Wheelchair sport classification was first experimented with by Ludwig Guttmann at the Stoke Mandeville Hospital during the 1940s, and was formalized in the 1950s. This was a medical based classification system. It was the used International Stoke Mandeville Wheelchair Sports Federation (ISMWSF) at their founding in 1960, when the first International Stoke Mandeville Games were held in Rome. The 1960s, 1970s and 1980s would see a debate about the merits of the medical based system. Changes towards a functional classification system started in some sports in the late 1970s and 1980s before going wider in the early 1990s. Major changes took place in the 1990s, which facilitated the ability for people with spinal cord injuries to compete with people with different types of disabilities. These trends continued into the 2000s.