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Jorg Teichmann, Kim Hébert-Losier, Rachel Tan, Han Wei Lem, Shabana Khanum, Ananthi Subramaniam, Wee-Kian Yeo, Dietmar Schmidtbleicher, and Christopher M. Beaven

Objective: Current return-to-sport decisions are primarily based on elapsed time since surgery or injury and strength measures. Given data that show rates of successful return to competitive sport at around 55%, there is strong rationale for adopting tools that will better inform return to sport decisions. The authors’ objective was to assess reactive strength as a metric for informing return-to-sport decisions. Design: Case-control design. Methods: Fifteen elite athletes from national sports teams (23 [6.0] y) in the final phase of their return-to-sport protocol following a unilateral knee injury and 16 age-matched control athletes (22 [4.6] y) performed a unilateral isometric strength test and 24-cm drop jump test. Pairwise comparisons were used to determine differences between legs within groups and differences in interleg asymmetry between groups. Results: Strength measures did not distinguish the control from the rehabilitation group; however, clear differences in the degree of asymmetry were apparent between the control and rehabilitation groups for contact time (Cohen d = 0.56; −0.14 to 1.27; 8.2%; P = .113), flight time (d = 1.10; 0.44 to 1.76; 16.0%; P = .002), and reactive strength index (d = 1.27; 0.50 to 2.04; 22.4%; P = .002). Conclusion: Reactive strength data provide insight into functional deficits that persist into the final phase of a return-to-sport protocol. The authors’ findings support the use of dynamic assessment tools to inform return-to-sport decisions to limit potential for reinjury.

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Nicole T. Gabana, Jeffrey B. Ruser, Mariya A. Yukhymenko-Lescroart, and Jenelle N. Gilbert

A holistic, multicultural approach to student-athlete mental health, well-being, and performance promotes the consideration of spiritual and religious identities in counseling and consultation. Preliminary research supports the interconnectedness of spirituality, religiosity, and gratitude in athletes; thus, this study sought to replicate Gabana, D’Addario, Luzzeri, and Soendergaard's study (2020) and extend the literature by examining a larger, independently sampled, more diverse data set and multiple types of gratitude. National Collegiate Athletic Association Division I–III student-athletes (N = 596) were surveyed to better understand how religious and spiritual identity related to trait, general-state, and sport-state gratitude. Results supported past research; athletes who self-identified as being both spiritual and religious reported greater dispositional (trait) gratitude than those who self-identified as spiritual/nonreligious or nonspiritual/nonreligious. Between group differences were not found when comparing general-state and sport-state gratitude. Findings strengthen and extend the understanding of spirituality, religion, and gratitude in sport. Limitations, practical implications, and future directions are discussed.

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James E. Kaishian and Regina M. Kaishian

The physical impacts of overtraining, sport specification, and burnout are well documented in the literature; however, the state of the student-athlete’s (SA’s) mental health is something that needs to be investigated more comprehensively. Literature on SA mental health has gained prevalence within the last 5 years. The combination of pressure from sport and academics, as well as the stigmatization of clinical mental health treatment, can have a significant effect on the SA’s psyche. This review explores the prevalence of mental health conditions (MHCs) in high school and collegiate SAs. This includes signs and symptoms of mental health diagnoses to include substance- and alcohol-related addictive disorders and risk factors of such. A systematic review of the CINAHL, ERIC, SPORTDiscus, APA PsycINFO, and Rehabilitation & Sports Medicine resource databases was conducted. The initial search yielded 855 results. Following double screening, 22 studies were included, all of which were deemed medium to high quality. The findings indicate an alarming presence of MHCs ranging from risk factors of alcohol use and major depressive disorders among SAs. There was a high prevalence of mental health issues among SAs who are Black, Indigenous, people of color (BIPOC), and Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ). In most cases, participation in competitive athletics (varsity) did not contribute to additional MHCs for SAs. Sport psychologists should play a role in mental health programming within athletic departments. Athletic departments should develop proactive, targeted strategies to address MHCs for SAs.

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Minhyun Kim, José A. Santiago, Chan Woong Park, and Emily A. Roper

Grounded in occupational socialization theory, the authors examined adapted physical education (APE) teachers’ job satisfaction. Twelve (nine female and three male) APE teachers who had 3–43 years of teaching experience participated in the study. A semistructured interview was employed. The interviews focused on the participants’ roles and responsibilities. The following questions guided this study: (a) What social agents positively impact APE teachers’ job satisfaction? (b) what APE teachers’ roles and responsibilities are related to job satisfaction? and (c) what type of working conditions are linked to APE teachers’ job satisfaction? Thematic analysis was employed to analyze the data. The following four themes emerged from the analysis: (a) support from administrators, physical education teachers, and colleagues; (b) relevant and meaningful professional development; (c) itinerant working conditions; and (d) seeing students’ progress and achievement. The results of this study provide several implications to enhance APE teachers’ job satisfaction.

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Sandra K. Hnat, Musa L. Audu, Ronald J. Triolo, and Roger D. Quinn

Estimating center of mass (COM) through sensor measurements is done to maintain walking and standing stability with exoskeletons. The authors present a method for estimating COM kinematics through an artificial neural network, which was trained by minimizing the mean squared error between COM displacements measured by a gold-standard motion capture system and recorded acceleration signals from body-mounted accelerometers. A total of 5 able-bodied participants were destabilized during standing through: (1) unexpected perturbations caused by 4 linear actuators pulling on the waist and (2) volitionally moving weighted jars on a shelf. Each movement type was averaged across all participants. The algorithm’s performance was quantified by the root mean square error and coefficient of determination (R 2) calculated from both the entire trial and during each perturbation type. Throughout the trials and movement types, the average coefficient of determination was 0.83, with 89% of the movements with R 2 > .70, while the average root mean square error ranged between 7.3% and 22.0%, corresponding to 0.5- and 0.94-cm error in both the coronal and sagittal planes. COM can be estimated in real time for balance control of exoskeletons for individuals with a spinal cord injury, and the procedure can be generalized for other gait studies.

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Alexandra M. Rodriguez, Alison Ede, Leilani Madrigal, Tiffanye Vargas, and Christy Greenleaf

This study aimed to assess the internalization of sociocultural attitudes and appearance comparison among U.S. athletes with physical disabilities. Female (n = 19) and male (n = 25) athletes between the ages of 18 and 73 years completed a quantitative survey along with two exploratory open-ended questions related to body appearance and influencers. Results showed significant correlations between internalization of the thin and low-body-fat ideal and appearance comparison (r = .55, p < .05) and internalization of the muscular ideal and appearance comparison (r = .76, p < .05) among women. For men, results showed a significant association between internalization of the muscular ideal and appearance comparison (r = .52, p < .05). The findings prompt further investigation of whether appearance comparison and internalization influence body dissatisfaction and disordered eating among athletes with physical disabilities.

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Ghada Regaieg, Sonia Sahli, and Gilles Kermarrec

The purpose of this study was to examine the effects of two pedagogical strategies in adapted physical education (hybrid virtual/real vs. conventional) on fundamental movement skills (FMS) in children with intellectual disability age 7–10 years. Children with intellectual disability (N = 24) were randomly assigned to either the hybrid (experimental group) or the conventional (control group) group and were evaluated across 10 weeks. The hybrid program was based on virtual and real game situations, while the conventional program was based on adapted sports. FMS were evaluated using the Test of Gross Motor Development-2 at pre- and postprogram for both groups. Both programs significantly improve locomotor skills, with significantly better improvement in the experimental group. However, a significant improvement was observed only among the experimental group for object-control skills and gross motor quotient. Based on these results, a hybrid program may be considered for FMS improvement.

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Darda Sales and Laura Misener

This study examined para swimmers’ athlete development experiences from the perspectives and reflections of athletes, and parents of athletes, with a focus on the constraints and challenges experienced. Guided by interpretive phenomenological analysis, 12 participants engaged in the interview process (seven parents and five athletes). Five themes were identified: fundamental skill development, personal connection, coaching, classification, and connecting with others “like me.” Through a discussion of the differences in development experiences between the participants in this study and the current literature on athlete development, the authors highlight areas of concern in applying a non-para-specific athlete development model to para swimmers. This study identifies several areas of consideration in the future design of a para athlete development framework or model.

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Shlomo Hammer, Elad Spitzer, and Shmuel Springer

Context: Achilles tendinopathy (AT) is a common musculoskeletal injury among runners. Eccentric exercises are considered first-line treatment. However, during the early stages of rehabilitation, patients are usually instructed to stop running. Backward running (BR) on a negative slope provides a similar eccentric load while enabling ongoing physical activity; thus, it may be suggested as an alternative treatment. Objectives: To determine the feasibility of a BR program as a treatment option for AT in runners. Design: Prospective, single-arm feasibility study. Setting: Outpatient clinic. Patients: Recreational runners diagnosed with AT and referred to the Meuhedet Health Services Physical Therapy Clinic in Jerusalem, Israel, from September 2019 to February 2020. Intervention: The patients completed a 5-week (9 sessions) rehabilitation program of supervised BR on a negatively inclined treadmill. Main Outcome Measures: Compliance with the program was evaluated by calculating the percentage of patients who completed the full protocol with no adverse events. Personal running-related goals were set before the program and were assessed following rehabilitation using the goal attainment scaling method. Forward-running time until the onset of relevant Achilles tendon pain, and the Victorian Institute of Sports Assessment Scale-Achilles were measured at baseline (T0), before treatment session 6 (T1), and after the last session (T2). Results: Among the 15 patients recruited, 14 (93%), average age 48.8 (10.4) years (86% males), completed the full protocol with no adverse events. Almost all participants (85.7%) achieved their running-related functional goals. Postintervention, the median forward-running time increased from 52.5 (92.5) to 900 (522.5) seconds (P = .008, effect size = .858), and the median Victorian Institute of Sports Assessment Scale-Achilles score improved by 28 points (P = .003, effect size = .881). Conclusions: BR on a negative slope may be a feasible treatment method for runners suffering from AT. Future randomized control trials are required to further validate the efficacy of this method.