Towards an Evidence-Based Classification System for Para Dressage: Associations between Impairment and Performance Measures

SIMPLE SUMMARY: In the sport of Para dressage, the combined performance of the Para athlete and the horse is judged subjectively. To provide a level playing field for athletes with a wide range of impairments, Para dressage athletes are classified based on the degree to which their impairment impacts sports performance. This study aimed to evaluate the effects of impairment on objective performance measures in Para athletes as a step towards developing an evidence-based classification system. Two groups of athletes comprising twenty-one elite Para athletes (classified grades I to V) and eleven non-disabled athletes (competing at Prix St. Georges or Grand Prix) were measured while performing a 2 min custom dressage test on a riding simulator and clinically assessed using a battery of impairment assessment tools. Statistical analysis considered the extent to which performance could be predicted from impairment measures. Impairment assessment tools related to sitting function could predict the impact of impairment on performance in Para athletes but not in non-disabled athletes. These findings provide evidence of sport-specific impairment assessments that could be used to enhance athlete classification. These findings pave the way for further studies using similar approaches to enhance the objectivity of classification between grades. ABSTRACT: This study follows a previously defined framework to investigate the impact of impairment on performance in Para dressage athletes. Twenty-one elite Para dressage athletes (grades I to V) and eleven non-disabled dressage athletes (competing at Prix St. Georges or Grand Prix) participated. Data were collected in two phases: performing a two minute custom dressage test on a riding simulator while kinematic data were synchronously collected using inertial measurement units (2000 Hz) and optical motion capture (100 Hz), and clinically assessed using a battery of impairment assessment tools administered by qualified therapists. Impairment and performance measures were compared between Para and non-disabled athletes. Significant differences between athlete groups were found for all impairment measures and two performance measures: simulator trunk harmonics (p = 0.027) and athlete trunk dynamic symmetry (p < 0.001). Impairment assessments of sitting function and muscle tone could predict 19 to 35% of the impact of impairment on performance in Para athletes but not in non-disabled athletes. These findings provide the basis for a robust, scientific evidence base, which can be used to aid in the refinement of the current classification system for Para dressage, to ensure that it is in line with the International Paralympic Committee’s mandate for evidence-based systems of classification.