Differing degrees of physical impairment translate into different levels of game performance for athletes with cerebral palsy (CP) who play soccer, a new study shows.

The study, “Activity limitation and match load in para‐footballers with cerebral palsy: An approach for evidence‐based classification,” was published recently in the Scandanavian Journal of Medicine & Science In Sports.

One component of organized para-sports, such as the Paralympics, is classification of impairment: essentially, this allows athletes to compete against others who have comparable natural physical abilities, allowing for a more even playing field, not unlike weight classes in boxing or wrestling.

In this study, researchers set out to compare impairment test results (for instance, measurements of balance or distance a person could jump) to more directly sport-related measurements (such as maximum speed attained or distance covered during a game) for soccer players with CP.

To do this the team had 48 male soccer players with CP (average age 23 years), who competed in a World Championships Qualification Tournament in Denmark, complete a battery of physical impairment tests. Then they compared those test results to analysis of the matches played in that tournament.

The participants were divided into three groups, FT5/6 (moderate spastic diplegia/moderate ataxia or athetosis), FT7 (moderate spastic hemiplegia), and FT8 (minimal impairment criteria for hypertonia, ataxia or athetosis), which broadly correspond to level of physical impairment. Among the study participants, there were nine, 32, and seven classified in each respective group.

Overall the results revealed that jumping, acceleration and change of direction ability are “determinant factors to discriminate among profiles and impairment severity” in CP soccer.

Participants in the FT8 class performed better than those in the FT5/FT6 group in all the activity limitation tests, except in dynamic balance. In addition, FT8 players exhibited better performance than those in the FT7 class in many of the tests.

In general, correlations between tests and match analysis values were classified as low-to-moderate. Interestingly, these correlations differed among the impairment groups.

For example, in the FT5/6 group, participants who were able to jump farther in the tests had significantly higher accelerations in the game, as did those with higher agility test scores.

In contrast, in the FT8 group, there were significant associations between balance scores and instances of more moderate acceleration and between coordination test scores and maximum speed attained during games.

In the FT7 group, there was a relative dearth of significant associations between test scores and performance in matches. “Regarding the FT7 class, no high associations were observed among activity limitation variables and the external load during the official football matches,” the researchers wrote.  (Notably, “football” is used here in the European sense, meaning soccer, not American or Australian rules football.)

Broadly, these findings suggest that the relationship between physical impairment, as measured in a controlled setting, and actual performance in a soccer game, is specific to the type of physical impairment experienced by the given individual. This suggests that further studies may be needed for detailed and accurate classification.

“Therefore,” the researchers concluded, “more research is needed to explore the relationships between the measurement of these impairments and the resulting activity limitation with the sports performance determinants found in this study.”