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Kimberly Long, Shawn Meredith and Gerald W. Bell

Autonomic dysreflexia (AD), which occurs in individuals with spinal cord injuries (SCI) above T-6, is caused by an exaggerated sympathetic nervous system (SNS) response to a noxious stimulus. Blood pressure (BP) elevation is a chief symptom of acute AD; this rise in BP makes AD potentially life threatening. Autonomic dysreflexia is also referred to as autonomic hyperreflexia. For this discussion, autonomic dysreflexia will be the term used. It is estimated that approximately 90% of competitive athletes with quadriplegia have intentionally induced AD in order to enhance performance (Burnham et al., 1994). This practice, which is called “boosting,” appears to be an effective, but potentially dangerous, performance enhancement technique. Individuals who work with athletes with SCI above T-6 should be aware of the symptoms, dangers, and treatment of AD, as well as the practice of boosting in order to ensure the safety of these athletes.

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Fraser Carson and Remco C. J. Polman

The aim of this case study was to investigate the emotional factors and coping strategies used by a professional rugby union player during rehabilitation from anterior cruciate ligament (ACL) injury. A dominant (qualitative) - less dominant (quantitative) mixed methodological approach was established concurrent with the athlete’s rehabilitation. Twice monthly interviews and a self-report diary were completed throughout the rehabilitation process. Six questionnaires were used to assess specific aspects of injury rehabilitation identified from previous literature, including emotional response, coping, social support, and perceived autonomy. Content analysis of each phase of the rehabilitation process established 34 higher-order themes split into two general dimensions: Influential Emotions or Coping Strategies. Findings highlight the benefit of problem-focused coping to improve autonomy and confidence. A sequential movement through a series of emotions (shock, depression, relief, encouragement, and confidence building) was also identified.

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Stephanie M. Mazerolle, Thomas G. Bowman and Jessica L. Barrett

Clinical education provides the backbone for the socialization process for athletic trainers. It is the chance for students to engage in the role, within a real-time learning environment that allows for not only the adoption of knowledge, skills, and critical decision making, but also the profession’s foundational behaviors of professional practice. Recent criticisms of the current education model, in which the degree is conferred, center on the lack of critical thinking and confidence in clinical practice for newly-credentialed athletic trainers, as many suggest there is concern for the abilities of students to transition to practice smoothly. We offer three areas of focus for clinical education experiences for students (autonomy, mentorship, and feedback), believing this could support the development of independent thinking and confidence in skills. Our discussions are focused on the evidence available, as well as personal experiences as educators and program administrators.

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Camilla Yuri Kawanishi and Márcia Greguol

This study aimed to perform a systematic review of studies that address the influence of physical activity on the quality of life and functional independence of adult individuals with spinal cord injury. The review was performed using data obtained from the MEDLINE, CINAHL, SciELO, LILACS, SPORTDiscus, Web of Science, Academic Search Premier, and PEDro databases using the following keywords: quality of life; functional independence; autonomy; independence; physical activity; activities of daily living; physical exercise; tetraplegia; paraplegia; spinal cord injury; physical disabilities; and wheelchair. Eleven studies met the inclusion criteria. Although there was a lack of consensus among the selected studies, the majority of them presented a strong correlation between physical activity and variables of quality of life and/or functional independence. Thus, physical activity appears to have an important influence on social relationships, functional independence, psychological factors, and physical aspects, which can enhance quality of life and independence in the performance of daily activities.

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G. Monique Butcher Mokha

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Anne Holding, Jo-Annie Fortin, Joëlle Carpentier, Nora Hope and Richard Koestner

, these athletes may benefit from autonomy enhancing interventions designed to help athletes internalise their motivation for retirement. These interventions could, for example, validate athletes’ emotional responses about retirement, explore athletes’ attitudes about retirement, and help athletes

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Kimberly S. Peer

Sports medicine professionals are facing new dilemmas in light of the changing dynamics of sport as an enterprise. These changes have considerable ethical implications as sports medicine team members are placed in challenging ethical decision-making situations that often create values tensions. These values conflicts have the potential to threaten and degrade the trust established through the mutual expectations inherent in the social contract between the health care providers and society. According to Starr,1 the social contract is defined as the relationship between medicine and society that is renegotiated in response to the complexities of modern medicine and contemporary society. Anchored in expectations of both society and the medical professions, this tacit contract provides a strong compass for professional practice as it exemplifies the powerful role and examines the deep responsibilities held by health care providers in our society. Although governed by professional boards and organizational codes of ethics, sports medicine professionals are challenged by the conflicts of interest between paternalistic care for the athlete and autonomous decisions often influenced by stakeholders other than the athletes themselves. Understanding how the construct of sport has impacted sports health care will better prepare sports medicine professionals for the ethical challenges they will likely face and, more importantly, facilitate awareness and change of the critical importance of upholding the integrity of the professional social contract.

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Sara L. Nottingham

autonomously upon graduation. 1 , 2 , 4 – 6 Several authors have argued the importance of effective supervision of athletic training students and provided strategies for proper supervision. 3 , 7 , 8 Additionally, researchers recognize that giving responsibility and autonomy is an essential component of the

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Terese Wilhelmsen, Marit Sørensen and Ørnulf N. Seippel

individual and contextual motivational conditions. Contextual Conditions: Perceived Motivational Climates in PE Three motivation climates (i.e., mastery, performance, and autonomy-supportive climates) serve as the contextual conditions in the analysis in addition to physical inclusion. The distinction

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Katherine R. Newsham

Performance enhancement is a multibillion dollar industry, with little known about the efficacy or safety of many practices. Many sport governing bodies have banned certain equipment, supplements, and drugs, yet, some athletes use anyway. This use may pose a danger to the individual user, as well as to other participants, and can challenge the integrity of the sport. We must consider how we, as health care professionals, balance personal autonomy, individual safety, and the integrity of sport in fulfilling our social contract.