A wide range of sports have been adapted to be played by people with various disabilities, as well as several that are unique to disabled athletes. Within each movement, different sports are practised at different levels; for example, not all sports in the Paralympic movement are part of the Paralympic Games. In addition, many sports are practiced by persons with a disability outside the formal sports movements.
Athletes who participate in Paralympic sport are grouped into ten major categories, based on their type of disability:
Physical Impairment – There are eight different types of physical impairment:
- Impaired muscle power – With impairments in this category, the force generated by muscles, such as the muscles of one limb, one side of the body or the lower half of the body is reduced, e.g. due to spinal-cord injury, spina bifida or polio.
- Impaired passive range of movement – Range of movement in one or more joints is reduced in a systematic way. Acute conditions such as arthritis are not included.
- Loss of limb or limb deficiency – A total or partial absence of bones or joints from partial or total loss due to illness, trauma, or congenital limb deficiency (e.g. dysmelia).
- Leg-length difference – Significant bone shortening occurs in one leg due to congenital deficiency or trauma.
- Short stature – Standing height is reduced due to shortened legs, arms and trunk, which are due to a musculoskeletal deficit of bone or cartilage structures.
- Hypertonia – Hypertonia is marked by an abnormal increase in muscle tension and reduced ability of a muscle to stretch. Hypertonia may result from injury, disease, or conditions which involve damage to the central nervous system (e.g. cerebral palsy).
- Ataxia – Ataxia is an impairment that consists of a lack of coordination of muscle movements (e.g. cerebral palsy, Friedreich’s ataxia).
- Athetosis – Athetosis is generally characterized by unbalanced, involuntary movements and a difficulty maintaining a symmetrical posture (e.g. cerebral palsy, choreoathetosis).
Visual Impairment – Athletes with visual impairment ranging from partial vision, sufficient to be judged legally blind, to total blindness. This includes impairment of one or more component of the visual system (eye structure, receptors, optic nerve pathway, and visual cortex). The sighted guides for athletes with a visual impairment are such a close and essential part of the competition that the athlete with visual impairment and the guide are considered a team. Beginning in 2012, these guides (along with sighted goalkeepers in 5-a-side football became eligible to receive medals of their own.
Intellectual Disability – Athletes with a significant impairment in intellectual functioning and associated limitations in adaptive behaviour. The IPC primarily serves athletes with physical disabilities, but the disability group Intellectual Disability has been added to some Paralympic Games. This includes only elite athletes with intellectual disabilities diagnosed before the age of 18. However, the IOC-recognized Special Olympics World Games are open to all people with intellectual disabilities.
The disability category determines who athletes compete against and which sports they participate in. Some sports are open to multiple disability categories (e.g. cycling), while others are restricted to only one (e.g. Five-a-side football). In some sports athletes from multiple categories compete, but only within their category (e.g. athletics), while in others athletes from different categories compete against one another (e.g. swimming). Events in the Paralympics are commonly labelled with the relevant disability category, such as Men’s Swimming Freestyle, indicating athletes with a severe physical impairment, or Ladies Table Tennis, indicating athletes with an intellectual disability.