Paralympic Sport

  • Yetsa A. Tuakli-WosornuEmail author
  • Fiona Doolan
  • Jan Lexell


As expressed by the International Paralympic Committee, four values underpin the Paralympic Movement: determination, equality, inspiration, and courage. This concise set of principles weaves its way through the stories of individual Paralympic athletes and anchors the history of the Paralympic Movement itself. Set against the backdrop of the two great world wars, the Paralympic Movement was created, in part, as a response to the need for progressive medical services for war-wounded citizens with impairments. Today, Paralympic sports continue to create a more inclusive society for people with impairments, emphasizing equality, hope, and humanity, in spite of physical differences. In this chapter, we contextualize the modern Paralympic Movement by reviewing its history and describing its sports. We then review a cornerstone feature of Paralympic sport, athlete classification. Common illnesses and injuries among Para athletes are then reviewed. We conclude by discussing controversies in Paralympic sport, including “boosting” among spinally injured athletes, and commonly used medications that have the potential to impact sports performance.


Paralympic Movement Disabled sports Athlete Athletes with disabilities Injury and illness Boosting 


  1. 1.
    Bailey S. Athlete first: a history of the paralympic movement. West Sussex: Wiley; 2008.Google Scholar
  2. 2.
    Guttmann L. Spinal cord injuries: comprehensive management and research. Oxford: Blackwell Scientific Publications; 1973.Google Scholar
  3. 3.
    Goodman S. Spirit of Stoke Mandeville: the story of Sir Ludwig Guttmann. London: Harper Collins Publishing LLC; 1986.Google Scholar
  4. 4.
    Guttmann L. History of the National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury. Paraplegia. 1967;5:115–26.PubMedGoogle Scholar
  5. 5.
    Gallagher M. Athletics. Aylesbury: British Sports Association for the Disabled; 1982.Google Scholar
  6. 6.
    Guttmann L. Textbook of sport for the disabled. Aylesbury: HM & M Publishers; 1976.Google Scholar
  7. 7.
    Brittain I. From Stoke Mandeville to Stratford: a history of the summer paralympic games. Champaign: Common Ground Publishing, LLC; 2012.Google Scholar
  8. 8.
    Guttmann L. The annual Stoke Mandeville games. The Cord. 1949;3:24.Google Scholar
  9. 9.
    Tuakli-Wosornu Y. ‘And thereby hangs a tale:’ current medical and scientific controversies in paralympic sport. Palaestra. 2016;30(3):9–13.Google Scholar
  10. 10.
    I.P. Committee. Accessed 1 Feb 2017.
  11. 11.
    The International Paralympic Committee Strategic Plan 2015 to 2018. I.P. Committee, editor. Bonn; 2015.Google Scholar
  12. 12.
    Tweedy S, Howe PD. Introduction to the paralympic movement. In: Vanlandewijck YC, Thompson WR, editors. The paralympic athlete. West Sussex: Wiley Blackwell; 2011.Google Scholar
  13. 13.
    Van de Vliet P. Paralympic athlete’s health. Br J Sports Med. 2012;46(7):458–9.CrossRefGoogle Scholar
  14. 14.
    Hart A. Classification: conceptual models. In: International Convention on Science, Education and Medicine in Sport (ICSEMIS). Glasgow; 2012.Google Scholar
  15. 15.
    Tweedy SM, Vanlandewijck YC. International Paralympic Committee position stand—background and scientific principles of classification in Paralympic sport. Br J Sports Med. 2011;45(4):259–69.CrossRefGoogle Scholar
  16. 16.
    I.P. Committee. IPC Classification Code and International Standards. Bonn; 2007.Google Scholar
  17. 17.
    I.P. Committee. International Standard for Athlete Evaluation, G.I.P.C. Bonn, editor.Google Scholar
  18. 18.
    Altmann VC, et al. Reliability of the revised wheelchair rugby trunk impairment classification system. Spinal Cord. 2013;51(12):913–8.CrossRefGoogle Scholar
  19. 19.
    Altmann VC, et al. Improvement of the classification system for wheelchair rugby: athlete priorities. Adapt Phys Activ Q. 2014;31(4):377–89.CrossRefGoogle Scholar
  20. 20.
    Altmann VC, et al. The impact of trunk impairment on performance of wheelchair activities with a focus on wheelchair court sports: a systematic review. Sports Med Open. 2015;1(1):6.CrossRefGoogle Scholar
  21. 21.
    Altmann VC, et al. The impact of trunk impairment on performance-determining activities in wheelchair rugby. Scand J Med Sci Sports. 2017;27(9):1005–14.CrossRefGoogle Scholar
  22. 22.
    Altmann VC, et al. Construct validity of the trunk impairment classification system in relation to objective measures of trunk impairment. Arch Phys Med Rehabil. 2016;97(3):437–44.CrossRefGoogle Scholar
  23. 23.
    Vanlandewijck Y, Theisen D, Daly D. Wheelchair propulsion biomechanics: implications for wheelchair sports. Sports Med. 2001;31(5):339–67.CrossRefGoogle Scholar
  24. 24.
    Vanlandewijck YC, Verellen J, Tweedy S. Towards evidence-based classification in wheelchair sports: impact of seating position on wheelchair acceleration. J Sports Sci. 2011;29(10):1089–96.CrossRefGoogle Scholar
  25. 25.
    Vanlandewijck YC, et al. Trunk strength effect on track wheelchair start: implications for classification. Med Sci Sports Exerc. 2011;43(12):2344–51.CrossRefGoogle Scholar
  26. 26.
    Connick M, Beckman E, Deuble D, et al. Developing tests of impaired coordination for Paralympic classification: normative values and test-retest reliability. Sports Eng. 2016;19:147–54.CrossRefGoogle Scholar
  27. 27.
    Deuble RL, et al. Using Fitts’ law to detect intentional misrepresentation. J Mot Behav. 2016;48(2):164–71.CrossRefGoogle Scholar
  28. 28.
    Tweedy S, Williams G, Bourke J. Selecting and modifying methods of manual muscle testing for classification in Paralympic sport. Euro J Adapt Activ. 2010;3(2):7–16.CrossRefGoogle Scholar
  29. 29.
    Blauwet C, Lexell J, Derman W. Paralympic sports medicine. In: Vanlandewijck YC, Thompson WR, editors. IOC handbook of sports medicine and science: training and coaching the paralympic athlete. West Sussex: Wiley Blackwell; 2016. p. 75–95.CrossRefGoogle Scholar
  30. 30.
    Ferrara MS, et al. A longitudinal study of injuries to athletes with disabilities. Int J Sports Med. 2000;21(3):221–4.CrossRefGoogle Scholar
  31. 31.
    Webborn N, Willick S, Emery CA. The injury experience at the 2010 winter paralympic games. Clin J Sport Med. 2012;22(1):3–9.PubMedGoogle Scholar
  32. 32.
    Webborn N, Willick S, Reeser JC. Injuries among disabled athletes during the 2002 Winter Paralympic Games. Med Sci Sports Exerc. 2006;38(5):811–5.CrossRefGoogle Scholar
  33. 33.
    Derman W, et al. Illness and injury in athletes during the competition period at the London 2012 Paralympic Games: development and implementation of a web-based surveillance system (WEB-IISS) for team medical staff. Br J Sports Med. 2013;47(7):420–5.CrossRefGoogle Scholar
  34. 34.
    Willick SE, et al. The epidemiology of injuries at the London 2012 Paralympic Games. Br J Sports Med. 2013;47(7):426–32.CrossRefGoogle Scholar
  35. 35.
    Tuakli-Wosornu YA, Derman W. Contemporary medical, scientific & social perspectives on para sport. Phys Med Rehabil Clin N Am. 2018;29(2):xvii–xviii.CrossRefGoogle Scholar
  36. 36.
    Tuakli-Wosornu Y, Mashkovskiy E, Ottesen T, Gentry M, Jensen D, Webborn N. Acute and chronic musculoskeletal injury in para sport. Phys Med Rehabil Clin N Am. 2018;29(2):205–43.CrossRefGoogle Scholar
  37. 37.
    Blauwet CA, et al. Risk of injuries in paralympic track and field differs by impairment and event discipline: a prospective cohort study at the London 2012 Paralympic Games. Am J Sports Med. 2016;44(6):1455–62.CrossRefGoogle Scholar
  38. 38.
    Webborn N, et al. The epidemiology of injuries in football at the London 2012 Paralympic Games. PM R. 2016;8(6):545–52.CrossRefGoogle Scholar
  39. 39.
    Willick SE, et al. The epidemiology of injuries in powerlifting at the London 2012 Paralympic Games: an analysis of 1411 athlete-days. Scand J Med Sci Sports. 2016;26(10):1233–8.CrossRefGoogle Scholar
  40. 40.
    Derman W, et al. High incidence of injury at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days. Br J Sports Med. 2016;50(17):1069–74.CrossRefGoogle Scholar
  41. 41.
    Schwellnus M, Derman W, Jordaan E, Blauwet CA, Emery C, Pit-Grosheide P, Marques NA, Martinez-Ferrer O, Stomphorst J, Van de Vliet P, Webborn N, Willick SE. Factors associated with illness in athletes participating in the London 2012 Paralympic Games—a prospective cohort study involving 49,910 athlete days. Br J Sports Med. 2013;47:433–40.CrossRefGoogle Scholar
  42. 42.
    Derman W, Schwellnus M, Jordaan E, Runciman P, Blauwet CA, Webborn N, Lexell J, Van de Vliet P, Tuakli-Wosornu Y, Kissick J, Stomphorst J. Sport, sex and age increase risk of illness at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51,198 athlete days. Br J Sports Med. 2018;52:17–23.CrossRefGoogle Scholar
  43. 43.
    Vanlandewijck YC, Thompson WR, editors. Training and coaching the paralympic athlete. Handbook of sports medicine and science. Hoboken: Wiley-Blackwell; 2016.Google Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  • Yetsa A. Tuakli-Wosornu
    • 1
    Email author
  • Fiona Doolan
    • 2
  • Jan Lexell
    • 3
  1. 1.Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenUSA
  2. 2.Trinity College Dublin School of MedicineDublin 2Ireland
  3. 3.Department of Neuroscience, Rehabilitation MedicineUppsala University and Uppsala University HospitalUppsalaSweden

Personalised recommendations