SU5

Coordination Impairments (Hypertonia/Spasticity, Motor Ataxia, Dyskinesia) - Non-playing arm: Spastic/ataxic/athetoid hemiplegia/diplegia/monoplegia with moderate involvement of upper limb but very mild involvement of lower limbs. Demonstrate a limitation in function based on spasticity, ataxia, athetosis or dystonic movements while performing during match or training. Clear evidence must include spasticity grade 1-2 in the affected upper limb. A clear difference needs to be demonstrated between active ranges of motion vs. passive. In addition, a clear difference between fast PROM against slow PROM needs to be demonstrated. All of the above, plus one of the criteria below: 1) Upper motor neuron reflex pattern must demonstrate: Clear unilateral clonus 4 beats or more; Noticeably brisk reflexes or clear difference in reflexes non-playing vs. playing arm. 2) Dysdiadochokinesia. 3) Dyssynergia and dysmetria. 4) In arm monoplegia the elbow must be involved with limitations in ROM. 5) For ataxia and athetosis, the Player must have clear signs of cerebellar dysfunction with incoordination of the upper limb. Impaired playing arm: If only playing arm impairment, then same criteria as for non-playing arm.

Limb Deficiency - Non-playing arm: ONE of the following patterns of impairment: 1) Unilateral amputation, through or above wrist (i.e., no carpal bones present in affected limb). 2) Unilateral dysmelia in which the length of the affected arm measured from acromion to fingertip is equal in length or shorter than the combined length of the humerus and the radius of the unaffected arm. Impaired playing arm: ONE of the following patterns of impairment: 1) Complete amputation of at least 3 digits excluding the thumb from at least the metacarpophalangeal joint, then no strapping of the racket to the hand allowed. 2) Complete amputation of at least 4 digits excluding the thumb from at least the metacarpophalangeal joint, then strapping of the racket allowed. 3) amputation of thumb and thenar eminence. 4) equivalent congenital deformity.

Impaired Passive Range of Movement - Non-playing arm: A unilateral upper limb impairment of PROM that meets THREE of the following criteria: 1) Shoulder abduction of 60 degrees available in the range. 2) Shoulder limitation of PROM in the plane of forward flexion (60 degrees). 3) Shoulder limitation of PROM in the plane of extension (20 degrees). 4) Elbow extension deficit of 70 degrees. 5) Ankylosis of the elbow of 80 degrees flexion. Wrist arthrodesis or ankylosis is not eligible on the non-playing arm side. Impaired playing arm meets ONE of the following criteria: 1) Shoulder abduction of 75 degrees. 2) Shoulder forward flexion of 90 degrees. 3) Shoulder horizontal adduction deficit of 90 degrees (measured from plane of scapula). 4) Shoulder external rotation (when arm abducted to 90 degrees) deficit of 30 degrees or more. 5) Elbow extension deficit of 90 degrees or ankylosis in any position (stiff elbow). 6) Available arc of motion of elbow in flexion-extension plane 30 degrees, from any beginning range-of-motion. 7) Wrist ankylosed in 50-degree in any position in the plane of flexion-extension (stiff wrist); and any four digits with 10 degrees of flexion/extension at the metacarpophalangeal joint.

Impaired Muscle Power - Non-playing arm: A unilateral upper limb impairment of muscle power that meets THREE of the following criteria: 1) Shoulder abduction loss of 3 muscle grade points (i.e., grade 2 shoulder abductors). 2) Shoulder forward flexion loss of 3 muscle grade points (i.e., grade 2 shoulder forward flexion). 3) Shoulder extension loss of 3 muscle grade points (i.e., grade 2 shoulder extension). 4) Loss of 2 muscle grade points in elbow flexion AND extension (i.e., grade 3 elbow extensors and flexors). Impaired playing arm meets ONE of the following criteria: 1) Shoulder abduction loss of 3 muscle grade points (i.e., grade 2 shoulder abductors). 2) Shoulder forward flexion loss of 3 muscle grade points (i.e., muscle grade of two). 3) Shoulder internal rotation loss of 3 muscle grade points (i.e., muscle grade of two). 4) Shoulder external rotation loss of 3 muscle grade points (i.e., muscle grade of 2). 5) Elbow flexion loss of 3 muscle grade points (i.e., muscle grade of 2). 6) Elbow extension loss of 3 muscle grade points (i.e., muscle grade of two).