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Barbara Baker, Eric Koch, Kevin Vicari and Kyle Walenta

Introduction: Sports-related concussions (SRCs) have received attention due to their prevalence in youth. An SRC results from a strong force causing neurological impairment. Recent research has recommended rehabilitation within the first week post-SRC after 24 to 48 hours of rest. The postacute phase is defined as 48 hours to 7 days post-SRC. It is imperative to evaluate the most effective mode and intensity of physical activity to reduce symptoms and improve outcomes. Methods: CINAHL, PubMed, SPORTDiscus, and Web of Science databases were used to search the terms “brain concussion” AND “exercise” and variations of these terms. The evidence level for each study was evaluated using the 2011 Oxford Center for Evidence-Based Medicine Guide. The methodological rigor of each study was evaluated using a scale adapted from Medlicott and Harris. Results: Two thousand sixty-eight records were identified. Six studies were included in this systematic review. Three studies were classified as moderately strong. The remaining 3 studies were considered weak. Five of the studies used either a cycle ergometer or a treadmill. The sixth study used walking, cycling, and swimming, as well as sports drills. All of these modes of exercise were determined to be safe. All studies utilized low- and moderate-intensity interventions, which were found to be nondetrimental and showed improved recovery time and symptom resolution. Five of the studies also incorporated components of high-intensity exercise that was also found to be nondetrimental, and they showed a positive influence on recovery time and symptom resolution. However, all activity in each of the reviewed studies started at a low level and progressed up to a higher level only as each individual client’s symptoms permitted. Discussion: Overall, this review found that various modes of activity at light-, moderate-, and high-intensity levels are efficacious and can be safely used during the postacute phase of SRC. Conclusion: Though the volume of literature at this time is limited, therapists should consider prescribing closely monitored individualized exercise programs utilizing progressive intensities when treating patients during the postacute phase of SRC.

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Alana Ninedek and Gregory S. Kelt

Context:

Recent literature has focused on the role of physiotherapists in addressing psychological sequelae of sport injury and rehabilitation.

Objective:

The study investigated sports physiotherapists' views of psychological characteristics that distinguished athletes who cope well with injury from those who cope poorly. Physiotherapists' opinions on the role of psychological skills in rehabilitation were also examined.

Design:

A questionnaire-based study.

Participants:

Participants were 150 physiotherapists who had completed, or were completing, a postgraduate sports physiotherapy program.

Main Outcome Measures:

The test instrument used was the Sports Physiotherapists' Views on Psychological Strategies questionnaire (adapted from Wiese et al1).

Results:

The physiotherapists reported communication skills, a positive attitude, intrinsic motivation, and realistic goal setting as important aspects of effective rehabilitation.

Conclusions:

The findings are discussed in relation to physiotherapists' roles in addressing basic psychological aspects of injury.

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Jacquelyn Allen Collinson

Despite a growing body of research on the sociology of time and, analogously, on the sociology of sport, to date there has been relatively little sports literature that takes time as the focus of the analysis. Given the centrality of time as a feature of most sports, this would seem a curious lacuna. The primary aims of this article are to contribute new perspectives on the subjective experience of sporting injury and to analyze some of the temporal dimensions of sporting “injury time” and subsequent rehabilitation. The article is based on data derived from a 2-year autoethnographic research project on 2 middle/long-distance runners, and concludes with some indicative comments regarding the need for sports physiotherapists and other health-care practitioners to take into account the subjective temporal dimension of injury and rehabilitative processes.

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Ailsa Niven

Context:

Athlete’s adherence behavior can influence the outcome of a rehabilitation program.

Objective:

To draw on sport physiotherapists’ expert knowledge to increase understanding of adherence issues in practice and identify factors that influence adherence and strategies that can be used to enhance adherence.

Design:

An interview design with inductive content analysis.

Participants:

Nine (6 women and 3 men) experienced sports physiotherapists.

Results:

Under-adherence and over-adherence were issues in practice for some practitioners, and adherence was viewed as important for successful recovery from injury. Three higher order themes emerged relating to the influence of athlete characteristics, situational characteristics, and characteristics of the injury and rehabilitation on both facilitating and preventing rehabilitation adherence. Strategies to improve adherence in practice emerged from the data and broadly addressed the key determinants of adherence.

Conclusion:

Adherence to rehabilitation is influenced by a number of factors and strategies to enhance adherence are identified.

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Jeroen de Bruijn, Henk van der Worp, Mark Korte, Astrid de Vries, Rick Nijland and Michel Brink

about the nature of the study, the associated risks, and their right to withdraw at any time during the study. They then provided written informed consent and the study was granted approval by the ethics commission. Two sports physiotherapists with multiple years of experience supervised the

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Josep C. Benítez-Martínez, Pablo Martínez-Ramírez, Fermín Valera-Garrido, Jose Casaña-Granell and Francesc Medina-Mirapeix

. All eligible players were informed of the study purposes and their voluntary participation was requested. In addition, all participants signed an informed consent form. Measures All data were collected by 2 experienced sports physiotherapists using a standardized procedure during a session which took