Before 2015 the hand classification in wheelchair rugby consisted of non-sport specific
tests. The hand classification was not in accordance with the classification code
introduced by the International Paralympic Committee in 2003. In 2015, the newly
revised wheelchair rugby classification manual was released, containing the revised
wheelchair rugby hand classification. Hand tests that were not functional sport-specific
tests were removed from the bench test in wheelchair rugby classification. Lumbrical,
interossei and thumb opposition manual muscle testing were added to the bench test
in wheelchair rugby classification.
On both national and international levels of classification, classifiers verbalised their
uncertainty to their fellow panel members regarding their hand placement on the
athlete’s hand and interpretation of the manual muscle testing of the hand that was
observed and tested. This justified reliability testing of the new hand classification.
The aim of this study was to determine the intra and inter-rater reliability of the manual
muscle testing in the new hand classification of wheelchair rugby.
This study followed a quantitative non-experimental, cross-sectional design.
The raters who took part in the study were active international wheelchair rugby
classifiers from all over the world. The raters received an electronic questionnaire
consisting of biographic information and three videos repeated two times. Each video
showed an athlete’s hand being classified by a classifier. The raters had to give a
manual muscle test grade for each subject (muscle) tested in each video by using tick
boxes. The manual muscle test grades that could be given were: 0-1, 2, 3 and 4-5. The first three raters in each international wheelchair rugby classification level who
completed the questionnaire were used for the data analysis.
The statistician used the two way model for the ICC in which each subject was rated
by the same raters to determine the absolute agreement for each objective. The
Medcalc program was used. To indicate the strength of agreement the ranges provided
by Landis and Koch (1977) were used: 0.0 – 0.2 slight, 0.21 – 0.4 fair, 0.41 – 0.6
moderate, 0.61 – 0.8 substantial and 0.81 – 1.00 almost perfect.
Raters one, two, five, seven, eight and nine’s intraclass correlation coefficient values
fell between 0.81-1.00 which is descriptive of almost perfect levels of intra-rater
reliability. Raters three, four and six’s intraclass correlation coefficient values fell
between 0.61-0.80 which is descriptive of substantial levels of intra-rater reliability.
However, none of the raters scored 100% when accuracy was determined. All three
levels had intraclass correlation coefficient values which is descriptive of almost perfect
levels of intra-rater reliability within each level.
Level 2, 3 and 4 classifiers had intraclass correlation coefficient values between 0.81-
1.00 which is descriptive of almost perfect levels of inter-rater reliability when the
manual muscle testing grades for the first and repeated videos were compared. Across
all nine raters there was a high intraclass correlation coefficient value which was
descriptive of almost perfect inter-rater reliability. The accuracy in each level and
across all nine raters was low.
Finger extensors, thumb abductor and thumb flexor showed intraclass correlation
coefficient values between 0.41-0.6 which is descriptive of moderate levels of intrarater
reliability. The only subjects (muscles) that were graded accurately when
compared to a memorandum were subjects with a manual muscle test grade 0-1 and
4-5. Most of the accurate manual muscle test grades were for athlete two in the video
footage. Athlete two was classified as having a 2.0 hand.
Dissertation (MOccThe)--University of Pretoria, 2017.