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Athletes’ Perspectives of the Classification System in Para Alpine Skiing for Those With Visual Impairment

Sara M. Douglas, Paul J. Kitchin, Andrew J. Jackson, Brendan T. Barrett, and Julie-Anne Little

This study explored the classification experiences and views of Para Alpine skiers with visual impairment. Data from 11  interviews were analyzed using reflexive thematic analysis to generate three themes: Suitability—The skiers questioned the suitability of the visual measurements, testing environment, and the information they received regarding classification; Exclusivity—Skiers felt certain aspects of the system remain exclusive due to the restrictions of sport classes and lack of the athlete voice; and (Dis)trust—Skiers felt distrust in those implementing the system and in other athletes due to intentional misrepresentation. Speculation surrounding this resulted in the skiers’ feeling doubt in their own classification. While there is not a “one size fits all” approach to classification, understanding skiers’ experiences can be a vital first step and will help to guide future research into the evolution of this sport’s classification.

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Erratum. The Relationship Between Childhood Trauma, Exercise Addiction, Emotion Regulation Difficulties, and Basic Psychological Needs in Türkiye

Journal of Clinical Sport Psychology

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Response of Knee Joint Biomechanics to Landing Under Internal and External Focus of Attention in Female Volleyball Players

Lukáš Slovák, David Zahradník, William M. Land, Javad Sarvestan, Joseph Hamill, and Reza Abdollahipour

The aim of this study was to examine the effect of attentional focus instructions on the biomechanical variables associated with the risk of anterior cruciate ligament injury of the knee joint during a drop landing task using a time series analysis. Ten female volleyball players (age: 20.4 ± 0.8 years, height: 169.7 ± 7.1 cm, mass: 57.6 ± 3.1 kg, experience: 6.3 ± 0.8 years) performed landings from a 50 cm height under three different attentional focus conditions: (1) external focus (focus on landing as soft as possible), (2) internal focus (focus on bending your knees when you land), and (3) control (no-focus instruction). Statistical parameter mapping in the sagittal plane during the crucial first 30% of landing time showed a significant effect of attentional focus instructions. Despite the similarity in landing performance across foci instructions, adopting an external focus instruction promoted reduced vertical ground reaction force and lower sagittal flexion moment during the first 30% of execution time compared to internal focus, suggesting reduced knee loading. Therefore, adopting an external focus of attention was suggested to reduce most biomechanical risk variables in the sagittal plane associated with anterior cruciate ligament injuries, compared to internal focus and control condition. No significant differences were found in the frontal and horizontal planes between the conditions during this crucial interval.

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Treating Dystonia in a Soccer Player Through an Integrated Rehabilitative Approach: A Case Report

Valeria Giorgi, Giovanni Apostolo, and Laura Bertelè

Context: Sport-related dystonia is a rare form of activity-specific dystonia that can severely impair an athlete’s ability to perform. Due to a lack of data on the condition, it is difficult to diagnose and often overlooked, and no gold standard treatment has yet been defined. Case Presentation: We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely. Management and Outcomes: An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer. Conclusions: This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations.

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Effect of Neurofeedback Training Along With Swimming Exercise on the Stress, Anxiety, Depression, Severity of Dependence, and Craving in Methamphetamine-Dependent Patients

Atefeh Fadaei, Mahmoud Najafi, Hossein Miladi-Gorji, Mohammad Ali Tajik-Mansoury, and Mohammad Afkar

This study investigated whether neurofeedback (NFB) training and swimming exercise (Swim) would reduce the stress, anxiety, depression, severity of dependence, and cravings in patients addicted to methamphetamines. Participants were allocated randomly to four groups: control group, NFB, Swim, and NFB/Swim. All groups completed the study questionnaire before and after treatment. The NFB, Swim, and NFB/Swim groups reported significantly less stress, cravings, and severity of dependence than the control group. The Swim and NFB/Swim groups had significantly lower depression scores than the control group. Also, the NFB/Swim group experienced less anxiety than the control group. However, the NFB/Swim group had lower levels of stress than the Swim group, and lower levels of anxiety and severity of dependence than the NFB group. These findings suggest that NFB training along with swimming exercise was effective in managing methamphetamine-related behavioral disturbances, which may help patients to manage their cravings.

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The Relationship Between Childhood Trauma, Exercise Addiction, Emotion Regulation Difficulties, and Basic Psychological Needs in Türkiye

Sema Gültekin Arayici and Serap Tekinsav Sutcu

Exercise addiction manifests as a behavioral compulsion where physical activity becomes excessively pursued, leading to potential harm to both physical and mental well-being, as well as interpersonal connections. This study aimed to investigate the mediating role of basic psychological needs and emotion regulation difficulties in the relationship between childhood trauma and exercise addiction. The study sample consisted of 386 regular exercisers who completed several questionnaires, including the Childhood Trauma Scale, Exercise Dependence Scale, Basic Need Satisfaction Scale, and Difficulty in Emotion Regulation Scale. The results of the analyses revealed that basic psychological needs and emotion regulation difficulties were significant predictors of exercise addiction symptoms, and they mediated the relationship between childhood trauma and exercise addiction. The findings contribute to the understanding of the factors that may lead to exercise addiction and have implications for prevention and treatment. In this context, the results and limitations are discussed in light of the relevant literature.

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Brazilian Women in Paralympic Sports: Uncovering Historical Milestones in the Summer Paralympic Games

Luiz Gustavo T. Fabricio dos Santos, Isabella dos Santos Alves, Náthali Fernanda Feliciano, Africa Alejandra Ortuño Torres, Luis Felipe Castelli Correia de Campos, and Maria Luiza Tanure Alves

The journey of Brazilian female Paralympians transcends mere statistical increases in women’s participation. Behind the modest athlete growth lies the reality of women who are doubly marginalized by the intersection of gender and disability in an arena tailored for able-bodied men. Our study aimed to catalyze critical discourses surrounding the historical trajectory of Paralympic women’s sports. Through a comprehensive documentary analysis based on the Brazilian Paralympic Committee’s official documents from 1976 to 2021, we sought to shed light on this complex scenario. Numerically, Brazil’s representation comprised 229 women who, predominantly, had physical impairments and engaged in individual sports. In addition to a sporting legacy deeply entrenched in physical rehabilitation with limited opportunities for team-based sports, we observed negative influences stemming from ableist and sexist narratives. A thorough investigation into Paralympic milestones revealed a multitude of social barriers and highlighted the significant impact of societal changes in reshaping athletic opportunities and challenging traditional stereotypes.

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Ten Years Gone

Patrick O. McKeon and Jennifer M. Medina McKeon

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Effective Stretching Positions of the Piriformis Muscle Evaluated Using Shear Wave Elastography

Hikari Itsuda, Masahide Yagi, Ko Yanase, Jun Umehara, Hiyu Mukai, and Noriaki Ichihashi

Context: Piriformis syndrome is often associated with muscle spasms and shortening of the piriformis muscle (PM). Physical therapy, including static stretching of the PM, is one of the treatments for this syndrome. However, the effective stretching position of the PM is unclear in vivo. This study aimed to determine the effective stretching positions of the PM using ultrasonic shear wave elastography. Design: Observational study. Methods: Twenty-one healthy young men (22.7 [2.4] y) participated in this study. The shear elastic modulus of the PM was measured at 12 stretching positions using shear wave elastography. Three of the 12 positions were tested with maximum internal rotation at 0°, 20°, or 40° hip adduction in 90° hip flexion. Nine of the 12 positions were tested with maximum external rotation at positions combined with 3 hip-flexion angles (70°, 90°, and 110°) and 3 hip-adduction angles (0°, 20°, and 40°). Results: The shear elastic modulus of the PM was significantly higher in the order of 40°, 20°, and 0° of adduction and higher in external rotation than in internal rotation. The shear elastic modulus of the PM was significantly greater in combined 110° hip flexion and 40° adduction with maximum external rotation than in all other positions. Conclusion: This study revealed that the position in which the PM was most stretched was maximum external rotation with 110° hip flexion and 40° hip adduction.

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Preoperative Rehabilitation Enhances Mental and Physical Well-Being in Anterior Cruciate Ligament-Injured Individuals: A Mixed Methods Study

Antoine Frouin, Nina Desfontaines, Lilian Lacourpaille, Antoine Nordez, and Guillaume Le Sant

Context: Rehabilitation after an anterior cruciate ligament injury is recommended to be started soon after the injury. When surgery is required, research supports the delivery of physiotherapy before anterior cruciate ligament reconstruction (prehabilitation) to optimize recovery and positive outcomes. Individuals attending prehabilitation have never been questioned regarding their adherence to prehabilitation, perception of utility in meeting needs, upcoming events, or anticipated recovery goals. Design: Mixed methods cross-sectional study: Methods: 25 individuals before anterior cruciate ligament reconstruction (43% of eligible individuals from 12 clinics during the delivery period) were surveyed on their mindset and recovery expectancies. Semistructured interviews conducted in 9 of 25 participants assessed their lived experience of prehabilitation. Results: Participants reported that preventing a reinjury (96% of responses) and feeling confident during daily activities about their knee (92%) were the higher rating expectations at this stage of their treatment course. Three themes were developed from the interviews and analyses. (1) Participants reported that prehabilitation was a period full of challenges with memories of the injury and uncertainties. (2) They viewed prehabilitation as a step to move forward by finding support and self-motivating. (3) They believed that prehabilitation would have positive impacts on the treatment outcomes. Participants were confident that prehabilitation would accelerate the recovery of muscle volume (88%) and strength (84%). Conclusion: Participants had positive experiences of prehabilitation, aligning with the findings on functional outcomes in the existing literature on prehabilitation.