The assessment of swimming propulsion should be a cornerstone of Paralympic swimming classification. However, current methods do not objectively account for this component. Purpose: To evaluate the swimming propulsion of swimmers with and without physical impairment using a 30-second maximal fully tethered freestyle swim test. Methods: Tethered forces were recorded during maximal fully tethered swimming in 80 competitive swimmers with (n=70) and without (n=10) physical impairment. The relationships between absolute and normalized tether forces and maximal freestyle swim speed were established using general additive models. Results: Para swimmers with physical impairment had lower absolute and normalized tether forces than able-bodied swimmers, and there were moderate positive correlations found between tether forces and sport class (t=.52-.55, P<.001). There was a nonlinear relationship between tether force and maximal freestyle swim speed in the participant cohort (adjusted R2=.78-.80, P<.001). Para swimmers with limb deficiency showed stronger relationships between tether force and maximal freestyle swim speed (adjusted R2=.78-.82, P<.001) than did Para swimmers with hypertonia (adjusted R2=.54-.73, P<.001) and impaired muscle power (adjusted R2=.61-.70, P<.001). Conclusions: Physical impairments affect Para swimmers` tether forces during maximal fully tethered freestyle swimming, explaining a significant proportion of their activity limitation. It is recommended that maximal fully tethered swimming be included in Paralympic swimming classification as an objective assessment of swimming propulsion.
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