These athletes will usually have elbow flexion and wrist dorsiflexion muscle power to grade 5, a decrease of shoulder muscle power especially pectoralis major, and triceps muscle power from grade 0-3.
Use elbow flexors and wrist dorsiflexors for propulsion. Sit in an upright position with knees under the chin. Have large push rims. Equivalent activity limitation to person with complete cord injury at cord level C5-6.

These athletes will usually have normal shoulder, elbow and wrist muscle power, poor to normal muscle of the finger flexors and extensors with there being wasting of the intrinsic muscles of the hands.
Use shoulders, elbows and wrist for propulsion. Usually have no trunk function. May use gloving techniques similar to the next two classes. Equivalent activity limitation to person with complete cord injury at cord level C7-8

T53
These athletes will have normal arm muscle power with no abdominal or lower spinal muscle activity.
Use different techniques to compensate for lack of abdominal musculature including lying horizontal. When the paces quickens in a race, their acceleration is slower than the T54 class. In general when acceleration occurs, the trunk rises off the legs due to a lack of abdominal muscles to hold the trunk down.
Usually have to interrupt the pushing cycle to adjust the compensator. Equivalent activity limitation to person with complete cord injury at cord level T1-7.

T54
These athletes will have normal arm muscle power with a range of trunk muscle power extending from partial trunk control to normal trunk control. Athletes who compete in this group may have significant leg muscle power.
These athletes have reasonable to normal trunk control which allows them to hold their trunk down when the propulsion force is applied to the push rim. Usually do not interrupt the pushing cycle to adjust the compensator. Can shift direction of the chair by sitting up and applying a trunk rotational force to the chair. Equivalent activity limitation to person with complete cord injury at cord level T8-S4.

Athletes competing in this class must meet one or more of the minimum disability criteria presented in Section 4.1.4 (limb deficiency), 4.1.5 (impaired PROM) and 4.1.6 (impaired muscle power) or 4.1.7 (leg length difference).
*PROM…Passive Range of Motion

**Please refer to Classification Manual for Physical Impairment of IPC Athletics.
http://ipc-athletics.paralympic.org/Classification/