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Jason S. Scibek and Christopher R. Carcia

Background:

The efficacy of a variety of noninvasive, conservative management techniques for calcific tendinopathy has been investigated and established for improving pain and function and/or facilitating a decrease in the size or presence of calcium deposits. Surprisingly, few have reported on the use of traditional therapeutic exercise and rehabilitation alone in the management of this condition, given the often spontaneous resorptive nature of calcium deposits. The purpose of this case is to present the results of a conservative approach, including therapeutic exercise, for the management of calcific tendinopathy of the supraspinatus, with an emphasis on patient outcomes.

Case Description:

The patient was a self-referred 41-y-old man with complaints of acute right-shoulder pain and difficulty sleeping. Imaging studies revealed liquefied calcium deposits in the right supraspinatus. The patient reported constant pain at rest (9/10) and tenderness in the area of the greater tuberosity. He exhibited a decrease in all shoulder motions and had reduced strength. The simple shoulder test (SST) revealed limited function (0/12). Conservative management included superficial modalities and medication for pain and a regimen of scapulothoracic and glenohumeral range-of-motion (ROM) and strengthening exercises.

Outcomes:

At discharge, pain levels decreased to 0/10 and SST scores increased to 12/12. ROM was full in all planes, and resisted motion was strong and pain free. The patient was able to engage in endurance activities and continue practicing as a health care provider.

Discussion:

The outcomes with respect to pain, function, and patient satisfaction provide evidence to support the use of conservative therapeutic interventions when managing patients with acute cases of calcific tendinopathy. Successful management of calcific tendinopathy requires attention to outcomes and an understanding of the pathophysiology, prognostic factors, and physical interventions based on the current stage of the calcium deposits and the patient’s status in the healing continuum.

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Motohide Miyahara and Alena Wafer

The teaching process and outcome in a skill theme program and a movement concepts program were described and analyzed in seven children with developmental coordination disorder. It was hypothesized that the skill theme program would improve targeted skills and perceived physical competence, whereas the movement concepts program would improve self-esteem and creativity. The seven children were taught individually by the same student teachers twice a week for a period of five weeks in one of the teaching methods. After a vacation, the teachers changed their teaching strategies and taught the same children using the alternative method. Although the hypothesis was generally supported, the children’s response to and progress in the programs varied. Possible factors influencing the variation were discussed.

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Charles A. Maher

This article reflects a response to the case of a freshman student-athlete lacrosse player who was in the process of transitioning into a Division I environment. Within the context of the case response, guidelines were provided for assessment of the student-athlete at four separate, yet interrelated levels of psychological development. These levels were: as a person; as a student-athlete who exists in a high-risk environment; as a teammate; and as a performer in the sport of lacrosse. Relatedly, it was suggested how the strengths and needs of this individual could be assessed and how resulting needs assessment information could be used in the design of an individual plan for the student-athlete. As such, it was suggested that the individual plan would most likely center on helping the individual to become increasingly aware of herself as a person and performer, to offer guidance in adhering to her physical rehabilitation, and to develop a routine for her daily preparation and for monitoring her practice and game performances. The case response concludes with a description of a framework for determining the student-athlete’s readiness for engaging in the plan and its activities.

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Jessie M. Wall, Janelle L. Kwee, Marvin J. McDonald and Richard A. Bradshaw

This study was the first to explore the treatment effects of observed and experiential integration (OEI) therapy for the salient psychological barriers to performance experienced by athletes. The hermeneutic single case efficacy design was used to explore the relationship between OEI therapy and athlete psychological functioning. The participant was a student-athlete who met the criteria for the performance dysfunction (multilevel classification system of Sport psychology) category, which indicates that subclinical issues were present. After five phases of data collection, a rich case record was compiled and referenced to develop skeptic and affirmative briefs and corresponding rebuttals by two research teams of three experts (OEI clinician, non-OEI clinician, and sport expert). Three independent judges adjudicated the cases and unanimously concluded that the client changed considerably to substantially and that OEI, the therapeutic relationship, and client expectancy were active variables in the change process.

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Aditi Mankad, Sandy Gordon and Karen Wallman

The present study features a psycholinguistic analysis, using Pennebaker’s (1989) emotional disclosure paradigm, of an athlete’s experience in recovering from injury. “GL,” a male athlete rehabilitating from anterior cruciate ligament reconstruction, participated in a 9-week testing protocol. A 3-day intervention was used, consisting of three 20-minute writing sessions, which promoted disclosure of negative emotions associated with injury and rehabilitation. In addition, measures of stress, mood disturbance, and self-esteem were administered from pre- to postintervention and at follow-up. Results revealed decreases in stress and mood disturbance, as well as an increase in self-esteem. Analysis of writing samples revealed increased use of linguistic markers indicating affective awareness. Findings also highlighted the importance of emotional disclosure and cognitive integration in reducing stress and enhancing understanding of injury.

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Gabriel Brizuela Costa, Miguel Polo Rubio, Salvador Llana Belloch and Pedro Pérez Soriano

This study, with a top T-52 class athlete, determines the relationship between stroke frequency (SF) and push time (PT) and wheelchair velocity (Wv) using different handrim diameters (HD) and the effect of different HDs on the athlete’s heart rate (HR) and blood lactate (LACT) at competition speeds. Wv shows a linear-direct relationship with SF but a linear-inverse relationship with PT (p < .001 in both cases). Using bigger handrims (0.37 m instead of 0.36 m), SF increases 6%, while PT decreases 27% (at 24 Km·h–1). HR (p < .0001) increases with Wv and is also affected by HD with differences between the 0.34 m—0.36 m handrim group (lower values) and the 0.37 m handrim (higher values). Significant interaction (p < .0001) is identified between HD and Wv. LACT results seem to follow the same direction as HR. This methodology helped the athlete to choose the optimum HD, and his achievements (some world records) indicate that HD optimization could be highly profitable in sport terms.

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Virginie de Bressy de Guast, Jim Golby, Anna Van Wersch and Fabienne d’Arripe-Longueville

This study presents a complete psychological skills training (PST) program with a wheelchair athlete and examines the program effectiveness using a mixed-method approach. After initial testing, the athlete followed a two-month program of self-confidence building, motivational, visualization/relaxation, and injury management techniques. Quantitative and qualitative methods were used to examine the impacts on performance and psychological abilities. The triangulated results suggest that the PST program was perceived as effective by the athlete in terms of his sporting performances and mental skills. The characteristics and implications of a PST program with this wheelchair athlete are discussed, as well as the study limitations and the perspectives for future research.

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Alex J. Rhinehart and Caroline C. Guindon

A 21-year-old female NCAA Division III soccer player presented with an insidious onset of posterior ankle pain. Lateral radiographs revealed a Stieda process, leading to a physician diagnosis of posterior ankle impingement (PAI). Mulligan Concept mobilizations with movement (MWM) were used to ameliorate patient complaints. The MWM glide was maintained during activity using a tape application. Return to play and patient improvement occurred dramatically faster while utilizing the MWM technique than other traditional methods used to treat this condition. This case report demonstrates a novel approach to treating Stieda process-related PAI that warrants further clinical inquiry.

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Heather VanOpdorp, Bonnie Van Lunen and James Swanson

Context:

Hip and pelvic injuries are often associated with direct trauma, but spe-cific fractures to the acetabulum are rare. The signs and symptoms of an acetabular fracture can mimic those of conditions that are more common at the hip area, and therefore the specificity of the diagnostic testing is crucial.

Objective:

To present the case of a female Division I college field-hockey player who developed a superomedial acetabular fracture.

Background:

The athlete’s initial complaint of intolerable hip pain decreased after a 3-week rest period but persisted with passive internal and external hip rotation. Additional diagnostic testing was needed to differentiate the various pathologies that were associated with her symptoms.

Conclusions:

Clinicians should be aware of the potential differential diagnoses of the hip and should investigate all potential possibilities even though they might not coincide with the initial injury.

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Andy Roosen, Matthew T.G. Pain and Mickaël Begon

Much research is ongoing into improving the accuracy of functional algorithms to determine joint centers (JC), but there has been limited testing using human movement data. This paper is in three parts: Part 1, errors in determining JCs from real human movement data using the SCoRE method; Part 2, variability of marker combinations during a punch; Part 3, variability in the JC due to reconstruction. Results indicate determining the JC of the shoulder or elbow with a triad of markers per segment with an accuracy greater than 20 mm is unlikely. Part 2 suggests conducting a pilot study with abundant markers to obtain triads, which are most stable due to differences of 300–400% in variability between triads. Variability due to the choice of reference frame for reconstruction during the punch ranged from 2.5 to 13.8 mm for the shoulder and 1.5 to 21.1 mm for the elbow. It would appear more pertinent to enhance the practical methods in situ than to further improve theoretical accuracy of functional methods.