Ludwig Guttmann at the Stoke Mandeville Hospital began experimenting with spinal cord injury sport classification systems during the 1940s using a medical based system. His classification system was formally formalized in 1952 at the Stoke Mandeville Hospital. This system was published in the Handbook of Rules, which was distributed to people involved with paraplegic sport at the time including coaches, doctors and physiotherapists in various countries. At the time, this classification system was a medical classification. The classification system has historically been based around the one used for athletics. Guttmann was subsequently adopted by the International Stoke Mandeville Wheelchair Sports Federation (ISMWSF) at their founding in 1960, when the first International Stoke Mandeville Games were held in Rome, Italy that year. During that first decade following the first Games, people oftentimes tried to cheat classification to get in classified more favorably. The group most likely to try to cheat at classification were wheelchair basketball players with complete spinal cord injuries located at the high thoracic transection of the spine. Classification in this decade and in the 1970s, involved being examined in a supine position on an examination table, where multiple medical classifiers would often stand around the player, poke and prod their muscles with their hands and with pins. The system had no built in privacy safeguards and players being classified were not insured privacy during medical classification nor with their medical records.