n p o inted M ik e M a rc u s (N a tio n a l P re s id e n t o f th e 7 * S p o rts A s s o c ia tio n f o r P a ra p le g ic s a n d O th e r physically D is a b le d ) as N a tio n a l C o a c h C o n v e n o r. TT0 p m en in th e ir field w e re in v ite d to b e e x a m in e rs a n d c o u rse s o n d iffe re n t s p o rts h a v e b e en h e ld in different cen tres. P e rm a n e n t s u b -c o m m itte e s h a v e also been fo rm e d f o r e ac h s p o r t a n d th e s e a re re s p o n s ib le for r e p o rtin g to th e N a tio n a l C o a c h C o n v e n o r. T h e aim is to e n s u re th a t th e A s s o c ia tio n h a s sufficient c o a c h e s w h o a re f u lly p ro fic ie n t in th e ir field a n d can give o u r c o m p e tito rs th e in te n s iv e c o a c h in g w h ic h they w ill n e ed if S o u th A f r ic a is g o in g to k e e p u p wjth th e re st o f th e w o rld in th e field o f sp o rts f o r the d isa b le d . T h e n e x t O ly m p ia d w ill b e h e ld in 1980 and w ill in c lu d e th e b lin d , a m p u te e s a n d c e re b ra l palsied in a d d itio n to th e p a ra ly s e d . S o u t h A f r ic a h a s b e e n a fu ll m e m b e r o f th e I n te r ­ n a tio n a l S to k e M a n d e v ille G a m e s F e d e r a tio n since 1962 a n d in 1975 w as a c c e p te d as a fu ll m e m b e r o f th e I n t e r n a t i o n a l S p o rts O rg a n is a tio n f o r th e D is a b le d . T h e Springbok te a m o f 1975, a n d a ll su c c e e d in g te a m s, w e re MARCH 1979 5 m u lti-ra c ia l tea m s se le c te d a t m u lti-ra c ia l tria ls. T h e C o n s titu tio n o f th e S.A . S p o rts A s s o c ia tio n fo r P a r a ­ p leg ic s a n d O th e r P h y s ic a lly D is a b le d (w hich is a c c e p te d b y b o th th e I.S .M .G .F . a n d th e I.S .O .D .) s ta te s th a t it w ill r e n d e r its se rv ic e s to a ll r a c ia l g ro u p s in S o u th A f r ic a a n d w ill p r o v id e f o r th e s p o rtin g n e e d s o f th o se w h o a re p h y sic a lly d is a b le d irre s p e c tiv e o f ra c e , re lig io n , n a tio n a l o rig in o r id ea lo g y . T h e a c h ie v e m e n ts o f d is a b le d s p o rts m e n a n d w o m e n h a v e s p re a d b e y o n d th e b o u n d s o f s p o rt f o r th e d is ­ a b le d . I n th e W e s te rn P ro v in c e , m e m b e rs o f th e P ro te a C lu b h a v e b een ta k in g p a r t in th e a b le -b o d ie d a rc h e ry a n d W e s te rn P r o v in c e T a b le te n n is leag u es f o r th e p a s t six y e ars. T e a m s f r o m th e S o u th e rn T r a n s v a a l a n d th e O ra n g e F r e e S ta te a lso ta k e p a r t in a b le -b o d ie d ta b le te n n is lea g u es. T h r o u g h th e ir a c h ie v e m e n ts, th e d is ­ a b le d h a v e b ro u g h t a g e n e ra l a w a re n e ss o f th e ir c a p a ­ b ilitie s to th e a tte n tio n o f e m p lo y e rs . T h e y h a v e d e m o n ­ stra te d t h a t a b ility , a n d n o t d is a b ility , c o u n ts a n d th a t, g iv e n a n e q u al c h a n c e , th e y can a n d in f a c t do h o ld th e i r o w n in m a n y fields o f e m p lo y m e n t. P H Y S I O T H E R A P Y CLASSIFICATION IN SPORT FOR THE DISABLED C. K.. V A N R E N S B U R G , B.Sc. (P h y s io th e ra p y ) (W itw a te rsra n d )* D ie d o e l van k la ssifik a sie is o m regverdige k o m - pelisle aan a lm a l le v erskaf. D il v a rieer van e e n v o u d ig lot baie in g e w ik k e ld en w o rd g e d u rig hersien en ver- ander. D ie h e rsie n e k la ssifik a sie , g e b a se er o p n euro- logiese o n d e rso e k , w o rd b e sk ry f. T h e p u rp o s e o f c la ss ific a tio n in s p o r t f o r th e d is ­ abled is to e n d e a v o u r to p r o v id e f a ir c o m p e titio n acc o rd in g to th e d e g re e o f d isa b ility . S p o rt f o r th e d is ­ abled is e x p a n d in g r a p id ly a n d n o w in c lu d e s s p o r t fo r the b lin d , fo r a m p u te e s a n d f o r th e c e re b ra l p a ls ie d as well as th e o rig in a l p a ra p le g ic s p o r t — w h ic h is w h e e lc h a ir s p o r t f o r p a ra p le g ic s , te tra p le g ic s , sp in a bifidas a n d c o m p a ra b le p o lio m y e litis v ictim s. C la s sific a tio n f o r th e b lin d a n d f o r a m p u te e s is fa irly s tr a ig h tf o r w a r d a n d is d o n e a c c o rd in g to set \ l e s . O n th e o th e r h a n d , c la ss ific a tio n f o r th e c e re b ra l 'S r'k lsie d ' s v e fy c o m p le x a n d as y e t n o s a tis fa c to ry system o f g ro u p in g th e v a rio u s d is a b ilitie s is a v a ila b le , b u t th e in te r n a tio n a l c o m m itte e is a t p re s e n t f o r m u la t­ ing a n ew c la ss ific a tio n w h ic h w ill b e u sed a t the In te rn a tio n a l G a m e s in 1979. C la s sific a tio n o f w h e e lc h a ir a th le te s f o r p a ra p le g ic sp o rt has b e e n d o n e f o r o v e r t h ir t y y e a rs a n d th e system h as g ra d u a lly b e e n c h a n g e d , e n la rg e d a n d im ­ p ro v e d , n a rro w in g d o w n th e d iffere n ce s o f d is a b ility w ith in e a c h class a n d in tro d u c in g n ew classes w h e re necessary. I n 1963, w h e n p a ra p le g ic s p o r t w as i n tr o ­ d uced in S o u th A f r ic a , th e c la ss ific a tio n sy ste m w as ra th e r b ro a d a n d e ac h class c o m p rise d r a th e r d ifferin g lesio n s a n d d is a b ilitie s , so th a t th e m o r e se v e re ly h a n d ic a p p e d a th le te s in e ac h class w e re a t a c o n ­ sid e ra b le d is a d v a n ta g e . U n fo rtu n a te ly , e ac h tim e th e system o f c la ss ific a tio n w as re v is e d o r m o d ifie d th e p re v io u s se t o f w o rld re c o rd s w as n o lo n g e r v a lid as the o ld classes c eased to exist. T h is p r o v e d r a th e r * S e n io r P h y s io th e r a p is t, E liz a b e th C o n r a d ie S chool a n d m e m b e r o f th e C la s sific a tio n C o m m itte e f o r P a ra p le g ic S p o rt. d e m o ra lis in g to th e s p o rts m e n a n d -w o m e n w h o h a d tr a in e d so h a rd to a tt a in th ese re c o rd s. A n e w system o f c la ssific a tio n w a s e v o lv e d in 1970 a n d w as fin ally a m e n d e d a n d re v is e d in 1972. T h is fo rm o f classifi­ c a tio n w as a c c e p te d b y th e I n te r n a tio n a l S to k e M a n d e v ille G a m e s C o m m itte e in J u ly 1974 a n d a p p e a rs to g ive e a c h a th le te th e m o st f a i r c h a n c e o f c o m ­ p e tin g o n e q u a l term s. M a n y a th le te s still c o m p la in o f v a ry in g a b ilitie s w ith in th e sa m e class b u t it m u s t b e re m e m b e re d th a t a ll in d iv id u a ls , h a n d ic a p p e d o r n o t, a re b o r n w ith d iffe re n c e s in c h a r a c te r a n d te m p e ra ­ m e n t as well as d iffere n ce s in p h y s ic a l a b ility a n d it is n o t re a s o n a b le to e x p e c t a c la ss ific a tio n sy ste m o r th e m e d ic a l e x a m in e r re s p o n s ib le f o r th e c la ssific a tio n to p r o v id e c o m p le te e q u a lity o f a b ility . F o r th e p u rp o s e o f in te r n a ti o n a l c la ssifica tio n , in o r d e r to b e a c c e p te d as a m e d ic a l e x a m in e r a d o c to r m u s t c o m p le te tw o fu ll w o rk in g se ssio n s a t th e I n t e r ­ n a tio n a l S to k e M a n d e v ille G a m e s w ith in a f o u r-y e a r p e r io d a n d m u s t b e a p p ro v e d b y th e m e d ic a l s u b ­ c o m m itte e . N e w d o c to rs c la ssify a th le te s u n d e r th e s u p e rv is io n o f c o m m itte e m e m b e rs . I n S o u th A fric a w e h a v e a c la ss ific a tio n c o m m itte e c o m p ris in g five d o c to rs , o n e p h y s io th e r a p is t a n d o n e o c c u p a tio n a l th e ra p is t. T h e m e m b e rs o f th e c o m m itte e w o rk in p a ir s to c la ssify d is a b le d a th le te s, w h ile d o u b tf u l o r b o r d e rlin e cases a r e d isc u sse d b y th e fu ll c o m m itte e . T h is c o m m itte e w ill p r o b a b ly b e e n la rg e d in th e f u tu r e to e n s u re th a t all a th le te s c a n b e classified p r i o r to th e a n n u a l S o u th A f r ic a n G a m e s so t h a t th ey k n o w in a d v a n c e in w h ic h class th e y w ill b e c o m ­ p e tin g . T h e re v is e d c la ss ific a tio n sy ste m is b a se d u p o n a n e u ro lo g ic a l e x a m in a tio n in w h ic h th e stre n g th o f th e re s id u a l m u s c u la tu re o f th e c o m p e tito r is d e te rm in e d . T h e official s ta te m e n t o n c la ss ific a tio n re a d s as fo llo w s: C lass I A — u p p e r c e rv ic a l le s io n s w ith tric e p s n o t fu n c tio n a l a g a in s t g ra v ity p lu s re sista n c e (i.e. g ra d e s 1 - 3). C lass IB — lo w e r c e rv ic a l le sio n s w ith g o o d o r n o rm a l tric e p s p o w e r (g ra d e s 4 - 5), w ris t e x te n so rs a n d R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) 6 F I S I O T E R A P I E MAART 1979 flexors, b u t fin g er flexors a n d e x te n so rs o f g ra d e s 0 - 3 . C lass 1C — L o w e r c erv ica l lesio n s w ith g o o d o r n o rm a l tric e p s , w ris t e x te n so rs a n d flexors, s tro n g fin g er flexors a n d e x te n so rs (g rad e s 4 - 5) b u t no in te ro sse i o r lu m b ric a ls o f fu n c tio n a l v alue. C lass 2 — F r o m b e lo w T / l level to T /5 level in c lu siv e — h a v in g n o u se fu l b a la n c e w h e n sittin g . C lass 3 — F r o m b e lo w T /5 to T /1 0 in c lu siv e — w ith a b ility to m a in ta in b a la n c e w h e n sittin g , ig n o rin g lo w e r a b d o m in a l m u sc le s o f n o n -fu n c tio n a l s tre n g th (g ra d e s 1 a n d 2). C lass 4 — F r o m b e lo w T /1 0 to L /3 in clu siv e . P o in t s c o re f o r lo w e r lim b s 1 - 20 in c lu siv e — tra u m a tic . P o in t s c o re f o r lo w e r lim b s 1 - 1 5 in c lu siv e — p o lio m y e litis . C lass 5 — B e lo w L /3 level. P o in t s c o re f o r lo w e r lim b s 21 - 40 in c lu siv e — tra u m a tic . P o in t sc o re f o r lo w e r lim b s 1 6 - 3 5 in c lu siv e — p o lio m y e litis . C lass 6 — P o in t sc o re fo r lo w e r lim b s 41 - 60 in ­ clu siv e — tra u m a tic . P o in t sc o re f o r lo w e r lim b s 3 6 - 5 0 in c lu siv e — p o lio m y e litis . C lasses 5 a n d 6 c o m p e te to g e th e r e x c e p t in sw im m in g . N o t e lig ib le f o r e n try in to in te r n a tio n a l c o m p e titio n . P o in t sc o re f o r lo w e r lim b s 61 a n d a b o v e — tra u m a tic . P o in t sc o re f o r lo w e r lim b s 51 a n d a b o v e — p o lio ­ m y e litis. A t th e S o u th A fric a n G a m e s a f u r t h e r class, C lass 7, h a s b e e n in tro d u c e d to a llo w c o m p e tito rs w ith m in im a l h a n d ic a p s to e n te r. T h is class in c lu d e s a th le te s w ith a p o in t sc o re f o r th e lo w e r lim b s o f 61 a n d a b o v e (tra u m a tic ) a n d 51 a n d a b o v e (p o lio m y e litis ). T h e m e th o d s o f m u sc le te s tin g a re th o se d e s c rib e d b y D a n ie ls a n d W o r th in g h a m (1972). M u scle s a re g ra d e d o n a 5 -p o in t system as fo llo w s: G r a d e 0 — T o ta l lack o f v o lu n ta ry c o n tra c tio n . G r a d e 1 — F a i n t c o n tra c tio n w ith o u t a n y m o v e m e n t o f th e lim b (trac e, flicker). G r a d e 2 — C o n tr a c tio n w ith v e ry w e a k m o v e m e n t th r o u g h o u t full ra n g e o f m o tio n w h e n g ra v ity is e lim in a te d . G r a d e 3 — C o n tr a c tio n w ith m o v e m e n t th ro u g h the c o m p le te jo in t ra n g e a g a in s t g r a v it y . . G r a d e 4 — C o n tra c tio n w ith m o v e m e n t th ro u g h the c o m p le te jo in t ra n g e a g a in s t g ra v ity a n d some re sista n c e . G r a d e 5 — C o n tr a c tio n o f n o rm a l s tre n g th th ro u g h fu ll ra n g e o f m o v e m e n t. T h e m u sc le g ro u p s c o n s id e re d in th is system of c la ssific a tio n , a n d th e m a x im a l p o in t sc o re fo u n d jn n o r m a l lo w e r lim b s, a re su m m a ris e d in th e tab le . J o in t M u s c le g ro u p L e ft leg R i g h t leg H i p F le x o rs 5 5 A b d u c to rs 5 5 K n e e A b d u c to rs 5 5 E x te n so rs 5 5 F le x o rs 5 5 A n k le E x te n so rs 5 5 P la n ta rfle x o rs 5 5 D o rs ifle x o rs 5 5 T o ta l 80 = 40 + 40 “ N o n - f u n c tio n a l ” m u sc le s, i.e. g ra d e s 1 a n d 2, are, h o w e v e r, n o t in c lu d e d in th e c a lc u la tio n o f th e p o i n | sc o re. \ V a rio u s fa c to rs o th e r th a n m u sc le s tre n g th a re also ta k e n in to a c c o u n t w h e n m a k in g th e final c la ssifica tio n . T h e s e fa c to rs a re p ro p r io c e p tiv e s e n s a tio n , sittin g b a la n c e , s p a s tic ity , d e fo rm itie s a n d a rth ro d e s e s , s tr a p ­ p in g , use o f o rth o s e s a n d tr a in in g e ffe c t/a th le tic a b ility . T h e I n te r n a ti o n a l S to k e M a n d e v ille G a m e s C lassific a ­ tio n G u id e (M c C a n n , 1974) gives d e ta ils o f h o w each o f th ese fa c to rs h a s a b e a rin g o f th e a b ili ty o f the a th le te a n d h o w th e y s h o u ld b e a ssessed in o r d e r to a c h ie v e u n i f o r m ity in c la ssifica tio n . T h e g u id e is d e ­ sig n e d to c o m p le m e n t th e official c la ss ific a tio n d e fin i­ tio n a n d sta te m e n t a n d h e lp s w ith b o th th e in te r­ p r e ta tio n o f th e o re tic a l a sp e c ts a n d th e p ra c tic a l a p p lic a tio n o f c la ssifica tio n . H o p e f u lly th is w ill lead to a u n if o r m c la ssific a tio n p ro c e ss th r o u g h o u t th e m a n y c o u n trie s w h ic h p a r tic ip a te in th e I n t e r n a tio n a l S to k e M a n d e v ille G a m es. References 1. D a n ie ls , L. a n d W o rth in g h a m , C. (1972) M u scle te stin g — te c h n iq u e s o f m a n u a l e x a m in a tio n , P h i la ­ d e lp h ia , W . B. S a u n d e rs Co. 2. M c C a n n , B. C a ib re (1974) l.S .M .G . C lassific a tio n G u id e fo r th e U se o f D o c to rs . 3. P o tg ie te r, 1. (1978) M e d ic a l R e p o r t on th e 1978 In te r n a tio n a l P a ra p le g ic G a m es. RIDING FOR THE DISABLED B E L IN D A S A M P S O N * 'n K o r l o o rsig v an die g e sk ie d e n is en d o e lste llin g s w o rd gegee. T e ra p e u tie se e ffe k t e w o rd g e n o e m en die v r y e ty d s o n fs p a n n in g w o r d b e k le m to o n . D ie o n tw ik k e - lin g in S u id - A fr ik a w o rd b e s k r y f. D ie v o o rd e le w ord o p g e so m en adresse in S u id - A fr ik a gegee. T h e c o n c e p t o f R id in g f o r th e D is a b le d e m e rg ed in th e e a rly 1950’s w h e n D a n is h b o rn M m e . L is H a r te l, se v e re ly d is a b le d b y p o lio m y e litis , w o n a s ilv e r m e d a l f o r D re ss a g e a t th e 1952 O ly m p ic s. T h is e n c o u ra g e d o th e rs to ta k e u p th e c au se fo r d is a b le d rid e rs a n d * C h a irm a n , S.A. R id in g f o r th e D is a b le d A s so c ia tio n . d u rin g th e m id d le 1950’s se v e ra l g ro u p s w e re s ta rte d in G r e a t B rita in , le a d in g to th e f o r m a tio n o f the R id in g f o r th e D is a b le d A s s o c ia tio n in 1969. T o d a y th e re a re o v e r 9 500 d is a b le d rid e rs in B r ita in a lo n e , a n d a s s o c ia te d m e m b e r g ro u p s e x ist t h r o u g h o u t E u ro p e , A m e ric a , C a n a d a , A u s tr a lia , N e w Z e a la n d a n d S o u th A fric a . T h e A s s o c ia tio n is a n o n -p ro fit-m a k in g o rg a n is a tio n a n d its a im is to p ro v id e rid in g fo r w h e e lc h a ir-b o u n d , c ru tc h -b o u n d a n d o th e r p h y s ic a lly d is a b le d p e rso n s a n d f o r so m e cases o f m e n ta l d isa b ility . T h e fo llo w in g ty p e s o f d is a b ility h a v e b e en a c c e p te d : c e re b ra l p a lsy , s p in a b ifida, d is s e m in a te d sc lero sis, m u s c u la r d y stro p h y , m u ltip le in ju rie s (in c lu d in g th a lid o m id e -in d u c e d d e ­ R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )