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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.

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Spasticity is graded on a 5-point scale

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"0" refers to floppy or low muscle tone

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"1" to normal muscle tone

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"2" to an increase in tone that does not restrict movements

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"3" to an increase in tone that does restrict movements

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"4" to stiff muscle tone that makes passive movements difficult or impossible.

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Coordination graded on a 6-point scale

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"0" refers to a lack of functional movement

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"1" to very severely restricted range of movement due to severe hypertonic muscle stiffness and/or very minimally coordinated movements

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"2" to severely restricted range of movement with severe spasticity-hypertonic muscle stiffness present and/or severe coordination problems

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"3" to moderate range of movement and moderate spasticity with tone restricting movement and/or moderate coordination problems

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"4" to almost full range of movement, with slight spasticity and slight increase in muscle tone and/or slight coordination problems

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"5" to normal coordination.

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.

Disability Sports Web Site                        © Michigan State University                        Revised 12/12/2007