Structure and Organization of Sport for People With Intellectual Disabilities Across Europe.

Opportunities to participate and compete in sports for athletes with intellectual disability (ID) have increased; however, this group still encounters limitations in accessing a comprehensive range of sports. This study addressed the current knowledge on how sport for people with ID is organized and the relationships between the major sport organizations for people with ID across 10 European countries. The participants were 29 national sport organizations for people with ID. Data were collected using semistructured interviews with representatives from the key organizations and analyzed thematically. From the results, two major themes emerged: (a) connection and networking between sport organizations and (b) organizational landscape of each nation (i.e., ID, multidisability, or mainstream). The results of this study contribute to understanding how sport for people with ID is organized across the participating nations, demonstrating different models of development and examples of good practice.

A Systematic Review of Digital Interventions to Promote Physical Activity in People With Intellectual Disabilities and/or Autism.

This systematic review synthesized the literature on digital health interventions for the promotion of physical activity (PA) among people with intellectual disabilities and/or autism. From an initial screening of 553 records, 10 studies underwent full-text review. Data were extracted relating to study, intervention, and sample characteristics and PA-related findings. Methodological quality was evaluated using the Crowe Critical Appraisal Tool. There were mixed findings pertaining to the effectiveness of digital health interventions for promoting PA among these populations. Positive results were reported for three of five active-video-game interventions, two of three social-media-based interventions, and one of two e-learning/multicomponent interventions. Digital health interventions can potentially be effective for promoting PA among people with intellectual disabilities and/or autism. However, the large variation in the samples and intervention types and a reliance on pre- and quasi-experimental research designs suggest that inferences should be made with caution and additional research is needed.

Effect of Water-Based vs. Land-Based Exercise Intervention (postCOVIDkids) on Exercise Capacity, Fatigue, and Quality of Life in Children with Post COVID-19 Condition: A Randomized Controlled Trial.

Evidence suggests that COVID-19 can cause lasting health consequences called post-COVID-19 condition. We conducted a three-group, randomized controlled trial for children aged 10-12 years with post COVID-19 condition. Participants were randomized to AQUA, LAND, or CONTROL groups. The AQUA and LAND training sessions were conducted twice a week for eight weeks. The primary outcomes were exercise capacity, measured using the modified Balke treadmill protocol, and fatigue, measured using the Cumulative Fatigue Symptoms Questionnaire (CFSQ). The secondary outcome was health-related quality of life (HRQoL), measured with the Pediatric Quality of Life Inventory (PedsQL) for children and parents. A total of 74 of the 86 children completed the intervention and attended the post-intervention assessment. The absolute maximal oxygen uptake (VO2max) values increased after both AQUA (p = 0.001) and LAND (p = 0.004) interventions. No significant differences were found in the degree of total fatigue and individual fatigue symptoms. A significant improvement was found in the PedsQL reported by the parents in the LAND group. In conclusion, the applied eight-week water-based and land-based exercise training programs improved exercise capacity in children aged 10-12 years old with post COVID-19 condition. The parents of the children in the training groups also noted an improvement in HRQoL.

Water-Based and Land-Based Exercise for Children with Post-COVID-19 Condition (postCOVIDkids)-Protocol for a Randomized Controlled Trial.

The most common symptoms of post-COVID-19 condition in children are fatigue, shortness of breath, exercise intolerance, and weakness. The post-COVID-19 condition in children can be very debilitating and lead to prolonged school absences, high morbidity, and limitations in daily functioning. The aim of this research project is to determine the effectiveness of land-based and water-based exercise interventions on exercise capacity, fatigue, health-related quality of life, and pulmonary function in children with post-COVID-19 condition. This study is a prospective randomized controlled study with pre- and post-intervention assessment. Participants will be recruited from Warsaw's primary schools and primary healthcare units according to the inclusion criteria: (i) symptoms of post-COVID-19 condition lasting more than one month following initial COVID-19 infection confirmed by the diagnosis by general practitioner (including obligatory fatigue and shortness of breath/respiratory problems); (ii) age 10-12 years old. Participants meeting the inclusion criteria will be randomized to one of three groups: water-based exercise, land-based exercise, or control (no exercise). We hope this study will provide guidance for long-COVID-19 rehabilitation in children.

Anaerobic Variables As Specific Determinants of Functional Classification in Wheelchair Basketball.

Every parasport is currently encouraged to consider evidence-based classification to develop their respective classification system. Therefore, the aims of this study were to: (1) assess the relationship between trunk function and anaerobic power determining proficiency in wheelchair basketball, and (2) define "natural classes" in wheelchair basketball based on anaerobic power. Fifty-nine elite players (representing five national teams) were divided into four main functional classes: Group 1 (n=17), Group 2 (n=14), Group 3 (n=16), Group 4 (n=12). They performed the 6x10s Anaerobic Power Test using an arm crank ergometer. Average values of mean power, peak power, relative mean power, relative peak power, and power decrement were calculated for the 6x10s and 3x10s tests. The Spearman's correlation matrix revealed significant correlations between classes and values recorded in the 6x10s test. This confirmation between anaerobic power and players' classification endorses the division of players into different classes. Furthermore, cluster analysis (with fair quality) divided players into two "natural classes". The first resulting class was mainly formed of participants from Group 1 (71%). An important complement to this research could be to consider wheelchair acceleration and the volume of trunk action in wheelchair basketball classification.

Aquatic Therapy for Persons with Neuromuscular Diseases - A Scoping Review.

BACKGROUND: Aquatic exercise is among the most common physical activity modalities performed by people with disabilities. OBJECTIVE: The present paper reviews currently-available research on aquatic therapy (AT) for persons with neuromuscular diseases (NMD). METHODS: A scoping review of the existing literature was conducted on PubMed, Embase, Medline, Scopus, Web of Science, SPORTdiscus, CINAHL and Lilacs from the earliest date available until October 2020. It follows the methodological framework for conducting a scoping review proposed by the Joanna Briggs Institute. RESULTS: A total of 28 articles were analyzed and the study parameters grouped by the topography of NMD; most of the studies (n = 16) addressed myopathies. A considerable increase in the number of studies was found over time, and heterogeneity was identified across and within AT interventions for persons with NMD; hence, to allow more effective interpretation of study results, there is a need to standardize the fundamental parameters and procedures for AT. CONCLUSIONS: This scoping review provides a comprehensive outline of available literature; the findings could serve as a starting point for clinical studies on the effects of AT on persons with NMD, and encourage a more coherent approach to their design.

Effects of Aquatic Therapy for Children with Autism Spectrum Disorder on Social Competence and Quality of Life: A Mixed Methods Study.

Autism Spectrum Disorder (ASD) is a constellation of social deficits and repetitive sensory-motor behaviours. Aquatic therapy (AT) may be effective in improving the social interactions and behaviours in children with ASD. The objective of this study was to evaluate the effects of an AT program on social competence and quality of life and to understand participant's experiences related to the intervention by obtaining qualitative data. A mixed methods intervention study was conducted among 6 children with ASD and their parents, with two research phases in a concurrent embedded design (an aquatic intervention as the quantitative design and a qualitative design in second step). The intervention and qualitative design followed international guidelines and were integrated into the method and reporting subheadings. Significant improvement was observed in the physical competence (p = 0.026) and important improvements in school functioning and aquatic skills, with no adverse events. Qualitative findings described: the meaning of AT intervention, patterns of behaviour and activities changes, social communication and social interaction. The aquatic intervention showed positive results for the social and physical competence, with elements of discordance, expansion, and confirmation between quantitative and qualitative results.

Does the Aquatic Breathing Program Improve Lung Function in Adolescents with Scoliosis?

Aim: To determine pulmonary parameters in adolescents with scoliosis after three weeks of intensive physiotherapeutic scoliosis-specific exercises based on the Aquatic Breathing Program (ABP) compared to corrective swimming (CS).Methods: A pretest-posttest control group design was used. The ABP group comprised 13 adolescents (age 14.2 ± 1.4) and the CS group 10 adolescents (age 14.1 ± 1.5) with mild to moderate scoliosis. Both groups participated in a threeweek intervention consisted of three types of exercises: corrective, general and aquatic. ABP group participated in the Aquatic Breathing Program and CS group took part in corrective swimming. Spirometric measurements were taken before and after the intervention.Results: ABP group demonstrated a greater increase (p = .05) in the predicted percentage values of forced expiratory volume in 1 s (FEV1) and maximal expiratory flow at 25% of forced vital capacity (MEF25), both in absolute terms and in percentage values (MEF25%pred) compared to the CS group. CS group exhibited lower values of all measured parameters in the second examination, and some of those differences were found to be statistically significant.Conclusions: The Aquatic Breathing Program can be used in adolescents with mild to moderate scoliosis to improve lung function.

Head-Out Water-Based Protocols to Assess Cardiorespiratory Fitness-Systematic Review.

The aquatic environment offers cardiorespiratory training and testing options particularly for individuals unable to adequately train or test on land because of weight bearing, pain or disability concerns. No systematic review exists describing cardiorespiratory fitness protocols used in an aquatic environment. This review investigated the different head-out water-based protocols used to assess cardiorespiratory fitness. Our comprehensive, systematic review included 41 studies with each included paper methodological quality assessed using the statistical review of general papers checklist. Diverse protocols arose with three major categories identified: conducted in shallow water, deep water, and using special equipment. Thirty-seven articles presented data for peak/maximal oxygen consumption (VO2peak/VO2max). Twenty-eight of 37 studies predefined criteria for reaching a valid VO2peak/VO2max with shallow water exercise demonstrating 20.6 to 57.2 mL/kg/min; deep water running 20.32 to 48.4 mL/kg/min; and underwater treadmill and cycling 28.64 to 62.2 mL/kg/min. No single, accepted head-out water-based protocol for evaluating cardiorespiratory fitness arose. For clinical use three cardiorespiratory fitness testing concepts ensued: water temperature of 28-30 °C with difference of maximum 1 °C between testing participants and/or testing sessions; water depth adapted for participant aquatic experiences and abilities; and intensity increment of 10-15 metronome beats per minute.

Wheelchair Basketball Competition Heart Rate Profile According to Players' Functional Classification, Tournament Level, Game Type, Game Quarter and Playing Time.

Heart rate is a popular parameter observed in team sports to plan training sessions with regard to load and sport specificity. Wheelchair basketball is an intermittent team game for physically impaired players. The study aim was to define heart rate profile of wheelchair basketball players in terms of their functional classification (category A: 1.0-2.5 points, category B: 3.0-4.5 points), tournament level (championships and friendly games), game type (close, balanced, and unbalanced), game quarter (1st, 2nd, 3rd, and 4th) and playing time (40-59%, 60-79%, and 80-100% in a quarter). Heart rate of 18 wheelchair basketball players was monitored in 22 games in four different tournaments, i.e., European Championships 2017, World Championships 2018, two friendly international tournaments of national teams (2017 and 2018). Heart rate (HRmean, HRpeak, %HRpeak, HRR, and %HRR) was monitored by Polar Team Pro (Kempele, Finland) during playing time on the court. Timeouts, quarter breaks, a half break, time on a bench were not taken into account in HR monitoring. The Kolmogorov-Smirnov test, the Mann-Whitney U test and the Kruskal-Wallis test were used. Fourteen players divided according to the classification into category A and B were included in the final calculations (n = 457 cases). Significantly higher HRmean, %HRpeak, HRpeak, and %HRR were noted among category B players, and higher %HRpeak and %HRR among category A players at the highest tournament level compared to friendly games. There were significant differences in %HRR and the percentage of time spent in HR zone I between the players with different playing time (40-59% versus 60-79%) in category B. No significant differences in HR were noted between four quarters. Among category A players, differences in HR in zone II were observed. Among category B players, statistically significant differences in % HRpeak, the percentage of time spent in HR zones I, II, III, and %HRR between close, balanced and unbalanced games were found. In conclusion, the intermittent nature of wheelchair basketball was confirmed. Monitoring heart rate in a game could be helpful in creating exercises with proper loads for better physical preparation of wheelchair basketball players. High intensity training sessions would be more beneficial in preparing players for game demands.

Accuracy of Impedance Cardiography for Hemodynamic Assessment During Rest and Exercise in Wheelchair Rugby Players.

Purpose: The aim of the study was to analyze the accuracy of impedance cardiography (ICG) for hemodynamic assessment in wheelchair rugby players during rest and exercise. Method: The study included 21 players (mean age 33.0 ± 5.4, 86% male) with posttraumatic tetraplegia. ECG, echocardiography, and gas exchange analysis during rest and exercise were used to obtain heart rate (HR), stroke volume (SV), and cardiac output (CO) for comparison with PhysioFlow®. Results: There was a good correlation between reference methods and ICG for HR, SV, CO at rest and CO at peak exercise (r = 0.69-0.77, p < .001) and a very good correlation for peak HR (r = 0.91, p < .0001). ICG overestimated SV at rest, CO at rest, and peak CO, which resulted in low intraclass correlation coefficients (ICC = 0.250 and 0.570). Conclusions: ICG can serve as a good estimate of basic hemodynamic parameters during rest and exercise in wheelchair rugby players but overestimates stroke volume and cardiac output.

Laboratory and Non-laboratory Assessment of Anaerobic Performance of Elite Male Wheelchair Basketball Athletes.

Wheelchair basketball is an adaptive Paralympic sport and wheelchair basketball players are under classification in sport. Coaches are looking for useful assessment tools (field-based tests) to evaluate players' anaerobic performance (anaerobic capacity). The aim of this study was to assess the validity of field-based tests for anaerobic performance evaluation for two functional categories of wheelchair basketball players and to create a calculator to predict mean or peak power on the basis of the selected field-based test results. Sixty-one elite male wheelchair basketball players performed the Wingate Anaerobic Test and the following field-based tests: 3 m sprint, 5 m sprint, 10 m sprint, 20 m sprint, basketball chest pass test, medicine ball (3 kg) chest pass test, bilateral handgrip, 3-6-9 m drill test, 30-s sprint test, agility drill test and 10 × 5 m sprint test. The participants were divided into two functional categories: A (classes from 1.0 to 2.5; n = 29) and B (classes from 3.0 to 4.5; n = 32) according to the International Wheelchair Basketball Federation rules. The large effect size (Cohen's d > 0.5) was found in four tests (3 m sprint, 5 m sprint, basketball chest pass test, medicine ball chest pass test; ES 0.90, 0.53, -0.96, -1.05). There were differences between category A and category B players regarding mean power, peak power and relative peak power. Peak power correlated with four tests, while mean power correlated with eight out of eleven tests. The formulas for estimating peak power or mean power in category A and B players were created separately. All the analyses confirmed that 3 m sprint, 5 m sprint, 10 m sprint, 20 m sprint, agility drill test, bilateral handgrip, 3-6-9 m drill test, 30-s sprint test, basketball chest pass test and medicine ball chest pass test are valid for non-laboratory anaerobic performance evaluation. Using the four formulas as a tool to predict mean or peak power on the basis of the selected field-based test results and functional categories will be helpful and will allow coaches and players to prepare pre-season, post-season and in-season conditioning exercises in wheelchair basketball.

Functional Movement Screen™ and history of injury in the assessment of potential risk of injury among team handball players.

BACKGROUND: Handball is known to be one of the team sports representing the highest risk of injury. Several investigators have tried to identify injury risk factors in team sports including handball and suggested the need to develop an optimal tool to capture and quantify the potential risk of injury. The aim of the study was to evaluate potential risk of injury among handball players. METHODS: This was a mixed-design study. Handball players from 1st and 2nd division were evaluated (N.=30) using the Functional Movement Screen™ (FMS™). Additionally, self-reported history of injury was collected during FMS™ evaluation and after 6 months. Competitive level, training experience, playing position, anthropometric features, symmetry of movement patterns and history of previous injury were analyzed while assessing the potential risk of injury. RESULTS: Significant difference between the right and left side (upper limb) was revealed for Shoulder Mobility Test (U=308.5, P=0.014). Odds Ratio analysis revealed that having previous injury in the last 12 months is the only statistically significant injury risk factor (OR=13.71, P=0.02). CONCLUSIONS: Based on this study we can assume that previous injury history reports are crucial in predicting injuries. FMS™ can help in identifying a typical adaptation in throwing shoulder among handball players, but should not be used alone to assess injury risk.

Participation in leisure activities and tourism among older people with and without disabilities in Poland.

Health conditions associated with aging might be related to disability and lead to decreased independence. Physical activity assists in maintaining independence throughout life as well as improves quality of life. Individuals with disabilities demonstrate overall less activity than sedentary persons without disabilities. Efforts to reduce age-related functional autonomy decline and to increase physical activity may require separate approaches for older adults with and without disabilities. The aim of the study was to compare physical activity and participation in leisure activities and tourism among older people with and without disabilities in Poland. A cross-sectional, multicenter study (PolSenior) randomly recruited participants aged 65 years and over, in a stratified, proportional draw performed in three stages from all 16 Polish provinces. 3743 people, 2653 (70.9%) without disabilities, and 1090 (29.1%) with disabilities responded providing general sociodemographic characteristics and various health behaviors including subjective physical activity level, leisure time activities, tourism and activity limitations. Older males without disability reported more physical activity than women with disability, while no differences were observed for females with and without disability. Polish older people with and without disability were more involved in gardening and staying in a garden allotment or a holiday home rather than participating in organized forms of sport, physical activity, and tourism. Health conditions arose as the most frequently indicated barrier toward participation in sport physical activity and tourism. In conclusion, strategies and programs to increase physical activity among older Polish people, with and without disability, should focus on preserving health and physical function.

Evaluation of Game Performance in Elite Male Sitting Volleyball Players.

The aims of the current study were (a) to analyze the differences in game performances of sitting volleyball athletes representing the different types of disabilities and (b) to assess whether the seated position vertical reach is one of the crucial factors in the game performance level of sitting volleyball athletes. One hundred male athletes from various national teams participating in the European Championships in Sitting Volleyball (2009) took part in this study. The athletes were categorized according to type of disability and the results of the vertical reach in a seated position. Thirtysix games were analyzed using the Game Performance Sheet for Sitting Volleyball. Twenty-three game performance parameters were studied. In addition, the sum and effectiveness of attacks, blocks, block services, services, ball receiving, and defensive actions were calculated. The main results indicated significant differences between athletes with minimal disability and athletes with single amputations from above the knee in the level of defensive performances and the summation of defensive actions. There was also a significant difference between athletes in relation to their vertical reach during activity and attacking actions, blocks, and ball receiving. In addition, there were strong relationships between the players' vertical reach scores and their activity and effectiveness in sitting volleyball. In conclusion, the accuracy of the World Organization Volleyball for Disabled classification systems for sitting volleyball players was confirmed. There is a strong relationship between players' vertical reach and their effectiveness in sitting volleyball.

Comparison of Aerobic Performance Testing Protocols in Elite Male Wheelchair Basketball Players.

In wheelchair sports, aerobic performance is commonly assessed with the use of an arm crank ergometer (ACE), a wheelchair ergometer (WCE) or a wheelchair treadmill (WCT). There are different protocols to identify peak oxygen uptake in wheelchair sports; however, only a few protocols have been applied to evaluate these conditions in wheelchair basketball players. The purpose of this study was to compare physiological responses during maximal exercise testing with the use of ACE and WCT in wheelchair basketball players. Twelve elite male wheelchair basketball players participated in this study. The research was performed during a training camp of the Polish National Wheelchair Basketball Team. The study participants were divided into two functional categories: A (players with class 1.0 - 2.5) and B (players with class 3.0 - 4.5). Two main maximal exercise tests, i.e. wheelchair treadmill stress test (WCT test) and arm crank ergometer stress test (ACE test) were used to evaluate aerobic performance of the players. There were no statistically significant differences in aerobic tests between the players from both groups. The comparison of results achieved in two aerobic tests performed on WCT and ACE did not reveal any significant differences between the analyzed variables (peak heart rate (HRpeak), peak oxygen uptake (VO2peak), minute ventilation (VE), anaerobic threshold (AT), lactate concentration (LApeak), and a drop in lactate concentration (%LA)). Strong correlations between results achieved in WCT and ACE tests were found for VO2peak, VE and LApeak. The main conclusion of the study is that both WCT and ACE tests may be useful when determining aerobic capacity of wheelchair basketball players. Moreover, both protocols can be used by athletes regardless of their functional capabilities and types of impairment.

Game Performance Evaluation in Male Goalball Players.

Goalball is a Paralympic sport exclusively for athletes who are visually impaired and blind. The aims of this study were twofold: to describe game performance of elite male goalball players based upon the degree of visual impairment, and to determine if game performance was related to anthropometric characteristics of elite male goalball players. The study sample consisted of 44 male goalball athletes. A total of 38 games were recorded during the Summer Paralympic Games in London 2012. Observations were reported using the Game Efficiency Sheet for Goalball. Additional anthropometric measurements included body mass (kg), body height (cm), the arm span (cm) and length of the body in the defensive position (cm). The results differentiating both groups showed that the players with total blindness obtained higher means than the players with visual impairment for game indicators such as the sum of defense (p = 0.03) and the sum of good defense (p = 0.04). The players with visual impairment obtained higher results than those with total blindness for attack efficiency (p = 0.04), the sum of penalty defenses (p = 0.01), and fouls (p = 0.01). The study showed that athletes with blindness demonstrated higher game performance in defence. However, athletes with visual impairment presented higher efficiency in offensive actions. The analyses confirmed that body mass, body height, the arm span and length of the body in the defensive position did not differentiate players' performance at the elite level.

Balance Functional Assessment in People with Visual Impairment.

The aims of this study were twofold: to assess the level of balance of people with visual impairment against the BOT-2 standard scores for the able-bodied, and to identify in which trials subjects had the greatest difficulties in maintaining balance with respect to the degree of vision loss and age categories. One hundred twenty-seven subjects with visual impairment aged 6-16 years, participated in the study (68 girls and 59 boys). The division for partially sighted people (61) and the blind (66) was made according to the WHO classification. Functional balance assessment was made using a balance subtest from the Bruininks-Oseretsky test. Significant relationships were noticed between age and the level of balance (χ2 = 8.35 p <0,05), as well as between the degree of vision loss and the level of balance (χ2 = 24.53 p <0,001). The level of balance of almost all blind subjects was below (20%) or well-below (60%) the average for the able-bodied. The subjects' ability to maintain balance was not dependent on gender and was associated primarily with the degree of visual impairment and age. Partially sighted people had better balance than the blind and the decrease in visual acuity resulted in reduction of balance skills. The lowest level of balance was observed in blind students aged 7-11 years. Elaborating physical fitness improvement programs for children and adolescents with visual impairment, diversity of age, the degree of vision loss and limitations of ablility to maintain balance should be taken into account.

Using ecological momentary assessment to evaluate current physical activity.

OBJECTIVE: The purpose of this study was to assess the value of ecological momentary assessment in evaluating physical activity among children, adolescents, and adults. It also determines whether ecological momentary assessment fulfills the criteria of validity, reliability, objectivity, norms, and standardization applied to the tools used for the evaluation of physical activity. METHODS: The EBSCO-CINHAL, Medline, PsycINFO, PubMed, and SPORTDiscuss databases were reviewed in December 2012 for articles associated with EMA. RESULTS: Of the 20 articles examined, half (10) used electronic methods for data collection, although various methods were used, ranging from pen and paper to smartphone applications. Ten studies used objective monitoring equipment. Nineteen studies were performed over 4 days. While the validity of the EMA method was discussed in 18 studies, only four found it to be objective. In all cases, the EMA procedures were precisely documented and confirmed to be feasible. CONCLUSIONS: Ecological momentary assessment is a valid, reliable, and feasible approach to evaluate activity and sedentary behavior. Researchers should be aware that while ecological momentary assessment offers many benefits, it simultaneously imposes many limitations which should be considered when studying physical activity.

Game performance in ice sledge hockey: an exploratory examination into type of disability and anthropometric parameters.

OBJECTIVE: To compare first disability and anthropometric variables and second disability and game efficiency measures. DESIGN: Prospective cohort study. SETTING: Winter Paralympic Games in Vancouver (2010). PARTICIPANTS: A sample of 54 (age, 30.85 ± 7.99 y) of the 114 elite ice sledge hockey athletes participated in this study. To be included in the analysis, an athlete had to participate for a minimum of 45 minutes in total and in a minimum of 2 games during the tournament. ASSESSMENT OF RISK FACTORS: Athletes were categorized according to type of disability into 4 groups: group 1 (double amputee above and below the knee), group 2 (single amputee above and below the knee), group 3 (spinal cord injury), and group 4 (other physical disabilities, including phocomelia, cerebral palsy, sclerosis multiplex, and lower limb paresis, and players with minimal disability). Before the tournament, athletes completed a Personal Questionnaire Form. Data including anthropometric measurements (seated position and range of arms) and length of the sledge were also collected. MAIN OUTCOME MEASURES: All 20 scheduled games were videotaped using 3 video cameras. The games were analyzed after the tournament by 5 observers. All observations were recorded using the Game Efficiency Sheet for Ice Sledge Hockey developed by the authors. Fourteen game parameters were included for analysis. RESULTS: The instrument was developed specifically for this project's exploratory analysis. Interobserver and intraobserver reliability were established by statistical analysis (r > 0.93 and r > 0.95, respectively). Significant differences between disability groups were found for training frequency (F3,50 = 4.73, P = 0.006), height (F3,50 = 12.54, P = 0.001), and sledge length (F3,50 = 12.35, P = 0.001). The results of the Tukey honestly significant difference post hoc analyses revealed significant differences between groups 1 and 4 (P = 0.026), 2 and 4 (P = 0.007), and 3 and 4 (P = 0.013) for training frequency. There were also significant differences between groups 1 and 2 (P < 0.001), 1 and 4 (P < 0.001), and 2 and 4 (P = 0.021) for body height. In sledge length, significant differences were observed between groups 1 and 2 (P < 0.001), 1 and 3 (P < 0.001), 1 and 4 (P = 0.016), and 2 and 4 (P = 0.028). There was no strong evidence to support disability group differences in game efficiency measures. CONCLUSIONS: The results may confirm the lack of a need for additional classification in sledge hockey beyond minimum eligibility or may enhance the argument that a classification system may be needed because the lower functioning disabilities are not being represented in the sport.