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Classification of Athletes
with Cerebral Palsy and
Related Neurological Conditions
Athletes with cerebral palsy, stroke, and head injury
are placed into one of eight classes based partly upon the degree of
spasticity, partly upon the athlete's coordination, and partly upon the
number of limbs/body parts involved. Classes 1-4 are for
athletes who compete from a seated position, and Classes 5-8 are
for athletes who are ambulatory. The following brief description
of the eight-class system was modified from the web site of the CP
Sport/England and Wales organization at
http://www.cpsport.org.
|
Class |
Brief Description |
| CP1 |
Athletes experience
movement difficulties that affect the entire body. Typically the
athlete cannot propel a manual wheelchair, often has difficulty
altering sitting position, often uses the trunk in head and arm
movements, has difficulty with grasp and release motions, and has no
functional use of the legs. |
| CP2 |
Athletes have
movement difficulties that affect the entire body. Typically the
athlete has trunk control that may involve limb movement, has
difficulty with consistent isolated shoulder movements, is able to
spread the fingers and thumbs - but not quickly, is able to hand or
foot push a manual wheelchair, and may be able to stand or walk but
is very unstable. |
| CP3 |
Athletes are
wheelchair users and have one affected upper limb. Typically the
athlete has a limited range of shoulder movement and a marked
difference in the function of the arms, is able to propel a manual
wheelchair - often with the heel of the hand and straight fingers,
has poor balance when sitting unsupported, raises the hips and
straightens the knees during vigorous arm use, and can stand or walk
if supported with crutches or other device. |
| CP4 |
Athletes are
wheelchair users whose arms are not affected. Typically the athlete
has good sitting balance and body movement, has arms and hands that
are unaffected, is capable of a strong controlled wheelchair push,
may walk with crutches or sticks, and uses a wheelchair or throwing
frame for sports. |
| CP5 |
Athletes are
ambulatory with both legs affected. Typically the athlete has
balance when standing, has noticeable hip and shoulder rotation when
walking, and has inwardly bent knees and sometimes flat feet. If
standing balance is poor, the athlete may elect to compete as a
Class 4 competitor from a sitting position. |
| CP6 |
Athletes are
ambulatory with all four limbs affected. Typically the athlete has
an overall lack of control during movement, is able to walk unaided
but has difficulty with balance, has a rolling head movement during
running, has difficulty hopping and skipping, and is unable to
sustain a clapping rhythm. |
| CP7 |
Athletes are
ambulatory with the arm and leg on the same side affected. Typically
the athlete is unable to hop on the affected leg, runs flat-footed
with the affected leg while the arm swings across the chest, often
tilts the head to one side during exertion, and has a normal
throwing action but with increased body movement. |
| CP8 |
Athletes have
minimal disability. Typically the athlete will have good balance and
only slight coordination problems, and the disability is more
obvious during exertion. The disability must be evident without
having to resort to medical proof. |
As mentioned earlier,
classification judgments depend in part upon spasticity levels
and coordination skills. Usually several movements are tested
when assessing spasticity and coordination, and points are
summed across movements.
 |
Spasticity is graded on a
5-point scale
 |
"0"
refers to floppy or low muscle tone
|
 |
"1"
to normal muscle tone
|
 |
"2"
to an increase in tone that does not restrict movements
|
 |
"3"
to an increase in tone that does restrict movements
|
 |
"4"
to stiff muscle tone that makes passive movements difficult or
impossible.
|
|
 |
Coordination graded on a
6-point scale
 |
"0" refers to a lack of
functional movement
|
 |
"1" to very severely restricted range of movement due to
severe hypertonic muscle stiffness and/or very minimally
coordinated movements
|
 |
"2" to severely restricted range of movement with severe spasticity-hypertonic muscle stiffness present and/or severe
coordination problems
|
 |
"3" to moderate
range of movement and moderate spasticity
with tone restricting movement and/or moderate coordination
problems
|
 |
"4" to almost full range of movement, with slight spasticity and slight increase in muscle tone and/or slight
coordination problems
|
 |
"5" to normal coordination.
|
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For
a more detailed information about the classification of athletes
with cerebral palsy and related neurological conditions, go to
the IPC web
site at
http://www.paralympic.org; click on "sports," then
"classification," then "athletes with cerebral palsy."
Interested persons may also consult the CP-ISRA web site at
http://www.cpisra.org.
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