This unique sport combines elements of basketball, handball and ice hockey. Wheelchair rugby was invented in Winnipeg in 1976. Today, it is played in 40 countries and is developing in several others. The 5-a-side version of wheelchair rugby was developed in the UK in 2017 by Great Britain Wheelchair Rugby.  The game was officially accepted by the IWRF in June 2021.  Like the Invictus variant, the 5-a-side game expands eligibility. The size of the team remains at 12. Large group classification: The Paralympic version of wheelchair rugby has been adapted with new variations of the rules. These variations expanded the rating system to allow players with higher functionality to compete. Typically, an athlete is assigned a class after completing the bench test and the pre-game functional test (observation of ball handling and wheelchair skills).
The performance of the athlete`s ball and wheelchair handling skills is observed during the on-field game to determine the athlete`s final class. Wheelchair rugby is a full contact game and contact with the chair is encouraged. However, to ensure player safety, players cannot hit another player`s wheelchair anywhere behind the rear wheel axle when the chair is rotating horizontally or vertically. Physical contact is also not allowed. New players and players from developing countries sometimes play wheelchairs adapted to wheelchair rugby by adding bumpers and temporary wings. Wheelchair rugby was founded in 1976 by five Canadian wheelchair athletes, Gerry Terwin, Duncan Campbell, Randy Dueck, Paul LeJeune and Chris Sargent, in Winnipeg, Manitoba, as a sport for people with quadriplegia.  Wheelchair rugby is played indoors on a hardwood court the same size as a basketball court – 28 metres long and 15 metres wide. The square markers required are a center line and circle, as well as a key area 8 meters wide and 1.75 meters deep at each end of the square. The sport was founded in Canada in 1977 and was developed as an alternative to wheelchair basketball.   In 1992, the International Paralympic Committee officially took over the management of sports for the disabled.  Wheelchair rugby has been regulated by IWAS since 1992, just before the sport began. IWAS also managed the sport`s classification page.
In 2010, the International Wheelchair Rugby Federation officially split from IWAS and took over the administration of the classification of their sport.  As of November 2022, there were thirty-one active countries playing wheelchair rugby and twenty-six other national teams in development, divided into three zones: At that time, wheelchair basketball was the most common team sport for wheelchair users. The physical demands of this sport on players to shoot dribbles and baskets have relegated paraplegic athletes with functional impairments of the upper and lower limbs to supporting roles. The new sport, originally called Murderball because of its aggressive full-contact nature, was designed to allow paraplegic athletes with a wide range of functional skills to play integral offensive and defensive roles. The American name is based on the requirement that all wheelchair rugby players must have disabilities that involve at least some loss of function in at least three limbs. While most have spinal cord injuries, players can also qualify for multiple amputations, neurological disorders, or other conditions. Players are assigned a functional level in points, and each team is limited to fielding a team with a total of eight points. Wheelchair rugby classification is the seven-tier system that assigns players a point value based on functional mobility to ensure parity of athletic ability on the field at any given time. It is classified by the International Wheelchair Rugby Federation. The classification process begins with an assessment of the athlete`s degree of disability to determine if the minimum requirements for wheelchair rugby are met. These require an athlete to have a neurological disability that affects at least three limbs or a non-neurological disability that affects all four limbs. The athlete then performs a series of muscle tests to assess the strength and range of motion of the upper limbs and trunks.
The athlete can then be assigned a ranking. Classification often involves subsequent observation of the competing athlete to confirm that physical function in game situations reflects what was observed during the muscle test. Physical contact between wheelchairs is allowed and is a large part of the game. However, physical contact between wheelchairs considered dangerous – such as hitting another player from behind – is not allowed. Direct physical contact between players is not allowed. Wheelchair rugby matches consist of four eight-minute quarters. If the game is tied at the end of the regular game, three-minute overtime periods will be played. In 1988, the United States Quad Rugby Association, now the United States Wheelchair Rugby Association (USWRA), was formed to regulate and promote the sport nationally and internationally. There are now more than 40 organized teams in the United States, and many more are in development. In addition to the teams in the United States, there are at least 29 international teams, with 20 more in development. Wheelchair rugby is one of the fastest growing wheelchair sports in the world. To play wheelchair rugby, athletes must have some form of disability with loss of function in the upper and lower limbs.
 The majority of wheelchair rugby athletes have spinal cord injuries in the cervical vertebrae. Other eligible players may have multiple amputations, polio or neurological disorders such as cerebral palsy, some forms of muscular dystrophy or Guillain-Barré syndrome, among others. Wheelchair rugby is usually played by two teams with up to twelve players.