2006 I went with the Great Britain squad to the World Athletics Championships in Assen, the Netherlands.’

He enrolled on a classification course and became a ‘trainee IPC classifier’. Several events and championships later, he was promoted to being a level 1 classifier and worked at an international level.

‘Before 2006, there were only two or three classifiers in the country, and it was very much based on the experience and opinion of the experts rather than scientific evidence.

‘Now it’s becoming more scientifically-based and so is opening up more to physios and doctors’

As well as classifying athletes, Mr Kinder sits on an IPC classification advisory group and teaches on its academy training course.

But, as he explains, virtually all his IPC work is unpaid and voluntary.

‘Naturally I get my expenses paid but it doesn’t provide any income other than one-off fees, for example for providing training or the occasional workshop at a national level.’

His primary motivation is a love of the job, but Mr Kinder warns that the role can be very demanding.

For UK athletes, classification usually takes place at the British Open Championships, held once a year, but in recent years UK Athletics has also introduced talent-spotting events and classifiers have been employed to run clinics throughout the country.

Additionally, international classifiers such as Mr Kinder have to travel to competition venues around the world to assess and observe athletes as they perform.

The average length of each initial assessment is about 45 minutes. While some take only 20 minutes more complex cases can more than an hour. ‘You can be working from 7 or 8am to 7 or 8pm,’ says Mr Kinder.

‘I get to work with great people from all around the world and am involved in allowing individuals to compete in competitive sport and achieve their full physical potential, despite their disability.’

Interested physios could start by making links with a local athletics squad. ‘In addition to being able to assess for impairments, any medically-minded person also needs to understand the activities involved in the sport they are interested in,’ Mr Kinder adds. fl

For more information on UK Athletics, visit: http://academy.uka.org.uk/parallel-success  
For the IPC, visit: www.paralympic.org

See more about physiotherapy and the Games in our London 2012 section.

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Article Information

Author(s)

Robert Millett

Issue date

20 June 2012

Volume number

18

Issue number

11
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