column medical
Ibsa gets up to date

Dr Roman Tolmatchev Medical Director, IBSA

The activity of the IBSA Medical Committee is constantly being updated: circumstances continue to dictate a correction of our way of working. The committee members may carry out some small modifications in a direct manner at competition time, but sometimes it is necessary to obtain the opinion of the technical representatives or of the General Assembly. I should like to outline some modifications and thoughts conerning these.

1. I still believe that a 3-category system such as ours is sufficient for an analysis of human physiology and for the IBSA approach to this. However, I do believe that it is possible to use these categories in different ways for the different kinds of competition. If visual functions do not play a decisive role in competition results, and do not place the athletes in a situation of inequality, then a fusion of categories, with the necessary prior coordination of the Technical Committee, could occur. It appears that in these cases, the question of modifying regulations has to be put before the General Assembly, especially where new sports are concerned.

2. We use the database that holds information concerning participants in the Barcelona Paralympics; coverage of this was extremely good. This database is continually being updated and today holds details of over 700 participants in Summer Sports and over 200 participants in Winter Sports and includes the use of modern equipment is a tremendous help for the activity of the committee, and will improve the quality of such activity and allow the dynamics of visual functions to be properly observed. I believe it is essential to ask the organizing committees of all the competitons to send in the names of all their participants, duly registered, in order of their respective national teams, to the medical committee of IBSA, two or three weeks before the events are to take place. This would allow for a rational planning of the work to be undertaken by the committee. The database is especially relevant for the organization of juvenile competitions. I should really like to establish contact with the organizers of the Barcelona '98 Juvenile Athletics Championships to ask them to carry out, on an obligatory basis, a medical check-up that would provide data for the IBSA medical committee as regards the medical status of each participant. This is extremely important for all althetes who are competing for the first time in a top category sports arena.

3. I believe that the current practise of presenting official complaints is a perfectly correct one. This modification was introduced during the Atlanta Paralympics. It means that the performance of the athelete can be observed over a prolonged period of time and that any complaints may be put before the Medical committee. The committee members also have an opportunity to assess visual parameters not only by means of a quick eye test, but also by means of the performance of the athletes while training, in the dining room, outdoors, etc. This would prove to be extremely helpful to the committee when decisions have to be made and when conflictive situations have to be resolved.

4. The IBSA Medical Committee does not hold information concerning competition classification in other areas (Asia, Latin America, Australia). We do not know if this work is simply not being done or whether we get no news of it. In my opinion, we should request the IBSA Continental Committee Chairmen to attract the attention of eye specialists in their area in our direction. When this materializes, then we shall be able to organize meetings at which an exchange of experiences could be very meaningful. In addition, we also recommend on an immediate basis the collective collaboration with experts in the field of medical matters concerning sport for the handicapped. We do know that there are some specialists in this field in some countries, and are particularly interested in receiving information concerning injuries sustained by handicapped sportsmen.

5. New types of sports should be promoted only after due consultation with members of the Medical Committee. For example, Powerlifting may produce a worsening of the peripheral retina which may lead to its detachment. It may also lead to a worsening of some cases of corneal ectasia, which increases the possiblility of haemorrage of the retina, etc. I do, however, consider that, for example in the case of Powerlifting and Judo, we ought to use a nosological classification other than that used for visual considerations. The General Assembly has exclusive authority in the area of such modifications. The Medical Committee will present its proposals for such additional classification.

6. The local (national) competition organizers often ask for help with medical examinations. However, the budget provisions for such competitions is too limited for them to be able to ask an IBSA specialist to carry these out. We should be aware of their financial limitations and I am in favour of local doctors being allowed to perform the necessary medical classification in these cases, in accordance with the Definitions and General Work Regulations as outlined in the IBSA Manual (chapter 8, April 1993). Pertinent details should be sent to the IBSA Medical Committee. Such athletes must also be examined by IBSA experts at high-level competition (Continental and World Championships, and at Paralympic Games level).