Journal Club December 2016: The Impact of Trunk Impairment on Performance-Determining Activities in Wheelchair Rugby

Article Title: The Impact of Trunk Impairment on Performance-Determining Activities in Wheelchair Rugby

Author: V. C. Altmann, B. E. Groen, A. L. Hart, Y. C. Vanlandewijck, J. van Limbeek, N. L.W. Keijsers

Journal: Scandinavian Journal of Medicine & Science in Sports


Imagine the game of rugby, one of the rougher contact sports played worldwide. Now imagine that each of those rugby athletes are tetraplegic and are in a wheelchair, but don’t tone down the contact. Wheels screeching, chairs crashing, crowds roaring! This is the adaptive sport known as wheelchair rugby.

The following study by Altmann et al. 2016 observed the impact of the severity of an individual’s trunk impairment on their performance in wheelchair rugby. They assessed the relationship between the Trunk Impairment Classifications (TIC) system with wheelchair activities that determine the performance in the sport of wheelchair rugby. Typically the lower the TIC score, the more physically impaired an individual is.

The study took 55 athletes with a variety of TIC scores and put them through a series of tests. Specifically, they looked at four activities that they thought would be really affected by trunk impairment, including: a 10-m sprint test, a turn test, a tilt test and a maximal initial acceleration test. Each athlete performed three trials per test. Two athletes participated simultaneously during each test, to ensure some competitiveness.

Ultimately the performance of a wheelchair rugby athlete is determined by three separate items: (1) how they avoid a hit (maneuverability and acceleration), (2) how well they hit (acceleration, peak speed and impulse of hit) and (3) how well they free themselves from being held by the opposing player’s chair (impulse and tilting). They better they performed on the four assigned activities, the better they would perform in a real-life athletic setting of a wheelchair rugby match.

As a result, the study showed that the players with higher TIC scores were better athletes in wheelchair rugby than those with lower TIC scores.

Discussion by James Meiling, OMS-II, Texas College of Osteopathic Medicine

Discussion Points:

  1. Why is it important to rank paraolympic athletes by severity of disability?
  2. Describe the terms hitting and tilting when related to wheelchair rugby.
  3. How would a larger sample size aid the committees that designed the Trunk Impairment Classification (TIC) guidelines?
  4. Athletes with which health conditions participated in this study? Additionally, how would each health condition affect the performance of each athlete?
  5. Why was it important to test two athletes at the same time? How would the results of the study have differed if they ran each test individually, one at a time?
  6. Can these results be used to determine effectiveness of an athlete in other adaptive sports?
  7. Why do guidelines differ from one adaptive sport to another?
  8. How could future studies improve upon the Trunk Impairment Classification system?
  9. With the results of this study, what implications does this have for the future athletes you see within your practice?

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Journal Discussion Questions December 2016

Journal Article December 2016