F33

Quadriplegic, triplegic, severe hemiplegic - Moderate (asymmetric or symmetric) quadriplegic or severe hemiplegic in a wheelchair with almost full functional strength in least impaired upper extremity. It is rare for an Athlete with athetosis to be included within this class unless he/she presents with a predominantly hemiplegic or triplegic profile with almost full function in the least impaired upper limb. Can propel a wheelchair independently.

Upper extremities - Moderate limitation spasticity Grade 2 in least impaired arm shown as limitation in extension and follow through. Least impaired hand may demonstrate cylindrical and spherical grasp with poor finger dexterity demonstrable in release of shot and discus.

Trunk control - F33 Athletes typically have good hand and arm but poor trunk function.

Lower extremities - Spasticity Grade 4 to 3. Some demonstrable function can be observed during transfer. May be able to ambulate with assistance or assistive devices but only for short distances.

Class F33/F34 differentiation: Sometimes a hemiplegic Athlete with spasticity Grade 4 to 3 in the more impaired arm and near normal function in the less impaired arm (i.e., an asymmetric diplegic Athlete) is more appropriate in Class F34. However, a close look must be given to the trunk movement, as it is often the determining factor. In all cases movement, follow through and release are ultimate considerations. Split classes can sometimes occur in these cases (i.e., F34, T33).