Psychological impact of sports activity in spinal cord injury patients

OBJECTIVE: To investigate whether sports activity is associated with better psychological profiles in patients with spinal cord injury (SCI) and to evaluate the effect of demographic factors on psychological benefits. METHODS: The State-Trait Anxiety Inventory, Form X2 (STAI-X2), the Eysenck Personality Questionnaire for extraversion (EPQ-R (E)) and the questionnaire for depression (QD) were administered in a cross-sectional study of 137 males with spinal cord injury including 52 tetraplegics and 85 paraplegics. The subjects were divided into two groups according to sports activity participation (high frequency vs no sports participation). Moreover, multiple regression analysis was adopted to investigate the influence of demographic variables, such as age, educational level, occupational status and marital status, on psychological variables. RESULTS: Analysis of variance revealed significant differences among the groups for anxiety (STAI-X2), extraversion (EPQ-R (E)) and depression (QD). In particular, SCI patients who did not practice sports showed higher anxiety and depression scores and lower extraversion scores than sports participants. In addition, with respect to the paraplegics, the tetraplegic group showed the lowest depression scores. Following multiple regression analysis, only the sports activity factor remained as an independent factor of anxiety scores. CONCLUSION: These findings demonstrate that sports activity is associated with better psychological status in SCI patients, irrespective of tetraplegia and paraplegia, and that psychological benefits are not emphasized by demographic factors.     

Physical activity and epilepsy: proven and predicted benefits

Epilepsy is a common disease found in 2% of the population, affecting people from all ages. Unfortunately, persons with epilepsy have previously been discouraged from participation in physical activity and sports for fear of inducing seizures or increasing seizure frequency. Despite a shift in medical recommendations toward encouraging rather than restricting participation, the stigma remains and persons with epilepsy continue to be less active than the general population. For this purpose, clinical and experimental studies have analysed the effect of physical exercise on epilepsy. Although there are rare cases of exercise-induced seizures, studies have shown that physical activity can decrease seizure frequency, as well as lead to improved cardiovascular and psychological health in people with epilepsy. The majority of physical activities or sports are safe for people with epilepsy to participate in with special attention to adequate seizure control, close monitoring of medications, and preparation of family or trainers. The evidence shows that patients with good seizure control can participate in both contact and non-contact sports without harmfully affecting seizure frequency. This article reviews the risks and benefits of physical activity in people with epilepsy, discusses sports in which persons with epilepsy may participate, and describes the positive effect of physical exercise in experimental models of epilepsy.     

Psychiatric and neuropsychological issues in sports medicine

This article reviews psychiatric/psychological issues in the athletic training room, including recognition of these issues and a framework for management. Because the majority of research has been conducted in college settings, most of the issues discussed are presented in the context of college sports, although the results generalize to other athletic arenas. Greater awareness of psychological issues, empirical research, and education about mental health issues in the sports medicine community are clearly needed.     

The handicapped in sports

The first U.S.O.C. workshop on sports medicine for the handicaPped athlete led to several conclusions. First and foremost, the disabled athlete as an amateur athlete with a desire to participate must ever be uppermost in our minds, hearts, and planning. It appears that one of our chief objectives within the U.S.O.C. should be a central unifying force operating with joint support of the Sports Medicine Council and the Handicapped in Sports Committee, under the Sports Medicine Division. This arrangement will serve as an information and clearing center for the better understanding of each other and each organization of sports for the disabled athletes. We need to identify and classify for attention the common problems inherent among these groups and coordinate our various efforts. Fundamental to improvement in the application of sports medicine concepts is development of a definite plan for the education of voluntary coaches and trained or professionally prepared coaches, athletic trainers, physical therapists, and physicians. A variety of concurrent approaches are feasible with initiative and sharing of resources. An additional venture must be to begin pooling and computerizing our present and future information in this regard (professional articles and medical records) within the U.S.O.C. information retrieval system. This must be systematized so the pertinent information can then the disseminated and furnished nationwide to anyone or any group dealing with the disabled athlete in sports. Ultimately, our objective is to make this information available to all handicapped people.(ABSTRACT TRUNCATED AT 250 WORDS)     

The young athlete: challenges of growth, development, and society

Youth sports provide numerous health-enhancing and other important benefits to participating children and adolescents. However, the motivations and goals of young athletes often conflict with those of adult stakeholders, and they are redirected. The youth sports industry has become exclusionary, as the professional model of development increasingly is prevalent and accepted. Youth who follow this model often cannot keep up with the unrealistic expectations and excessive demands. Too much play, training, travel, and pressure frequently lead to a variety of physical and psychological problems, particularly concurrent with the vulnerability of a young athlete going through pre- or early adolescence and the rapid growth phase. The need for alternative models, emphasizing fun and fundamentals, is becoming increasingly clear and urgent. With appropriate changes, youth sports once again can be an effective entry point for a lifetime of healthy sports participation and enjoyment.     

Mehr als Nebenwirkungen: Ein theoretisches Modell zu den physischen,psychischen und sozialen Wirkungen des Sports

This review summarizes the current state of research about the physical, psychological and social effects of sport.A synoptic model divides sport into organized school and club sports and non-organized leisure time physical activities.The health benefit affects both the entire development of children and the biopsychosocial salutogenesis of adults.Thus, what is being learned in the framework of sporting activities (socialization in sport) can also be important for other domains of daily life (socialization through sport).     

Sports medicine in the new millennium: a vision for 2020.

Globalisation, empowerment and technological change will determine the emerging directions in sports medicine in the new millennium. Networks and alliances of scientist and clinician services, as well as electronic profiling of athletes' learning styles, genetic predisposition and other variables, will enhance the spectrum of sports medicine services. Visionary direction will require changes in the organisational paradigms employed, the communication of information to athletes and coaches and the methodologies of assessment. An emphasis on prevention science and clinical and educational interventions will require a clearer focus. The sports medicine scientist and clinician of today must utilise the endowments suggested by Covey and the multiple intelligence models advanced by Gardner in capturing the clarity of focus for sports medicine in the new millennium.     

临床科室赋权管理方式改革提升医疗工作人员工作满意度的机制研究

目的 医疗工作人员离职率高是我国医疗健康领域存在的一个严重问题,其主要是由于工作满意度较差所致。因此本文旨在研究临床科室赋权管理方式改革与医疗人员工作满意度之间的因果关系。方法 本研究调查分析了中国人民解放军空军军医大学两家大型公立三级甲等综合医院,经过临床科室赋权管理方式改革后进行问卷调查分析。医疗工作人员受访者 回答有关领导力转型,科室赋权改革和工作满意度的5点Likert量表问题。使用偏最小二乘结构方程模型（PLS-SEM）分析测量并估计路径模型参数。统计分析以检查科室赋权改革是否介导了领导力转型与工作满意度之间的关系。结果 本研究表明,科室赋权改革可以调解领导力改革对医疗人员工作满意度的影响。赋予员工权力不仅是提高工作满意度所必不可少的,而且还调解了领导力改革与医疗人员工作满意度之间的关系。结论 通过加强赋权以及领导力改革能够显著提升医疗人员的工作满意度,为有关医疗行业工作满意度的研究做出了贡献。同时,本研究为寻求提高医疗人员工作满意度的医疗管理者提供了重要的政策见解。     

Sports massage. A comprehensive review

The science of sports massage is of interest to many populations including athletes, athletic trainers, coaches, as well as sports physiologists. While evidence to support or refute the effects of massage on sports performance is insufficient to make definitive statements, new reports and trends within data help formulate an understanding of sports massage. This article will review sports massage research on topics including lactate clearance, delayed onset of muscle soreness (DOMS), muscle fatigue, the psychological effect of massage, and injury prevention and treatment. Articles referenced in Medline, Cochrane Database, the authors library, and references from articles are included in this review. Most studies contain methodological limitations including inadequate therapist training, insufficient duration of treatment, few subjects, or over or under working of muscles that limit a practical conclusion. Muscle soreness associated with DOMS is reduced with massage, although whether force recovers more quickly is still unclear. The research literature to date is insufficient to conclude whether massage facilitates recovery from a fatiguing effort. Both tissue healing and a psychological effect of massage are areas that may prove promising with further research. Results from published literature support a positive trend for massage to benefit athletic recovery and performance; a need for further research into sports massage, especially well-designed studies utilizing therapists specifically trained to administer this type of therapy, is warranted.     

Intensive training in young athletes.

An increasing number of children take part in organized sporting activities, undergoing intensive training and high level competition from an early age. Although intensive training in children may foster health benefits, many are injured as a result of training, often quite seriously. This paper reviews some of the areas of research dealing with intensively trained young athletes, and focuses on physical, cardiovascular and muscular effects, sports injuries and psychological effects of intensive training. It is concluded that measures should be taken to modify present training and competition schemes to avoid the deleterious effects of intensive physical activity on these children.     

Psychological factors during rehabilitation of patients with Achilles or patellar tendinopathy: a cross-sectional study

Objectiveto examine psychological factors during rehabilitation of patients with Achilles or patellar tendinopathy as well as the association between psychological factors and tendinopathy severity, sport participation, and satisfaction with activity level and tendon function.Designcross-sectional study. Setting: online survey platform.Participants119 patients (mean age: 44 years (SD 14)) diagnosed with Achilles or patellar tendinopathy.Main outcome measuresA range of patient-reported psychological and outcome measures were recorded. Multivariate regression analyses were performed to establish the association between each psychological factor and outcome measures, adjusted for relevant confounders.ResultsPsychological readiness and confidence to return to sports (I-PRRS) and pain catastrophizing (PCS) were significantly associated with tendinopathy severity (modified VISA), sport participation(OSTRC-O), and satisfaction. Kinesiophobia (TSK) and the importance to patients of returning to pre-injury activity level were significantly associated with sports participation and satisfaction.ConclusionThe current study provides evidence of impairments in psychological factors during rehabilitation of patients with Achilles and patellar tendinopathy. Most investigated psychological factors were associated with tendinopathy severity, function, participation, and satisfaction. Physical therapists should recognize patients with lack of psychological readiness to return to sports and also patients with kinesiophobia or catastrophizing thoughts when experiencing pain.     

Wheelchair sports medicine

Wheelchair sports medicine involves the assessment of recreational and competitive sport capacities of physically disabled individuals, medical classification to allow fair competition among athletes with various types and degrees of disability, the prevention, diagnosis, and treatment of athletic injuries, and research into the biomechanics and physiology of wheelchair athletics. Involvement in wheelchair sports medicine activities increases professional awareness and provides a valuable referral source for organized sports activities.     

中国跳水队备战伦敦奥运会的心理科技服务

自国家跳水队科研团队组建以来,在多达4个奥运周期的综合科技保障工作中,我们在开展运动心理训练理论探索的同时,不断探索、创新,为中国跳水队运动员提供了多样、有效、实用的心理训练方法。本文通过介绍跳水科研团队在备战伦敦奥运会周期中主要采取的训练现场表象心理技能强化训练、奥运集训信息共享平台服务、训练基地心理综合调节促进、重点运动员个性化心理干预、伦敦奥运会逆境应对心理手册制定与应用及奥运比赛现场场景模拟训练等心理调节手段,揭示了运动员心理训练需要不断创新、与时俱进。充分利用各种现代新技术手段来实现与运动员的交流是中国运动员心理训练的重要方式和发展趋势。     

Functional health: innovations in research on physical activity with older adults

PURPOSE: This symposium was structured to provide two keynote addresses and recent innovations on the topic of physical activity interventions. OVERVIEW: In the first paper, Drs. W. Jack Rejeski and Lawrence R. Brawley combine the content of their two keynotes into a single integrative review. This paper is then followed by four studies that build on and extend the research reviewed in their keynotes. The first is a study that examines the measurement properties of a scale designed to assess older adults' desire for physical competence. The second is an experiment that tests the efficacy of a brief intervention for increasing older adults' motives to attend educational sessions on physical activity in the context of assisted living. The third involves a pilot study in older adults that explores the feasibility and efficacy of using a group-mediated intervention for psychological empowerment in conjunction with more traditional methods of strength training. The fourth examines an innovative intervention that was designed to link the abilities acquired during strength training to older adults' performance of activities of daily living. CONCLUSIONS: Physical activity interventions should be designed to promote collaborative relationships between interventionists and participants. Older adults bring with them symptoms, emotions, motives, and beliefs that are as important to adherence and to the outcomes of interventions as the physical training regimen itself. Furthermore, from the perspective of both behavior change and physical training, the design of physical activity programs for older adults should pay close attention to intended objectives.     

Psychiatric and neuropsychological issues in sport medicine

This article reviews what is known about training room psychiatric/psychological issues and how to recognize them, and provides an initial framework for how to manage them. There is some focus on psychiatric issues involved in collegiate sports medicine environments, because the majority of research on this topic has been done with this population, but it is believed that this information generalizes to other athletic settings. Greater awareness of these problems, empirical research, and education about mental health issues in the sports medicine community is clearly needed.     

Incidence, severity, aetiology and prevention of sports injuries. A review of concepts.

Notwithstanding the healthy influence of sporting activities on risk factors, in particular those of cardiovascular disease, it is becoming increasingly apparent that sports can present a danger to health in the form of sports injuries. The extent of the sports injury problem calls for preventative action based on the results of epidemiological research. For the interpretation of these facts uniform definitions are needed and limitations of research designs should be known. Measures to prevent sports injuries form part of what is called the 'sequence of prevention'. Firstly the extent of the sports injury problem must be identified and described. Secondly the factors and mechanisms which play a part in the occurrence of sports injuries have to be identified. The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries. This measure should be based on the aetiological factors and the mechanism as identified in the second step. Finally the effect of the measures must be evaluated by repeating the first step. In this review some aspects of the first and second step of the sequence of prevention are discussed. The extent of the sports injury problem is often described by injury incidence and by indicators of the severity of sports injuries. Sports injury incidence should preferably be expressed as the number of sports injuries per exposure time (e.g. per 1000 hours of sports participation) in order to facilitate the comparability of research results. However, one should realise that the outcome of research applying this definition of sports injury incidence is highly dependent on the definitions of 'sports injury' and 'sports participation'. The outcome of such research also depends on the applied research design and research methodology. The incidence of sports injuries depends on: the method used to count injuries (e.g. prospective vs retrospective); the method used to establish the population at risk; and on the representativeness of the sample. Severity of sports injuries can be described on the basis of 6 criteria: the nature of the sports injury; the duration and nature of treatment; sporting time lost; working time lost; permanent damage; and cost. Here also uniform definitions are important and necessary in order to enhance the comparability of research data. In the second step of the 'sequence of prevention' the aetiological factors that play a role in the occurrence of a sports injury have to be identified by epidemiological studies. Epidemiological research on the aetiology of sports injuries requires a conceptual model.(ABSTRACT TRUNCATED AT 400 WORDS)     

Exercise and mental health. Beneficial and detrimental effects

Physical exercise is increasingly being advocated as a means to maintain and enhance good mental health. In general, findings from research indicate that exercise is associated with improvements in mental health including mood state and self-esteem, although a causal link has not been established. Research on acute exercise indicates that 20 to 40 minutes of aerobic activity results in improvements in state anxiety and mood that persist for several hours. These transitory changes in mood occur in both individuals with normal or elevated levels of anxiety, but appear to be limited to aerobic forms of exercise. In the case of long term exercise programmes, improvements in the mental health of 'normal' individuals are either modest in magnitude or do not occur, whereas the changes for those with elevated anxiety or depression are more pronounced. Evidence from studies involving clinical samples indicates that the psychological benefits associated with exercise are comparable to gains found with standard forms of psychotherapy. Hence, for healthy individuals the principal psychological benefit of exercise may be that of prevention, whereas in those suffering from mild to moderate emotional illness exercise may function as a means of treatment. Exercise may also result in detrimental changes in mental health. Some individuals can become overly dependent on physical activity and exercise to an excessive degree. This abuse of exercise can result in disturbances in mood and worsened physical health. In the case of athletes the intense training, or overtraining, necessary for endurance sports consistently results in increased mood disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Developmental overview of child and youth sports for the twenty-first century

This article presents an overview of sporting participation for children and adolescents from psychological, physical, social, developmental, and historical perspectives. The following areas are reviewed: (1) normal developmental readiness and sporting participation; (2) benefits and risks of athletic participation for the child and adolescent; (3) self concept and sporting participation; (4) adverse psychophysiological and somatoform effects of sports; (5) interactional and systemic contributions to adverse physical and psychological effects; (6) a historical/social perspective of sport in the United States; (7) the current and future role of psychiatrists in conjunction with sports medicine physicians; (8) the sports psychiatry interview of the child, family, and coach; and (9) summary and future challenges.