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Monna Arvinen-Barrow, Brian Hemmings, Caryl A. Becker and Lynn Booth

To gain an insight to the existing suggestions and recommendations on chartered physiotherapists’ preferred methods of delivery for further training in sport psychology.

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Carla Sordoni, Craig Hall and Lorie Forwell

Objectives:

To determine whether athletes use motivational and cognitive imagery during injury rehabilitation and to develop an instrument for measuring imagery use.

Design:

A survey concerning imagery use during rehabilitation was administered to injured athletes.

Setting:

The Fowler Kennedy Sport Medicine Clinic in London, Ontario, Canada.

Participants:

Injured athletes (N = 71) receiving physiotherapy.

Main Outcome Measure:

The Athletic Injury Imagery Questionnaire (AIIQ).

Results:

As hypothesized, 2 distinct factors emerged from the items on the AIIQ: motivational and cognitive imagery. Motivational imagery was used more often than cognitive imagery in this context, yet less frequently than in other sport situations (eg, training and competition).

Conclusions:

The study indicates that the AIIQ is a potentially useful tool through which physiotherapists and sport psychologists can examine athletes' use of imagery in injury rehabilitation.

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Salvatore Masala, Roberto Fiori, Mario Raguso, Christine Ojango, Marco Morini, Alessandro Cuzzolino, Eros Calabria and Giovanni Simonetti

Context:

Chronic pubalgia affects around 10% of athletes.

Objective:

To determine the role of pulse-dose radiofrequency (PDRF) in athletes with chronic pubalgia and investigate the causes with imaging.

Design:

Prospective nonrandomized single-group study.

Patients:

PDRF was performed on 32 patients with a chronic pain that had been refractory to conservative therapies during the last 3 mo.

Intervention:

The genital branches of the genitofemoral, ilioinguinal, and iliohypogastric nerves and the obturator nerve were the goals of treatment. A 10-cm, 20-gauge cannula was inserted with a percutaneous access on the upper and lower edges of the iliopubic branch. After the spindle was removed, a radiofrequency needle with a 10-mm “active tip” was inserted. The radiofrequency technique was performed with 1200 pulses at 45 V and 20-ms duration, followed by a 480-ms silent phase.

Main Outcome Measures:

The follow-up with a clinical examination was performed at 1, 3, 6, and 9 mo after the procedure. During the follow-up visits, the patients were asked to rate their pain on a 0–10 VAS scale.

Results:

All of the enrolled patients completed the study. Mean VAS score before the treatment was 8.4 ± 0.6. Twenty-four patients had a reduction of pain VAS scores more than 50% during all follow-up visits and started training and physiotherapy in the days after the radiofrequency procedure. Six patients, each treated 2 times, had a reduction more than 50% of VAS scores and could start training and physiotherapy only after the 2nd procedure. One patient had no pain relief with 2 treatments. Pain intensity decreased up to 9 mo in 31 patients (mean VAS scores 3.4 ± 0.5 at 6 mo and 3.8 ± 0.9 at 9 mo). No complications were observed.

Conclusions:

PDRF is an effective and safe technique in management of chronic pubalgia in athletes.

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Ozgur Surenkok, Aydan Aytar and Gul Baltaci

Objective:

The aim of this study was to evaluate the initial effects of scapular mobilization (SM) on shoulder range of motion (ROM), scapular upward rotation, pain, and function.

Design:

Pretest–posttest for 3 groups (SM, sham, and control).

Setting:

A double-blinded, randomized, placebo-controlled trial was conducted to evaluate the initial effect of the SM at a sports physiotherapy clinic.

Participants:

39 subjects (22 women, 17 men; mean age 54.30 ± 14.16 y, age range 20-77 y).

Interventions:

A visual analog scale, ROM, scapular upward rotation, and function were assessed before and just after SM. SM (n = 13) consisted of the application of superoinferior gliding, rotations, and distraction to the scapula. The sham (n = 13) condition replicated the treatment condition except for the hand positioning. The control group (n = 13) did not undergo any physiotherapy and rehabilitation program.

Main Outcome Measures:

Pain severity was assessed with a visual analog scale. Scapular upward rotation was measured with a baseline digital inclinometer. Constant Shoulder Score (CSS) was used to measure shoulder function.

Results:

After SM, we found significant improvements for shoulder ROM, scapular upward rotation, and CSS between pretreatment and posttreatment compared with the sham and control groups. In the sham group, shoulder-ROM values increased or decreased for the shoulder and scapular upward rotation was not changed. Pain, ROM, and physical function of the shoulder were not significantly different in the sham group than in controls (P > .05).

Conclusions:

SM may be a useful manual therapy technique to apply to participants with a painful limitation of the shoulder. SM increases ROM and decreases pain intensity.

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Danielle Lovett Carter and Norelee Kennedy

Background:

Hip arthroscopy is a minimally invasive surgical procedure. Femoroacetabular impingement (FAI) is being increasingly recognized as a cause of hip pain in athletes and is a growing indication for arthroscopic surgery. Few studies have attempted to address patient views on outcome after arthroscopy, and no qualitative studies have been carried out to date.

Objectives:

To explore athletes' perceptions of rehabilitation outcome, the rehabilitative process, and return to sport and to gain insight into factors that affected this process.

Methodology:

A retrospective qualitative approach was adopted using semistructured interviews. Eight eligible participants were interviewed. Each had been treated with hip arthroscopy for FAI from September to November 2010. Data were audiotaped, transcribed verbatim, and analyzed using thematic analysis.

Results:

Three main themes emerged. (1) The ability to participate in sport; athletes were relatively satisfied with outcome despite some limitations in sporting ability. (2) Perceptions of hip problems; there was a lack of understanding and an association of hip problems with older people among the general public. (3) Athletes' perception of rehabilitation; athletes were dissatisfied with the rehabilitation and sought greater physiotherapy input.

Conclusions:

Overall, athletes were relatively satisfied with their outcome 1 y after hip arthroscopy, despite some having to adapt their sporting activities. Key areas that need to be addressed in future research include factors affecting outcomes of hip arthroscopy, longer-term outcomes, perception of FAI among the public and health practitioners, and the development of a standardized evidence-based rehabilitation protocol.

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Dennis Liem, Katharina Van Fabeck, Wolfgang Poetzl, Winfried Winkelmann and Georg Gosheger

Context:

With the rising number of patients with total hip arthroplasty, there is demand for sporting activities for these patients to stay physically active.

Objectives:

The goal of this study was to evaluate satisfaction and golfing performance for golfers after total hip arthroplasty.

Study Design:

Retrospective cohort study.

Patients:

Data of 46 golfers with an average age of 66.5 years (46–79 years) with an average follow up of 58.8 months (7–253 months) after total hip arthroplasty was analysed.

Results:

37 patients (80.4%) were able to return completely pain free, 9 patients still had pain during golf (19.6%). While satisfaction was high regardless of gender or affected side, only male golfers significantly improved their handicap and driving distance. Time spent on the golf course was the same pre- and postoperatively. Average time for returning to practice was 3.8 months; time until a full round of golf was 5.2 months. Postoperative physiotherapy was a significant factor in achieving an improved performance postoperatively.

Conclusions:

Golfers can return to the golf course with the same frequency and performance level to stay physically active after total hip arthroplasty.

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Cormac G. Ryan, Patricia Schofield and Denis J. Martin

Negative views of older adults can lead to suboptimal care. For older adults with persistent low back pain (LBP), promotion of physical activity by health care professionals is important. Health care professionals’ views of older adults are influenced by their training. This study aimed to compare recommendations for physical activity for managing persistent LBP offered by students in physiotherapy and occupational therapy to an older person vs. a younger person. In a cross-sectional online survey, participants (N = 77) randomly received a vignette of either a 40-yr-old or 70-yr-old patient with persistent LBP. Other than age, the vignettes were identical. There was no difference between the younger and older vignettes in the likelihood of participants making overall appropriate physical activity recommendations—63% vs. 59%, OR (95%CI) = 1.19 (0.48–2.99), p = .71—although there was a trend toward age bias on recommendations specific to daily activity. Postqualification education may be where ageist views need to be addressed.

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Koya Mine, Takashi Nakayama, Steve Milanese and Karen Grimmer

Context:

Posterior shoulder tightness (PST) and glenohumeral internal-rotation deficit (GIRD) can contribute to shoulder pain suffered by athletes engaged in overhead sporting activities. Stretching is a common intervention to resolve PST and GIRD, but it has weak evidence of effectiveness to date.

Objective:

This systematic review aimed to collect and synthesize effectiveness data from English- and Japanese-language randomized controlled trials (RCTs) investigating stretching interventions for PST and GIRD.

Evidence Acquisition:

7 English databases and 3 Japanese databases were searched from inception until December 5, 2015. Only English- and Japanese-language RCTs were considered. Risk of bias in the included studies was assessed using the Physiotherapy Evidence Database scale. Data were synthesized qualitatively.

Evidence Synthesis:

Eight English-language and 2 Japanese-language papers of low to high quality were included. There was moderate evidence for positive immediate and short-term effects of cross-body stretch on PST and GIRD in asymptomatic young subjects. Moderate evidence was found to suggest that active sleeper stretch might not be more effective than no intervention to improve PST and GIRD in the short term.

Conclusions:

Cross-body stretch can be effective to improve PST and GIRD in asymptomatic young subjects immediately or in the short term. Further study with methodological rigor is necessary to investigate the long-term effectiveness of stretching interventions on PST and GIRD in symptomatic patients.

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Daniela Mirandola, Guido Miccinesi, Maria Grazia Muraca, Eleonora Sgambati, Marco Monaci and Mirca Marini

Background:

Physical activity interventions are known to be effective in improving the physical and psychological complaints of breast cancer survivors.

Purpose:

To investigate the impact of a specific exercise training program on upper limb mobility and quality of life in breast cancer survivors.

Methods:

The study included 55 women recruited at the Cancer Rehabilitation Centre in Florence after the completion of breast cancer treatment and rehabilitative physiotherapy. All participants underwent an 8-week specific exercise training to improve upper limb mobility function and quality of life. Anthropometric parameters were measured, and each subject underwent a battery of fitness tests to assess shoulder-arm mobility, range of motion, and back flexibility before and after specific exercise program. All participants filled out the Short Form-12 and numerical rating scale questionnaires to assess the quality of life and to quantify back and shoulder pain intensity.

Results:

The evaluation of shoulder-arm mobility and self-reported questionnaire data revealed a statistically significant improvement after completion of our specific exercise program.

Conclusion:

An organized specific program of adapted physical activity can be effective in reducing the main adverse effects of surgery and oncological therapy, and may significantly improve shoulder-arm mobility and quality of life in breast cancer survivors.

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Dennis-Peter Born, Billy Sperlich and Hans-Christer Holmberg

To assess original research addressing the effect of the application of compression clothing on sport performance and recovery after exercise, a computer-based literature research was performed in July 2011 using the electronic databases PubMed, MEDLINE, SPORTDiscus, and Web of Science. Studies examining the effect of compression clothing on endurance, strength and power, motor control, and physiological, psychological, and biomechanical parameters during or after exercise were included, and means and measures of variability of the outcome measures were recorded to estimate the effect size (Hedges g) and associated 95% confidence intervals for comparisons of experimental (compression) and control trials (noncompression). The characteristics of the compression clothing, participants, and study design were also extracted. The original research from peer-reviewed journals was examined using the Physiotherapy Evidence Database (PEDro) Scale. Results indicated small effect sizes for the application of compression clothing during exercise for shortduration sprints (10–60 m), vertical-jump height, extending time to exhaustion (such as running at VO2max or during incremental tests), and time-trial performance (3–60 min). When compression clothing was applied for recovery purposes after exercise, small to moderate effect sizes were observed in recovery of maximal strength and power, especially vertical-jump exercise; reductions in muscle swelling and perceived muscle pain; blood lactate removal; and increases in body temperature. These results suggest that the application of compression clothing may assist athletic performance and recovery in given situations with consideration of the effects magnitude and practical relevance.