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Matthew P. Bejar, Leslee A. Fisher, Benjamin H. Nam, Leslie K. Larsen, Jamie M. Fynes and Rebecca A. Zakrajsek

Although the biopsychosocial model of sport injury rehabilitation (Brewer, Andersen, & Van Raalte, 2002) is one of the most comprehensive frameworks to address athletes’ postinjury responses, there has been little research centralizing the myriad of cultural factors (e.g., nationality, ethnicity, socioeconomic status) that can impact psychological, social/contextual, and biological factors that, in turn, impact athletes’ recovery. The purpose of the current study was to explore high-level South Korean athletes’ experiences of injury and rehabilitation. Retrospective semistructured interviews were conducted with 11 retired high-level South Korean athletes. Employing Consensual Qualitative Research (CQR) methodology (Hill, 2012), four domains were constructed from the data: (a) Experience of the South Korean Sport System, (b) Immediate Post-Injury Perceptions, (c) Experience of Recovery Process, and (d) Post-Injury Reflections. The findings indicated that participants’ experiences of the forced hierarchy and power dynamics within the South Korean athletic specialist system influenced perceived sport injury rehabilitation outcomes.

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Diane M. Wiese and Maureen R. Weiss

Psychological rehabilitation in response to physical injury is of primary concern to athletes, trainers, coaches, and sport psychologists. To date, there is little empirical research to shed light on this topic, as well as on the role of sport psychology practitioners in facilitating the prevention, rehabilitation, and recovery from athletic injuries. The purpose of this paper is to consolidate and report the information available on the nature of injuries and make suggestions concerning the application of sport psychology principles when working with injured athletes. Four major concerns are addressed with regard to current knowledge and practical implications: how injuries happen, how athletes respond to injuries, how psychological rehabilitation as well as physical recovery from injuries can be facilitated, and determining when injured athletes are psychologically ready to return to competition.

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Scott W. Cheatham, Keelan R. Enseki and Morey J. Kolber

Context:

Hip arthroscopy has become an increasingly popular option for active individuals with recalcitrant hip pain. Conditions that may be addressed through hip arthroscopy include labral pathology, femoral acetabular impingement, capsular hyperlaxity, ligamentum teres tears, and the presence of intra-articular bodies. Although the body of literature examining operative procedures has grown, there is a paucity of evidence specifically on the efficacy of postoperative rehabilitation programs. To date, there are no systematic reviews that have evaluated the available evidence on postoperative rehabilitation.

Objective:

To evaluate the available evidence on postoperative rehabilitation programs after arthroscopy of the hip joint.

Evidence Acquisition:

A search of the PubMed, CINAHL, SPORTDiscus, ProQuest, and Google Scholar databases was conducted in January 2014 according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews.

Evidence Synthesis:

Six studies met the inclusion criteria and were either case series or case reports (level 4 evidence) that described a 4- or 5-phase postoperative rehabilitation program. The available evidence supports a postoperative period of restricted weight bearing and mobility; however, the specific interventions in the postoperative phases are variable with no comparison trials.

Conclusion:

This review identified a paucity of evidence on postoperative rehabilitation after hip arthroscopy. Existing reports are descriptive in nature, so the superiority of a particular approach cannot be determined. One can surmise from existing studies that a 4- to 5-stage program with an initial period of weight-bearing and mobility precautions is efficacious in regard to function, patient satisfaction, and return to competitive-level athletics. Clinicians may consider such a program as a general guideline but should individualize treatment according to the surgical procedure and surgeon guidelines. Future research should focus on comparative trials to determine the effect of specific postoperative rehabilitation designs.

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James J. Irrgang, Susan L. Whitney and Emily D. Cox

Recently there has been emphasis on including balance and proprioceptive training in the rehabilitation of sports-related lower extremity injuries. It is believed that injury to joint and musculotendinous structures results in altered somatosensory information that adversely affects motor control. This may result in increased risk for recurrent injury, decreased performance, or both. Balance and proprioceptive training have been advocated to restore motor control to the lower extremity. This paper will review the current scientific rationale for use of balance and proprioceptive training in the rehabilitation of sports-related lower extremity injuries. Additionally, guidelines for training to improve balance and proprioception will be discussed.

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Joe Hart, Damien Clement, Jordan Hamson-Utley, Monna Arvinen-Barrow, Cindra Kamphoff, Rebecca A. Zakrajsek and Scott B. Martin

Context:

Injured athletes begin the rehabilitation process with expectations about the nature of the working relationship with an athletic trainer. These expectations can infuence the effectiveness of the assistance provided.

Objective:

To determine whether male and female athletes differed in terms of expectations about injury rehabilitation services with an athletic trainer.

Design:

A questionnaire was administered to student athletes that assessed expectations about injury rehabilitation. Setting: Five colleges and universities.

Patients or Other Participants:

Questionnaire responses were provided by 679 student athletes (443 males and 236 females).

Main Outcome Measure:

Responses to the Expectations about Athletic Training questionnaire were used to assess factors identifed as Personal Commitment, Facilitative Conditions, Athletic Trainer Expertise, and Realism.

Results:

A statistically signifcant interaction between gender and prior experience was identifed. Male athletes with no prior experience had lower expectations for a facilitative environment. Female athletes with prior experience were less likely to have realistic expectations.

Conclusions:

Gender and prior experience infuence athletes’ expectations of injury rehabilitation with an athletic trainer.

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Jim Taylor and Shel Taylor

This article addresses the essential role that pain plays in the rehabilitation of sports injury. It will describe important information and approaches that applied sport psychologists can use to more effectively manage pain in injured athletes. The article includes a brief discussion of the most accepted theories of pain. Types of pain that injured athletes may experience and how they can learn to discriminate between them will be discussed. The article will also consider how pain can be a useful tool as information about injured athletes’ current status in recovery and the need to modify their rehabilitation regimens. The value of measuring pain will be examined with emphasis on determining a simple and easy means of assessing pain. Next, the article will examine why nonpharmacological pain management may be a useful adjunct to pharmacological pain control. Then, a brief description of the most commonly used pain medications and a detailed description of common nonpharmacological pain-management strategies will be furnished. A discussion of how nonpharmacological pain management can be incorporated into the traditional rehabilitation process will be offered. Finally, the article will describe the role that sport psychologists can play in the management of sport injury-related pain. The objective of this article is to provide applied practitioners with the knowledge and tools necessary to assist injured athletes in mitigating the pain they will experience during recovery as a means of facilitating their rehabilitation and return to sport.

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Monna Arvinen-Barrow, Damien Clement, Jennifer Jordan Hamson-Utley, Cindra Kamphoff, Rebecca Zakrajsek, Sae-Mi Lee, Brian Hemmings, Taru Lintunen and Scott B. Martin

Context:

Athletes enter injury rehabilitation with certain expectations about the recovery process, outcomes, and the professional providing treatment. Their expectations influence the effectiveness of the assistance received and affect the overall rehabilitation process. Expectations may vary depending on numerous factors such as sport experience, gender, sport type, and cultural background. Unfortunately, limited information is available on athletes’ expectations about sport-injury rehabilitation.

Objective:

To examine possible differences in athletes’ expectations about sport-injury rehabilitation based on their country of residence and type of sport (contact vs noncontact).

Design:

Cross-sectional.

Setting:

Recreational, college, and professional athletes from the US, UK, and Finland were surveyed.

Participants:

Of the 1209 athletes ranging from 12 to 80 y of age (mean 23.46 ± 7.91), 529 US [80%], 253 UK [86%], and 199 Finnish [82%] athletes provided details of their geographical location and were included in the final analyses.

Main Outcome Measures:

The Expectations About Athletic Training (EAAT) questionnaire was used to determine athletes’ expectations about personal commitment, facilitative conditions, and the expertise of the sports-medicine professional (SMP).

Results:

A 3 × 2 MANCOVA revealed significant main effects for country (P = .0001, ηp 2 = .055) and sport type (P = .0001, ηp 2 = .023). Specifically, US athletes were found to have higher expectations of personal commitment and facilitative conditions than their UK and Finnish counterparts. Athletes participating in contact sports had higher expectations of facilitative conditions and the expertise of the SMP than did athletes participating in noncontact sports.

Conclusions:

SMPs, especially those in the US, should consider the sport and environment when providing services. In addition, SMPs need to highlight and demonstrate their expertise during the rehabilitation process, especially for those who compete in contact sports.

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Megan Self, Simon Driver, Laurel Stevens and Ann Marie Warren

Traumatic brain injury (TBI) is a significant public health issue due to the incidence, complexity, and cost associated with treatment. The purpose of this study was to determine physical activity (PA) knowledge, attitudes, intentions, and barriers among individuals with a TBI undergoing outpatient rehabilitation. Seventeen participants completed a series of group interviews regarding their PA needs. A qualitative research design was adopted and trustworthiness was established through investigator triangulation of data. A cross-case analysis was completed to identify themes and conceptual patterns. The main themes identified were (a) an inability to differentiate between PA and physical therapy, (b) a limited knowledge of PA health benefits and the relationship to rehabilitation, and (c) an interest in participating in a PA based health promotion program. Future interventions should educate individuals about PA, the associated health benefits, and the role PA plays in the rehabilitation process.

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Lori Bolgla and Terry Malone

Objective:

To provide evidence regarding the therapeutic effects of exercise on subjects with patellofemoral-pain syndrome (PFPS).

Data Sources:

Evidence was compiled with data located using the Medline, CINAHL, and SPORTDiscus databases from 1985 to 2004 using the key words patellofemoral pain syndrome, exercise, rehabilitation, and strength.

Study Selection:

The literature review examined intervention studies evaluating the effectiveness of exercise in subjects specif-cally diagnosed with PFPS. Articles were selected based on clinical relevance to PFPS rehabilitation that required an intervention of a minimum of 4 weeks.

Data Synthesis:

The review supports using exercise as the primary treatment for PFPS.

Conclusions:

Evidence exists regarding the use of isometric, isotonic, isokinetic, and closed kinetic chain exercise. Although clinicians have advocated the use of biofeedback and patella taping, there is limited evidence regarding the efficacy of these interventions on subjects diagnosed with PFPS.

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Tania Pizzari, Helen McBurney, Nicholas F. Taylor and Julian A. Feller

Objective:

To investigate the subjective experience of anterior cruciate ligament (ACL) rehabilitation and identify variables that influence adherence as perceived by ACL-reconstructed patients.

Design:

A qualitative study using in-depth interviews to gather data and thematic coding to analyze findings.

Setting:

Participants were interviewed at home or in their workplace.

Participants:

Eleven patients were interviewed at an average of 4.8 months (SD = 0.8) after ACL reconstruction.

Results:

Using thematic coding of the interview data, 3 categories of variables influencing adherence emerged: environmental factors, physical factors, and psychological factors. Variables specifically affecting adherence to home exercise were perceived lack of time and a lack of self-motivation. Fear of reinjury emerged as a significant consideration for those who were nonadherent. Factors such as therapist support, the rehabilitation clinic, and the progression of exercises were identified as being important for attendance at physiotherapy appointments and adherence during appointments.