Manual Dexterity and Intralimb Coordination Assessment to Distinguish Different Levels of Impairment in Boccia Players with Cerebral Palsy

Abstract

BackgroundBoccia is a paralympic sport played by athletes with severe neurological impairments affecting all four limbs. Impaired manual dexterity (MD) and intralimb coordination (ILC) may limit individuals’ ability to perform certain activities such as grasping, releasing, or manipulating objects, which are essential tasks for daily life or to participate in para sports such as boccia. However, there are currently no specific instruments available to assess hand–arm coordination in boccia players with severe cerebral palsy (CP).PurposeTo design new sport-specific coordination tests to assess impaired MD and ILC in boccia players; afterward, quantify to what extent their coordination is impaired compared to a control group (CG) without neurological impairments.MethodsSeventy-three recreational boccia players with severe CP (BC1: age = 34.01 ± 16.43 years; BC2: age = 33.97 ± 14.29 years), and 19 healthy adults (age = 27.89 ± 7.08 years) completed the test battery. The Box and Block test (BBT) and Box and Ball test (BBLT) were used to assess MD and four tapping tests to assess upper ILC.ResultsBoth MD tests were able to discriminate between sport classes. Boccia players obtained better scores in the BBLT in comparison to the BBT, showing that the BBLT had more appropriate testing features. On the other hand, only one of the ILC tests was able to discriminate between sport classes, displaying the highest practical significance (d = −1.12). Participants with CP scored significantly worse in all the coordination tests compared to the CG.ConclusionUsing sport-specific equipment facilitated grasp function during the MD assessment. Regarding the ILC, the type of movement (continuous vs. discrete) seems to be more relevant for classification than the movement direction (vertical vs. horizontal) or the presence of a ball.

Classifying motor coordination impairment in Para swimmers with brain injury

“…4 Research has provided some understanding of how these clinical features impact on sport and exercise performance, [5][6][7] with performance deficits being attributed to losses in strength, 8 9 joint range of motion 10 and motor coordination. 11 Motor coordination, which is defined as the ability to produce skilled movement fluidly, rapidly and accurately is affected in Para athletes with brain injury. 4 10 It is yet to be reported how swim performance is affected by motor coordination impairment.…”

Inter-Rater Reliability, Concurrent Validity and Sensitivity of Current Methods to Assess Trunk Function in Boccia Players with Cerebral Palsy

“…These results can be construed from different perspectives. On the one hand, the allocation of a sport class in Boccia is not based solely on players´trunk function, as there are other factors to consider, such as arm function or manual dexterity [21], that usually have greater importance for the classifiers for decision-making due to the high impact on performance (i.e., ball throwing). This rationale would be supported by the fact that dynamic posturographic tasks were also unable to discriminate between BC1 and BC2 classes.…”

Challenges and opportunities in wheelchair basketball classification– A Delphi study

“…It is recommended to develop a clear structure based on evidence on how to classify these athletes. Inspiration for research strategies can be found in published studies measuring coordination in other parasports such as athletics and boccia (Connick et al, 2016;Roldan et al, 2017).…”