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The Four Factors of SCI Athletic Performance - Erik Kondo

Updated: Feb 3, 2023

You did “awesome!” This phrase is thrown quite a bit when describing how a person with spinal cord injury performed some type of athletic endeavor. But, how does one actually determine what is awesome, mediocre, or down right poorly performed given the totality of circumstances involved?

When it comes to evaluation of the athletic performance or accomplishment of someone with a spinal cord injury, there are Four Factors that must be considered. Each one of these Factors is a contributor to the person’s resulting performance. How much each Factor contributes varies on a case-by-case basis, but they are all most be considered.

The Four Factors are:

1. Environmental Factor – This Factor represents the surroundings and circumstances in which the person performs. In a handcycle or wheelchair race for example, the Environmental Factor is the race course, the weather, the terrain, the spectators, race officials/volunteers, the race’s policies and procedures, etc. All of these elements add together to create the environmental setting for the Racer.

2. Assistive Equipment Factor – For most athletic undertakings by a person with SCI, some type of assistive equipment is required. It could be a handcycle, racing wheelchair, monoski, sports wheelchair, or something else. Swimming is a rare exception. The majority of athletic pursuits by a person with SCI, require some type of specialized adaptive equipment.

3. Neurological Function Factor – A spinal cord injury by its very nature reduces a person’s control over his or her body to some degree. The remaining neurological function will vary from person to person. It can be rated somewhere on a continuum where one end is represented by almost no impairment of function and the other end by almost total impairment of function.

4. Acquired Ability Factor – This Factor results from the person developing the bodily skill and/or ability to perform a given athletic task. It represents the capability to execute a movement/task/skill in a certain manner that was learned and developed through practice and/or experience.

When it comes to an Able-Bodied person, the primary factor for consideration is Acquired Ability. The other Factors are relatively insignificant. Here is why.

Since the surrounding environment is by default created to accommodate Able-Bodied people, all environments are for the most part suitable for them. In other words, the Environment is automatically taken into consideration. Generally speaking, it has the same effect of all Able-Bodied people. Contrast this situation to a person with spinal cord injury who during a running/wheeling race has to negotiate a flight of stairs in a wheelchair. The specific environment has the potential to have a much greater effect on a person with SCI when combined with the other Factors.

A bicycle is an example of assistive equipment for an Able-Bodied person. While there is a wide variety in the output performance of different types of bicycles, there is also a wide availability of them. In other words, Able-Bodied people are usually able to access the equipment they require to perform at their level of ability. World Class cyclists don’t race with $100 bicycles. They are able to obtain and use the grade of equipment that corresponds to their high level of performance. And that also goes for the majority of the Able-Bodied population.

On the other hand, people with SCI are much less likely to get the assistive equipment they require to maximize their performance due to a combination of high price and low availability. In a race, there could easily be one person who competes with the high-end racing equipment while the others use low-end recreational devices.

An Able-Bodied person by definition doesn’t have a neurological impairment. Therefore, he (or she) doesn’t have more or less bodily function than his competitors. They all have the same level of no impairment. Thus, making them functionally equal on a neurological basis.

Not so for people with spinal cord injury. A person’s site of injury and neurological completeness of injury has a dramatic effect on what bodily functions are available to them. Athletic performance depends on bodily performance. All else being equal, the more bodily function a person has available to use, the more he or she will be able to do. For example, a paraplegic who has full use of his (or her) trunk muscles will be able to move and stabilize his body in a manner that a paraplegic without use of his truck muscles will not be able to do. The bodily mechanics of the two people are different and the performance result will also be different.

Most people who are not deeply familiar with spinal cord injury and associated assistive equipment are unable to accurately take into consideration the effects of the Environmental Factor, Assistive Equipment Factor, and Neurological Function Factor. Therefore, their evaluation mistakenly assumes that the primary factor in rating performance is Acquired Ability.

When it comes to accurately evaluating the athletic performance of a person with spinal cord injury, the Four Factors must be all taken into consideration.


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