Anna Christakou

Rehabilitation from sports injuries: from theory to practice

A great number of injuries occur in the context of recreational physical activities and competitive athletics. Adherence to sport injury rehabilitation means an injured athletes compliance (or not) to a sports medicine/injury personnels instructions of participating in a rehabilitation programme in a clinic, and/or doing rehabilitation exercises at home. It has emerged as an area of interest among physiotherapists and other allied professionals (i.e. sport trainers, physicians). This article reviews compliance among injured athletes in the recovery process by presenting the protection motivation theory, personal investment theory and models of cognitive appraisal. Also it reviews key research findings about these three theoretical models. In addition practical guidelines and specific strategies are offered to sport injury rehabilitation personnel to enhance an athletes adherence to injury rehabilitation. Sports medicine/injury personnel should educate athletes about their injuries and rehabilitation and increase effective communication and active listening. Also sports medicine/injury personnel should provide social support and encourage positive beliefs of injured athletes. In addition, coping with pain and setting short-term goals help athletes to increase their compliance to programmes of rehabilitation.

Effect of neuromuscular stimulation and individualized rehabilitation on muscle strength in Intensive Care Unit survivors: A randomized trial

Purpose Intensive Care Unit (ICU) survivors experience muscle weakness leading to restrictions in functional ability. Neuromuscular electrical stimulation (NMES) has been an alternative to exercise in critically ill patients. The aim of our study was to investigate its effects along with individualized rehabilitation on muscle strength of ICU survivors. Material and methods Following ICU discharge, 128 patients (age: 53 ± 16 years) were randomly assigned to daily NMES sessions and individualized rehabilitation (NMES group) or to control group. Muscle strength was assessed by the Medical Research Council (MRC) score and hand grip at hospital discharge. Secondary outcomes were functional ability and hospital length of stay. Results MRC, handgrip, functional status and hospital length of stay did not differ at hospital discharge between groups (p > 0.05). &Dgr;MRC% one and two weeks after ICU discharge tended to be higher in NMES group, while it was significant higher in NMES group of patients with ICU‐acquired weakness at two weeks (p = 0.05). Conclusions NMES and personalized physiotherapy in ICU survivors did not result in greater improvement of muscle strength and functional status at hospital discharge. However, in patients with ICU‐aw NMES may be effective. The potential benefits of rehabilitation strategies should be explored in larger number of patients in future studies. Clinical trial registration: www.Clinicaltrials.gov: NCT01717833 HighlightsRandomized trial implementing Neuromuscular Electrical Stimulation (NMES) and rehabilitation program in ICU survivors.The program was performed from ICU discharge to hospital discharge.Outcome measures included assessment of muscle strength, functional ability and hospital length of stay.MRC, handgrip strength, functional status and length of stay did not differ at hospital.MRC improved significantly in patients with ICU‐acquired weakness after 2 weeks of NMES.Intervention may be beneficial in ICU survivors with ICU‐acquired weakness.

Comparing the psychometric properties of the pediatric outcomes data collection instrument and the activities scales for kids: a review.

The aim of this study was to review and evaluate the psychometric properties of two general musculoskeletal outcome measures focusing on pediatric physical disability, namely, the Pediatric Outcomes Data Collection Instrument (PODCI) and the Activities Scales for Kids (ASK). Although this review reveals the psychometric superiority of ASK to PODCI, further research should confirm the psychometric properties of both the instruments. A number of psychometric issues need to be further addressed. Specifically, future studies should examine additional types of reliability and validity, for example, content, construct, criterion, and discriminant with more sophisticated statistical analyses, for example, Aiken’s item content validity coefficient and confirmatory factor analysis. Until these issues are addressed, researchers should be cautious utilizing these instruments in children with musculoskeletal problems in a clinical setting.

Development and validation of the Causes of Re-Injury Worry Questionnaire

Re-injury worry is an important construct in competitive sport that may influence performance and increase the risk of re-injury. However, there are currently no available instruments to measure the causes of re-injury worry. The purpose of this study was to develop the Causes of Re-Injury Worry Questionnaire (CR-IWQ). The study was conducted in three independent research phases to investigate the following: (a) the content relevance, (b) the factor structure and the factorial validity, (c) the concurrent validity, (d) the discriminant validity, and (e) the test-retest reliability (intraclass correlation coefficients; ICC), and the internal consistency of the instrument. Exploratory factor analysis (EFA) was chosen to examine the factor structure of the CR-IWQ. Confirmatory factor analysis (CFA) was used to examine further the factorial validity of the instrument. A number of valid constructs were used to assess the concurrent and discriminant validity of the CR-IWQ. The reliability of the new instrument was examined using Pearson r (ICC) and Cronbach α. Three hundred and seventy athletes with an acute musculoskeletal sport injury in the last year participated in the study. EFA revealed a 12-item model, representing two factors (“Re-injury worry due to rehabilitation” and “Re-injury worry due to opponents ability”). CFA supported the two-factor model of the CR-IWQ. The concurrent and discriminant validity of the CR-IWQ was confirmed by examining correlations between the CR-IWQ with other constructs. The ICCs and the Cronbach α indices of the CR-IWQ were acceptable. We have demonstrated that the CR-IWQ is a good psychometric instrument that can be used for clinical and research purposes.