Objectives: Classification in Paralympic Sport aims to minimize the impact of 10 eligible types of impairment on the outcome of competition. Methods for assessing the extent to which a given body structure or function has been impaired are required, but are challenging because it is not possible to directly measure an absence or loss. Rather, impairment must be inferred by measurement of extant body structures or functions. Methods: This manuscript reviews the literature concerning the assessment of strength with the aim of identifying and describing the most appropriate method for inferring strength impairment in para-athletes. Results: It is posited that the most appropriate voluntary strength assessment method for inferring strength loss in para-athletes will be multi-joint, isometric tests performed at joint angles that facilitate maximum force production. Conclusions: Evidence suggests such methods will permit development of tests that are specific to a variety of para-sports and which are reliable, ratio-scaled, and resistant to training. Future research should: develop sport-specific tests which are suitable for assessment of athletes with strength impairments of variable severity and distribution; and scientifically evaluate the extent to which such tests permit strength impairment to be validly inferred, including specific evaluation of the extent to which such measures respond to athletic training.
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