Justin A. Haegele
Karissa L. Johnson, Danielle L. Cormier, Kent C. Kowalski, and Amber D. Mosewich
Helping athletes cope effectively with injury is likely of great interest to many sport stakeholders. Mental toughness is one psychological factor positively associated with resilience and sport performance, though stubborn persistence through injury might not always be conducive to adaptive athlete outcomes. Self-compassion—a balanced, nonjudgmental approach in relating to oneself when experiencing suffering—might help circumvent these pitfalls and complement injury recovery. The purpose of this study was to explore the relationship between mental toughness and self-compassion in a sport injury context. This study consisted of 2 phases—phase I quantitatively assessed the relationships between mental toughness, self-compassion, and other psychological constructs, while phase II used qualitative interviews to corroborate and inform these findings. In phase I, competitive athletes who were injured at the time of data collection (n = 81) completed mental toughness, self-compassion, coping resources, self-esteem, and self-criticism questionnaires. Self-compassion was positively correlated with mental toughness (r = .48, P < .01), coping resources (r = .54, P < .05), and self-esteem (r = .60, P < .01). Self-compassion and self-criticism were negatively correlated with each other (r = –.52, P < .01). Results from hierarchical multiple regression analyses revealed that self-compassion was a significant predictor of mental toughness (ΔR 2 = .07, P < .01), coping resources (ΔR 2 = .10, P < .01), and self-criticism (ΔR 2 = .06, P < .01), beyond the effects of self-esteem. Four injured athletes who scored above the median on mental toughness and self-compassion measures were interviewed in phase II. Thematic analysis generated 2 themes: (1) self-compassion grants access to wise mental toughness and (2) mental toughness helps activate self-compassionate actions during injury. These findings are consistent with recent research and suggest that both mental toughness and self-compassion can work together to help athletes cope with sport injury.
Jacqueline A. Augustine, Sarah Rothstein, Larissa True, and Kevin D. Dames
Context: A variety of gait retraining interventions are available to modify running mechanics associated with musculoskeletal injuries. These often require specialized equipment and/or personnel to prompt the runner toward specific strategies. Objective: To determine whether instructing female recreational runners to “run quietly” could decrease impact force characteristics. Design: Cohort. Setting: Research laboratory. Participants: Fifteen healthy female recreational runners (24  y) volunteered. Interventions: Baseline testing occurred on day 1 (baseline), a posttraining assessment occurred on day 2 (training), and a final assessment occurred 1 week after training on day 3 (follow-up). A smartphone decibel measuring app was used to provide biofeedback on the decibel level of foot strike on day 2 (training). Main Outcomes: Peak vertical force, impact transient, peak and average vertical loading rate, ground contact time, and running economy were collected on each day and compared via repeated-measures analyses of variance. Results: Vertical ground reaction force was lower at follow-up (2.30 bodyweights [BW]) versus baseline (2.39 BW, P = .023) and training (2.34 BW, P = .047). Maximal loading rate decreased from baseline (69.70 BW·s−1) to training (62.24 BW·s−1, P = .021) and follow-up (60.35 BW·s−1, P = .031). There was no change in running economy. Conclusions: Our findings demonstrate that simple instructions to “run quietly” can yield immediate and sustained reductions in impact force profiles, which do not influence running economy.
Kwok Ng, Sean Healy, Wesley O’Brien, Lauren Rodriguez, Marie Murphy, and Angela Carlin
For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D−), Sedentary Behaviors (D−), Family & Peers (C), School (C−), Community & Environment (B−), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities.
Eleftherios Paraskevopoulos, George Koumantakis, and Maria Papandreou
Context: Neuromobilization exercises (NE) could be a useful therapeutic tool to induce analgesia and increase function and range of motion (ROM) in patients with musculoskeletal pathologies with neuropathic components; however, the effectiveness of this intervention in patients with cervical radiculopathy (CR) is unknown. Objective: To determine the effectiveness of NE in CR on pain, function, and ROM. Design: Systematic review and meta-analysis. Evidence Acquisition: An electronic search was performed in the MEDLINE, Scopus, PEDro, and EBSCO databases from inception until June 2022. The authors included randomized clinical trials that evaluated the effectiveness of NE against control groups or other interventions that aimed to treat patients with CR. Evidence Synthesis: Seven clinical trials met the eligibility criteria, and for the quantitative synthesis, 5 studies were included. For the studies that compared NE with a control group, the standardized mean difference for pain was −1.33/10 (95% confidence interval [CI], −1.80 to −0.86; P < .01; I 2 = 0%), for function with the Neck Disability Index was −1.21/50 (95% CI, −1.67 to −0.75; P < .01; I 2 = 0%), and for neck flexion and extensions was 0.66 (95% CI, 0.23 to 1.10; P < .01; I 2 = 0%) and 0.47 (95% CI, 0.04 to 0.90; P < .01; I 2 = 0%), respectively, with evidence of clinical effectiveness. These findings were based on moderate-quality evidence according to the Grading of Recommendation, Assessment, Development, and Evaluation rating. In studies that compared NE with other interventions, the meta-analysis failed to demonstrate the statistical or clinical superiority of NE. Conclusions: Moderate quality of evidence suggests that NE may be superior to no treatment for pain, function, and ROM in patients with CR. In contrast, NE are not superior to other interventions in the same outcomes, based on low- to very low-quality evidence. More high-quality research is needed to assess the consistency of these results.
Tess M.R. Carswell, Brenton G. Hordacre, Marc D. Klimstra, and Joshua W. Giles
Research addressing lower limb amputee gait and prosthetic design often focuses on men, despite female lower limb amputees having different risk factors and lower success with their prosthetics overall. It is widely agreed that sex differences exist in able-bodied gait, but research analyzing sex differences in amputee gait is rare. This study compared male and female transtibial amputee gait to ascertain potential sex differences. Forty-five transtibial amputees were asked to walk at their self-selected speed, and spatiotemporal gait data were obtained. Both the mean and variability metric of parameters were analyzed for 10 male and 10 female participants. For all participants, amputated limbs had a shorter stance time, longer swing time, and larger step length. Females had a 10% shorter stance time and 26% larger normalized step and stride length than males. Female participants also walked over 20% faster than male participants. Finally, significant interactions were found in the mean and variability metric of stride velocity, indicating greater variability in women. These findings suggest that sex differences exist in transtibial amputee gait, offering possible explanations for the different comorbidities experienced by female lower limb amputees. These results have major implications for female amputees and for sex-specific research, rehabilitation, and prosthetic design.
Hannah Bennett, Robert Owens, and Tanya Prewitt-White
Hangue Park, Alexander N. Klishko, Kyunggeune Oh, Celina Zhang, Gina Grenga, Kinsey R. Herrin, John F. Dalton IV, Robert S. Kistenberg, Michel A. Lemay, Mark Pitkin, Stephen P. DeWeerth, and Boris I. Prilutsky
Cutaneous feedback from feet is involved in regulation of muscle activity during locomotion, and the lack of this feedback results in motor deficits. We tested the hypothesis that locomotor changes caused by local unilateral anesthesia of paw pads in the cat could be reduced/reversed by electrical stimulation of cutaneous and proprioceptive afferents in the distal tibial nerve during stance. Several split-belt conditions were investigated in four adult female cats. In addition, we investigated the effects of similar distal tibial nerve stimulation on overground walking of one male cat that had a transtibial, bone-anchored prosthesis for 29 months and, thus, had no cutaneous/proprioceptive feedback from the foot. In all treadmill conditions, cats walked with intact cutaneous feedback (control), with right fore- and hindpaw pads anesthetized by lidocaine injections, and with a combination of anesthesia and electrical stimulation of the ipsilateral distal tibial nerve during the stance phase at 1.2× threshold of afferent activation. Electrical stimulation of the distal tibial nerve during the stance phase of walking with anesthetized ipsilateral paw pads reversed or significantly reduced the effects of paw pad anesthesia on several kinematic variables, including lateral center of mass shift, cycle and swing durations, and duty factor. We also found that stimulation of the residual distal tibial nerve in the prosthetic hindlimb often had different effects on kinematics compared with stimulation of the intact hindlimb with paw anesthetized. We suggest that stimulation of cutaneous and proprioceptive afferents in the distal tibial nerve provides functionally meaningful motion-dependent sensory feedback, and stimulation responses depend on limb conditions.
Matthew R. Kutz
Athletic training and the environment in which it is practiced is constantly changing. The emergent environment is volatile, uncertain, complex, and ambiguous. This new environment necessitates an adjustment to athletic training education particularly as it pertains to the instruction and development of the nonclinical skills (meta-skills) needed for clinical settings. One such meta-skill is contextual intelligence. Contextual intelligence is the capacity to recognize the convergence of different variables and respond to the emerging context as it is developing. Practicing contextual intelligence includes integrating 12 specific behaviors and the 3D thinking framework of hindsight, insight, and foresight into clinical decision making.