USA BOCCIA CERTIFIED CLASSIFIER PROGRAM COUSRE

WELCOME! 2016

PURPOSE In order to give the Boccia community in the United States a clear understanding of the process and goals of Classification, USA Boccia has developed a Classifier Certification Program. This program will allow individuals who are involved in local and or regional Boccia clubs, physical or occupational therapy, and medicine to identify potential individuals who are eligible to play Boccia, by establishing quality Classification systems at the local and regional level. Quality Classification Systems will help grow the sport.

CLASSIFICATION SOURCES: BISFed Classification Rules – 2nd Edition, May 2013: http://www.bisfed.com/wp-content/uploads/2014/01/BISFed-Boccia-Classification-Rules-2nd-Edition-2013.pdf USA Boccia Classifications, February 2016: http://usaboccia.org

Certified Classifier By completing this program you will achieve the designation of “Certified Classifier” which is a beginner or entry level classifier To achieve the level of USA National Classifier’s you must attend a seperate BISFed sponsored program To achieve the level of International Classifier additional training is required

SCOPE: One Step at a Time… Data collected by Certified Classifiers from local and regional classifications will be stored to use at the local and regional levels. This data is VERY important. These classifications will NOT be nationally recognized, and athletes will still need to be formally classified by a National Classification Team. Certified Classifiers do not classify at the National level because of the implications for the US Team. Certified Classifiers may observe the process at Nationals. (This isn’t “pulling rank”, we just want to develop base skills first) Once candidates pass the Classifier Certification Program exam (online or in-person), they will be Certified Classifiers. Once candidates pass the exam and observe an organized Boccia competition (provide documentation), they will be eligible to teach and certify others for the purpose of developing local and regional Classification Teams (MD, PT/OT, and Sports Tech) in order to further validate results. Once candidates become Certified Classifiers and observe an organized Boccia competition, they will be eligible to pursue BISFed certification.

Part 1: Understanding Classification: Classification should be clear, no mystery. WHAT is Classification: Placing athletes in the appropriate class. We classify on ability (what athletes CAN do). Yes, diagnoses have a critical role, but the spirit of Classification is functional ability. Classification is NOT for finding skills or improving skills (although that can be a byproduct) WHY do we Classify: Basic fairness (goes without saying). 2 Consistency in the classes (equal function competition). WHAT RULES is Classification based from: 1; BISFed. 2; USA Boccia. NOTHING ELSE. WHEN can does Classification occur: Classification ONLY occurs at specific situations at specific times, only blatantly obvious (cheating) observations can be considered, and should be noted and reported. Off-Court testing and On-Court observations are the ONLY appropriate times to classify. Off-Court testing takes place BEFORE the competition starts, On-court observations take place DURING the competition. How do we Classify: General decorum; friendly and professional manner (make ‘em relax), introduce yourself and your role, say what you are doing, if deciding with other classifiers, step away from the player when discussing decision, review decision with player and coach.

How do we Classify Cont’d: Obtain written consent beforehand (including on-court video), minors, etc. Review minors under 15 annually (pre-adolescence vs. adolescence vs. adulthood). WHAT is the appropriate procedure: What are the Classification personnel and roles: (MD, PT/OT, & SPORTS TECHNICAL) Sports Technicals can be anyone involved in Boccia. USUALLY ALL THREE TYPES WOULD BE REQUIRED, AND MULTIPLE PERSONNEL IS STILL ENCOURAGED. HOWEVER, FOR PRACTICAL PURPOSES AND BECAUSE THESE CLASSIFICATIONS ARE LIMITED, ONE CLASSIFIER CAN FILL THE ROLES OF ALL THREE AS NEEDED. Roles: MD; medical assessment, PT/OT; physical assessment, Sport Technical; sport assessment . No role specification for Certified Classifier Program (but keep records of roles for future Classification Team development). WHERE do we Classify: Appropriate off-court evaluation space (an area off-court and away from others at a competition before play starts). Then observe on-court during competition. During the off-court evaluation; until players are 18, they must have a parent present (optional coach), or two designated adults present (one being a coach); 18 & over, coach/team representative present/tournament staff present (Never be alone with a player). Players are evaluated in the chair that they play in. Inform players that you will observe them in competition. During the on-court observation; Classifiers see if they can confirm the off-court findings. If unclear or suspicious, list player as “Review Status” to be classified again at the next opportunity, send video. When observing, be courteous (whisper, hand over your mouth).

Documentation: Cataloging results Create local and regional spreadsheets of players with names, classifications, and organizations. Results to be used at the local/regional level, not at the National level or beyond, BE SURE PLAYERS AND COACHES UNDERSTAND. Send catalogues with contact information to USA Boccia Head Classifier, Sam Williams (samuel.williams83@gmail.com)

PART 2: Methods of assessment of Classification and how to evaluate and identify the classes of Boccia. Types of assessment: *MUST COMPLETE ALL THREE ASSESSMENTS. 1.Diagnostic/Medical (MD); type of disability, onset, age. Diagnostic information narrows the possible classes, but is only the first step. 2.Physical (PT/OT); baseline abilities of movement, spasticity, strength, ROM (range of motion). Going to have to ask tough and obvious questions (can you walk?). TEST ALL LIMBS NO MATTER WHAT PLAYERS/COACHES TELL YOU. NO SINGLE PHYSICAL ASSESSMENT ITEM GIVES A CLASSIFICATION. 3. Technical (Sports Technical); the moments before, during, and after the throw, kick, or other release. How does the body function during a simulated game situation? ALL three pieces together to get a Classification.

Class terminology: 1: BC (Boccia Classification), NE (Non-Eligible to play), & Open (Non-BC Eligible Classification). 2: BISFed and USA Boccia: BC1, BC2, BC3, & BC4. 3: BISFed only: NE. 4: USA Boccia only: BC5, BC6, & Open. Class specifications overview: a: BC1: SEVERE CEREBRAL ORIGIN THROWING OR KICKING CLASS b: BC2: MODERATE CEREBRAL ORIGIN THROWING CLASS c: BC3: VERY SEVERE CEREBRAL ORIGIN OR NON-CEREBRAL ORGIN RAMP CLASS d: BC4: “MODERATE” NON-CEREBRAL ORIGIN THROWING CLASS e: BC5 (USA ONLY): MILD CEREBRAL ORIGIN THROWING CLASS f: BC6 (USA ONLY): “MILD” NON-CEREBRAL ORIGIN THROWING CLASS g: Open (USA ONLY): ANY PHYSICAL DISABILITY

Australian Spasticity Assessment Scale (ASAS) (BC1-3, BC5, & Open): 0 No catch on Rapid Passive Movement (RPM) [i.e. no Spasticity] 1 Catch occurs on RPM followed by release. There is no resistance to RPM throughout the rest of the remaining range. 2 Catch occurs in the second half of the available range (after halfway point) during RPM and is followed by resistance throughout the remaining range. 3 Catch occurs in the first half of the available range (up to and including the halfway point) during RPM and is followed by resistance throughout the remaining range. 4 When attempting RPM, the body part appears fixed but moves on slow passive movement.

Assessment of Muscle Strength (BC3* & BC4, BC6, & Open): Muscle Testing (Strength scale) 0 Total lack of voluntary contraction. 1 Faint contraction without any movement of the limb (trace, flicker). 2 Contraction with very weak movement through full range of motion when gravity is eliminated. 3 Contraction with movement through the complete joint range against gravity without resistance. 4 Contraction with full range of movement against gravity and some resistance. 5 Contraction of normal strength

Range of Motion Describes the flexibility of a joint

BC1: Tell-Tale BC1 Diagnosis: Athlete typically has Cerebral Palsy possibly TBI/ABI & other Cerebral Origin injuries with loco motor dysfunction affecting the whole body (ALL 4 limbs affected) Typical BC1 athlete physical profile: a) not usually be able to propel a manual wheelchair b) often has difficulty altering the sitting position, greatly supported by chair; to test, have athletes touch toes 3 times fast WITHOUT using their head to move, test bending side to side same way c) often uses the trunk in head and arm movements; NO to little disassociation; poor trunk d) has no functional use of the legs; probably NO walking; probably NO transfers e) has severe to moderate spasticity, athetosis, and or ataxia; ASAS#: 3-4 Typical BC1 athlete functions: a) MOST LIKELY is unable able to pick up balls; PROBABLY needs balls handed/placed to them via their optional BC1 Sport Assistant; test by having athlete try to take ball from your grip, see if their hand or your hand “gives” first, 3 times fast; that DOESN’T involve swatting, it’s gripping & grasping b) has difficulty with grasp and release motion; weak grasp; hand stiffens upon release; grip and grasp usually look severe; overhand and or underhand throw; when asked to let go of a ball at the sound of a clap with arm extended, there is a delay. Do 3 times fast c) usually has elbow spasticity catch BEFORE 90 degrees of passive extension at 90 degrees of passive shoulder flexion; do the motion 3 times and FAST: Raise player’s arm so elbow is straight out in front of body, flex elbow, grab just above elbow on back of arm, with your other arm pull their forearm until you feel the FIRST catch, do 3 times FAST d) release balls when throwing BEFORE 90 degrees of elbow extension e) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters BC1 Foot Player: a) possibly be able to kick balls with purpose and direction, if unable to throw (BC1 Foot Player); BE SURE TO TEST. b) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters

BC2: Tell-Tale BC2 Diagnosis: Athlete typically has Cerebral Palsy possibly TBI/ABI & other Cerebral Origin injuries with loco motor dysfunction affecting the whole body (ALL 4 limbs affected) Typical BC2 athlete physical profile: a) usually has relatively good trunk control (better than BC1s), but all 4 limbs and head are used to stabilize, test with bending and side to side motions FAST b) has difficulties with consistent isolated shoulder movement, but HAS disassociation c) might be able to spread fingers and thumb, touch fingers to thumb but not quickly d) might be able to hand or foot push a wheelchair , but does not have to e) might be able to stand/walk, but is very unstable; NO running f) has severe to mild spasticity, athetosis, and or ataxia, ASAS#: 2-3 Typical BC2 athlete functions: a) CAN pick up balls and throw b) stronger grasp and grip than BC1, more fluid/relaxed hands and wrist, can have multiple throwing styles (overhand & underhand); probably quicker release with clap test; your hand should “give” first on taking-from-hand test c) usually has elbow catch AFTER 90 degrees BEFORE 180 degrees of passive extension at 90 degrees of passive shoulder flexion; do the motion 3 times and FAST: Raise player’s arm so elbow is straight out in front of body, flex elbow, grab just above elbow on back of arm, with your other arm pull their forearm until you feel the FIRST catch, do 3 times FAST d) release when throwing AFTER 90 degrees BEFORE 180 degrees of elbow extension e) not able to CONSISTENTLY catch balls QUICKLY tossed to them from a meter away f) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters, they should easily reach at least ¾ of court (7m)

BC3: Tell-Tale BC3 Diagnoses: Athletes can have Cerebral Palsy or other Cerebral Origin injuries (TBI/ABI). Athletes can also have NON-Cerebral Origin injuries (upper SCIs) or degenerative conditions (MD, SMA). Both Cerebral Origin and Non-Cerebral Origin designations must separately be noted for Pairs play (BISFed rules). Athletes have severe loco motor dysfunction in ALL 4 limbs. Typical BC3 athlete physical profile: a) probably unable to propel a manual wheelchair, b) very poor trunk c) has no functional use of the legs; NO walking; NO transfers d) has severe to moderate spasticity, athetosis, and or ataxia; or extremely low tone; ASAS#: 3-4 (CP/TBI); Muscle Strength#: typically 0-2 (Non-CP/Non-TBI) Typical BC3 athlete functions: a) unable to pick up balls; unable to grasp balls; unable to reasonably throw balls (50% of balls to the “+” (5m), within 1-2 meters) b) must use an assistive device (ramp) to play BC1 Foot Player Link, OR BC4 (NON-Cerebral Origin) Foot Player Link: a) might able to kick balls with purpose and direction, BE SURE TO TEST b) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters

BC4: BE CAREFUL… This is tricky. Tell-Tale BC4 Diagnoses: Athletes have NON-Cerebral Origin injuries with loco motor dysfunction affecting the whole body (ALL 4 limbs affected); Upper SCIs (quads, typically C6 & above), Myopathies (MD/SMA), ALS, even quad amputees etc. Typical BC4 athlete physical profile: a) use a manual or power chair b) has impairment of function and might have some limitation in active functional range of movement due to weakness and lack of control affecting the upper limbs/trunk/lower limbs; NO FUNCTIONAL TRICEPS (arm gives or flops after release, gravity assisted); trunk gives or is greatly supported by chair when throwing c) overall muscle strength of 3/5 or less; no body area functionally (maintained through throw) above 3/5; when testing triceps, block shoulder first, then have the athlete use triceps to resist your arm to isolate triceps; also have the athlete first lift their arms straight out in front against your hand, then have them put their arms out to the side and do the same test d) head is often used to position body before or after shot, particularly in Myopathies e) might walk with assistance or using a walking aid, but doubtful Typical BC4 athlete functions: a) is able to pick up or place balls (except Foot Players) b) can have mechanics of throwing similar to BC1 or BC2 athletes, overhand/underhand, from chest, across body etc; usually if an SCI can throw overhand, they have too much shoulder strength (release should be BELOW 90 degrees of shoulder flexion), Myopathies can throw overhand, just as long as their arms give after the throw; also, release should be BELOW 90 degrees of shoulder flexion c) can have a variety of grips and grasps, even 2 hands; possibly wear gloves if approved by classification staff d) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters BC4 Foot Player (Sport Assistant): a) possibly be able to kick balls with purpose and direction, if unable to throw, BE SURE TO TEST b) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters

BC5 (USA ONLY): Class for BC2s that Class Out. Tell-Tale BC5 Diagnosis: Athlete typically has Cerebral Palsy, possibly TBI/ABI & other Cerebral Origin injuries with loco motor dysfunction affecting the whole body (ALL 4 limbs affected). Typical BC5 athlete physical profile: a) usually has great trunk control (better than BC2s), all 4 limbs and head are NOT used to stabilize, test with bending and side to side motions FAST b) has difficulties with consistent isolated shoulder movement, but HAS disassociation c) might be able to spread fingers and thumb, touch fingers to thumb but not quickly d) might be able to hand or foot push a wheelchair , but does not have to e) might be able to stand/walk, but is very unstable; NO running f) has mild to NO spasticity, athetosis, and or ataxia; ASAS#: 0-1 Typical BC5 athlete functions: a) CAN pick up balls and throw b) stronger grasp and grip than BC2, REALLY fluid/relaxed hands and wrist, can have multiple throwing styles (overhand & underhand); drops on clap; rips ball from your hand c) has NO elbow catch AFTER 90 degrees BEFORE 180 degrees of passive extension at 90 degrees of passive shoulder flexion (NO CATCH); do the motion 3 times and FAST d) release when throwing AT 180 degrees of elbow extension e) usually not able to CONSISTENTLY catch balls QUICKLY tossed to them from a meter away (maybe better than a BC2) f) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters, they should easily reach at least ¾+ of court (7m+)

BC6 (USA ONLY): CLASS FOR BC4s THAT CLASS OUT. Tell-Tale BC6 Diagnoses: Athletes have NON-Cerebral Origin injuries with loco motor dysfunction affecting the whole body (ALL 4 limbs affected); Upper SCIs (quads, typically C6 & above), Myopathies (MD/SMA), ALS, even quad amputees etc. Typical BC6 athlete physical profile: a) use a manual or power chair; maybe self transfer b) has good trunk c)FUNCTIONAL TRICEPS (arm does NOT give or flop after release, NO gravity assistance) d) overall muscle strength of 4/5 or more; any functional body area 4/5 or more; when testing triceps, block shoulder first, then have the athlete use triceps to resist your arm to isolate triceps; when testing shoulders in Myopathies, do not block shoulders, have the athlete first lift their arms straight out in front against your hand, then have them put their arms out to the side and do the same test e) might walk with assistance or using a walking aid, but doubtful Typical BC6 athlete functions: a) is able to pick up or place balls b) can have mechanics of throwing similar to BC4 athletes, overhand/underhand c) CAN throw overhand; CAN release above shoulders d) can have a variety of grips and grasps, even 2 hands; less involved hands than BC4s e) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters (should get 7m+)

OPEN (USA ONLY): NOT A BC CLASS. . . Tell-Tale Open Diagnoses: ANY TYPE OF PHYSICAL DISABILITY. Yes, ANY type: CP/TBI, SCI (all kinds), Myopathies, Dwarfs, Amputees, etc. All 4 limbs do NOT have to be affected. Typical Open athlete physical profile: a) use a manual or power chair; walk independently or with walking aid; run: high degree of ability b) can self transfer very easily c) Virtually no spasticity, athetosis, and or ataxia IF AT ALL Typical Open athlete functions: a) is able to pick up or place balls b) if able to throw, no difficulty with grasp or grip; probably baseball throw; no elbow catches; very strong c) has throwing or kicking mechanics that are too “good” for BC1-6 (can throw ball past back line (10m) without it touching on court; or kick ball past the “+” (5m), like 6m (high double arm amputee)) d) is able to propel balls “onto court”: 50% of balls to the “+” (5m), within 1-2 meters from a SEATED position

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