Medical care before and during the Winter Paralympic Games in Turin 2006, Vancouver 2010 and Sochi 2014

Medical care in disabled sports is crucial both as prophylaxis and as ongoing medical intervention. The aim of this paper was to present changes in the quality of medical care over the consecutive Paralympic Games (PG). The study encompassed 31 paralympians: Turin (11), Vancouver (12), and Sochi (8) competing in cross-country skiing, alpine skiing, biathlon and snowboarding. The first, questionnaire-based, part of the study was conducted in Poland before the PG. The athletes assessed the quality of care provided by physicians, physiologists, dieticians, and physiotherapists, as well as their cooperation with the massage therapist and the psychologist. The other part of the study concerned the athletes’ health before leaving for the PG, as well as their diseases and injuries during the PG. The quality of medical care was poor before the 2006 PG, but satisfactory before the subsequent PG. Only few athletes made use of psychological support, assessing it as poor before the 2006 PG and satisfactory before the 2010 and 2014 PG. The athletes’ health condition was good during all PG. The health status of cross-country skiers was confirmed by a medical fitness certificate before all PG, while that of alpine skiers only before the 2014 PG. There were no serious diseases; training injuries precluded two athletes from participation. The quality of medical care before the PG was poor, however, became satisfactory during the actual PG. The resulting ad hoc pattern deviates from the accepted standards in medical care in disabled sports

Traumas and injuries in volleyball players with and without hearing impairment (self-reported)

Celem pracy była ocena wybranych czynników urazowych oraz rodzaju obrażeń sportowych, jakich doznały w swojej karierze zawodniczej osoby z niepełnosprawnością narządu słuchu, w porównaniu do sportowców pełnosprawnych trenujących piłkę siatkową. Badaniami objęto 87 mężczyzn - finalistów Akademickich Mistrzostw Polski w Piłce Siatkowej (46 osób) oraz Mistrzostw Polski Niesłyszących w Piłce Siatkowej (41 osób). W badaniach przeprowadzonych metodą sondażu diagnostycznego wykorzystano autorską ankietę Bartosza Molika "Urazy i obrażenia w sporcie osób niepełnosprawnych", którą za zgodą autora dostosowano do potrzeb zawodników niesłyszących oraz pełnosprawnych. Po wykonanej analizie danych stwierdzono, iż w piłce siatkowej uprawianej przez osoby zarówno niesłyszące jak i pełnosprawne nie ma zróżnicowania zawodników pod względem doznania urazów sportowych. Specyfika powyższej dyscypliny sprawia natomiast, że u osób trenujących istotnym miejscem najczęstszych urazów okazał się staw skokowy, a rodzajem obrażenia - skręcenie oraz zespoły przeciążeniowe. Ponadto nie zauważono występowania istotnej zależności między stażem zawodniczym a liczbą doznanych urazów. Przerwa zaś w treningu - spowodowana odniesionymi obrażeniami - była dłuższa u zawodników pełnosprawnych w porównaniu do siatkarzy z uszkodzeniem narządu słuchu. Przypuszcza się, iż mogła ona wynikać z konieczności przedłużania opieki lekarskiej w szpitalu po przebytym zabiegu operacyjnym.The aim of the work was to analyse risk factors for physical traumas and types of sports injuries in volleyball players with hearing impairment compared with able-bodied players, throughout their sporting career. The study encompassed 87 men, finalists of the Polish Academic Volleyball Championship (46 players) and the Polish Deaf Volleyball Championship (41 players). The questionnaire-based study made use of Molik’s original questionnaire “Traumas and injuries in disabled sports”, duly adapted for the needs of deaf players as well as able-bodied players. Data analysis showed that there were no differences between volleyball players with hearing impairment and able-bodied players with regard to traumas. Due to the specificity of this sport discipline, the most frequent trauma site was the ankle and the most frequent injury types were sprains and overuse. No significant correlation was observed between experience and the number of traumas incurred. Injury-related breaks in training were longer in able-bodied players, possibly due to the need for prolonged medical care following surgery

Polish paralympic sports in the opinion of athletes and coaches in retrospective studies

The study aimed to identify the limitations observed in Polish Paralympic sport depending on the environment in which athletes train on a daily basis. The study included 581 persons divided into two basic groups. The first group consists of athletes (n = 324) and coaches (n = 88) appointed to the national team by associations and unions providing sports training exclusively for athletes with disabilities. The second group consisted of athletes with disabilities (n = 146) and their coaches (n = 23), who work in national sports associations working for both able-bodied and disabled people. The study used the diagnostic survey method with a questionnaire developed by Sobiecka. The difficulties indicated by the respondents referred to various aspects related to the activity in professional sport. Particularly emphasised difficulties were related to organizational and financial limitations as well as the management and coaching staff. At the same time, it was demonstrated that the environment was a differentiating factor between the studied groups of athletes and coaches

Standards of conditions during preparations for the Summer Paralympic Games between 2004 and 2012 assessed by Polish athletes

The quality of training conditions affects sporting success, injuries and health. The aim of the work was to present the conditions during the preparations of Polish athletes for the Summer Paralympic Games 2004–2012. The study encompassed 271 paralympians: Athens (91), Beijing (89) and London (91), competing in 13 disciplines. The research was based on a two-part questionnaire by Kłodecka-Różalska adjusted for disabled sports, and was conducted one month before each PG. Part 1 contained 20 closed-ended questions regarding conditions during preparations, while Part 2 concerned socio-demographic and sports-related data. Three levels of conditions: good, satisfactory and poor, were identified. The analysis showed that while the relationships between the athletes were good in all the preparatory periods, the co-operation with the paralympic coaches worsened. The standards of accommodation, food and sports facilities lowered. Personal orthopaedic supply was satisfactory in London; personal sporting equipment was good at all PG. The quality of medical care was the highest in London. The co-operation with physicians, physiotherapists and massage therapists was satisfactory. Consultations with the dietician were sporadic and assessed as poor. Psychological consultations were rare but satisfactory in Beijing and London. Contacts with the mass media were poor at all PG. Although combining private life, work, and education with sport was satisfactory, it was increasingly difficult to manage, particularly before London. The conditions during preparations for the PG 2004–2012 varied. Improvement was noticed only in the quality of medical care and personal orthopaedic supply

Medical aspect of the preparation for the 2016 Summer Paralympics in the opinion of athletes and their coaches

Systematyczne badania naukowe przeprowadzane w polskim środowisku paraolimpijskim wykazały, iż poważnym a zarazem negatywnym zjawiskiem, wpływającym na warunki uprawiania sportu przez osoby z niepełnosprawnością, jest brak profilaktyki oraz dostępu do szeroko rozumianej opieki medycznej. Celem badań była ocena warunków w zakresie opieki medycznej, w jakich przygotowywali się zawodnicy i zawodniczki do udziału w XV Letnich Igrzyskach Paraolimpijskich w Rio de Janeiro 2016, z uwzględnieniem środowiska sportowego (polskich związków sportowych i ogólnopolskich organizacji sportowych działających wyłącznie dla osób z niepełnosprawnością), w którym na co dzień trenowali. Badaniami objęto łącznie 80 sportowców z uszkodzeniem narządu ruchu oraz z dysfunkcją wzroku (28 zawodniczek i 52 zawodników), a także 25 szkoleniowców (3 kobiety i 22 mężczyzn), zakwalifikowanych do kadry paraolimpijskiej. Wśród badanych wyodrębniono cztery grupy: pierwsza liczyła 22 paraolimpijczyków wywodzących się z sześciu polskich związków sportowych, druga - 58 sportowców zrzeszonych w ogólnopolskich organizacjach prowadzących szkolenie sportowe tylko dla zawodniczek i zawodników z określonymi dysfunkcjami, trzecia - 9 szkoleniowców reprezentacji paraolimpijskiej powołanych przez władze polskich związków, a czwarta - 16 trenerów, przedstawicieli ogólnopolskich organizacji sportowych pracujących jedynie z osobami z niepełnosprawnością. W badaniach posłużono się metodą sondażu diagnostycznego, wykorzystując kwestionariusz ankiety Jadwigi Kłodeckiej-Różalskiej, który za zgodą autorki zmodyfikowano na potrzeby sportu niepełnosprawnych. Składał się on z dwóch części: pierwsza obejmowała 2 pytania otwarte i 23 zamknięte, a druga - "metryczka" - zawierała informacje o cechach społeczno-demograficznych oraz sportowych badanych osób. Następnie z kwestionariusza wyodrębniono opinie dotyczące wyłącznie aspektu przygotowania medycznego, które skategoryzowano. Do analizy danych wykorzystano metody statystyki opisowej oraz metody wnioskowania statystycznego. Ponadto w każdej grupie badanych (sportowców i szkoleniowców) uwzględniono środowisko sportowe. Otrzymane wyniki pozwoliły na stwierdzenie, iż podczas przygotowań paraolimpijskich nie zapewniono opieki medycznej wszystkim osobom powołanym do kadry narodowej. Poza tym wypowiedzi zawodniczek i zawodników polskiej reprezentacji, a także ich szkoleniowców, w sprawie odbywania regularnych badań w zakresie medycyny sportowej w okresie przygotowań paraolimpijskich Rio de Janeiro 2016, były zróżnicowane w poszczególnych środowiskach sportowych. Badania ujawniły również - obok pozytywnych - opinie niezadowalające sportowców, bądź ich szkoleniowców, w zakresie efektów realizowania opieki lekarskiej oraz współpracy z dietetykiem i fizjologiem. Natomiast zbliżone oceny pozytywne (o zróżnicowanym poziomie), wyrażone zarówno przez sportowców jak i szkoleniowców z obydwu środowisk sportowych, dotyczyły tylko dostępu do opieki lekarskiej oraz współpracy z psychologiem.Systematic scientific research conducted in the Polish Paralympic environment revealed a serious and negative phenomenon of the lack of prevention and access to medical care in the broad sense of the term that has an effect on conditions of practising sports by people with disabilities. The aim of the study was to assess the conditions of medical care during preparation of athletes for participation in the 15th Summer Paralympic Games in Rio de Janeiro in 2016, taking into account the athletic environment (Polish sports associations and national sports organizations operating exclusively for people with disabilities) in which they practised on a daily basis. The study covered a total of 80 athletes with musculoskeletal disorders and vision impairments (28 female and 52 male athletes) and 25 coaches (3 women and 22 men), qualified for the Paralympic team. The participants were divided into four groups: the first group consisted of 22 Paralympians from six Polish sports associations, the second group consisted of 58 athletes associated in national organizations providing sports training only for female and male athletes with specific dysfunctions, the third group was 9 coaches of the Paralympic national team appointed by the Polish authorities, and the fourth group was 16 coaches, representatives of national sports organizations working only for people with disabilities. A diagnostic survey method was employed in the study, based on the questionnaire prepared by Jadwiga Kłodecka-Różalska, which, with the author’s consent, was adjusted to the needs of disabled sports. It consisted of two parts: the first one consisted of 2 open and 23 closed questions, whereas the second one contained respondent data about sociodemographic and athletic characteristics of the athletes. Next, the opinions concerning only the aspect of medical preparation were separated from the questionnaire and categorized. The data were analysed by means of descriptive statistics and statistical reasoning methods. Furthermore, athletic environment was taken into account in each study group (athletes and coaches). The results led to the conclusion that during Paralympic preparations, adequate medical care was not provided to all athletes appointed to the national team. Furthermore, the statements of the athletes from the Polish national team and their coaches concerning the regular sports medical examinations during the period of preparations for the Paralympic Games in Rio de Janeiro in 2016 were differentiated in individual athletic environments. Besides positive statements, the survey also found unsatisfactory opinions of athletes or their coaches regarding the effects of medical care and working with dieticians and physiologists. Similar positive assessments (at different levels), expressed by both athletes and coaches from both athletic environments, concerned only the access to medical care and working with a psychologist

Sexuality of disabled athletes depending on the form of locomotion

The main purpose of this study was to determine sexuality of disabled athletes depending on the form of locomotion. The study included 170 disabled athletes, aged between 18 and 45. The entire population was divided into 3 research groups depending on the form of locomotion: moving on wheelchairs (n=52), on crutches (n=29) and unaided (n=89). The research tool was a questionnaire voluntarily and anonymously completed by the respondents of the research groups. The questionnaire was composed of a general part concerning the socio-demographic conditions, medical history, health problems, a part dedicated to physical disability as well as the Polish version of the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) evaluating sexual life. STATISTICA 10.0 for Windows was used in the statistical analysis. Subjects moving on crutches were significantly older than ones moving on wheelchairs and unaided (34.41 ±11.00 vs. 30.49 ±10.44 and 27.99 ±10.51 years, respectively) (p=0.018). Clinically significant erectile dysfunctions were most often diagnosed in athletes moving on wheelchairs (70.27%), followed by athletes moving on crutches and moving unaided (60% and 35.42%, respectively; p=0.048). Clinical sexual dysfunctions were diagnosed on a similar level among all female athletes. It was concluded that the form of locomotion may determine sexuality of disabled men. Males on wheelchair revealed the worst sexual functioning. Female athletes moving on wheelchairs, on crutches and moving unaided were comparable in the aspect of their sexual life

Sexual Health of Polish Athletes with Disabilities

The purpose of this study was to determine sexual functioning of Polish athletes with disabilities (including paralympians). The study encompassed 218 people with physical disabilities, aged between 18 and 45 (149 men and 69 women). The entire research population was divided into three groups: Polish paralympians (n = 45), athletes with disabilities (n = 126) and non-athletes with disabilities (n = 47). The quality of sexual life of Polish paralympians was measured by using the Polish version of Female Sexual Function Index and International Index of Erectile Function. Clinically significant erectile dysfunctions were most often diagnosed in non-athletes (83.33%) with 50% result of severe erectile dysfunctions, followed by athletes and paralympians with comparable results of 56.98% and 54.17% respectively (p = 0.00388). Statistically significant clinical sexual dysfunctions concerned lubrication, orgasm as well as pain domains, and prevailed among female non-athletes (68.42%, 68.42% and 57.89%). Practising sports at the highest level has a favourable effect on the sexuality of men and women with physical disabilities. Men with physical disabilities manifest more sexual disorders than women, an aspect which should be considered by health-care professionals working with people with disabilities

Analysis of the link between the redox state and enzymatic activity of the HtrA (DegP) protein from Escherichia coli

Bacterial HtrAs are proteases engaged in extracytoplasmic activities during stressful conditions and pathogenesis. A model prokaryotic HtrA (HtrA/DegP from Escherichia coli) requires activation to cleave its substrates efficiently. In the inactive state of the enzyme, one of the regulatory loops, termed LA, forms inhibitory contacts in the area of the active center. Reduction of the disulfide bond located in the middle of LA stimulates HtrA activity in vivo suggesting that this S-S bond may play a regulatory role, although the mechanism of this stimulation is not known. Here, we show that HtrA lacking an S-S bridge cleaved a model peptide substrate more efficiently and exhibited a higher affinity for a protein substrate. An LA loop lacking the disulfide was more exposed to the solvent; hence, at least some of the interactions involving this loop must have been disturbed. The protein without S-S bonds demonstrated lower thermal stability and was more easily converted to a dodecameric active oligomeric form. Thus, the lack of the disulfide within LA affected the stability and the overall structure of the HtrA molecule. In this study, we have also demonstrated that in vitro human thioredoxin 1 is able to reduce HtrA; thus, reduction of HtrA can be performed enzymatically

Proces integracji polskich środowisk sportowych

The purpose of the research was to present an opinion regarding the present state and changes occurring in Polish sport for the disabled as a consequence of a process of integrating Polish sports communities after the Act of Sport, June 25 2010, went into effect, in order to develop the expertise required by the Ministry of Sports and Tourism. The study included a total of 895 people (177 women, 718 men), who constituted 95.9% of respondents planned for the research from two sports communities. The first group, 573 people (115 women, 458 men), were the representatives of associations and unions conducting training exclusively for competitors with a disability. The second group, 322 people (62 women, 260 men), were representatives of Polish sports associations operating in one specific sports discipline for both able-bodied athletes and those with disabilities. Overall, the study included: 613 athletes (142 women, 471 men) from the national team with a sight or locomotive dysfunction from all disciplines practised in Poland, 143 coaches (16 women, 127 men) of Polish national teams, 120 board members (18 women, 102 men) and 19 chairmen (1 woman, 18 men) from nationwide sports organisations in which people with disabilities train on a daily basis. A diagnostic survey method was employed, utilising an authorial questionnaire entitled „The process of integrating Polish sports communities”. The questionnaire included the following thematic areas: integration of sport for the disabled with the sporting community of able-bodied people, positive aspects and problems occurring in sport, and the forms of assistance expected by sports associations, unions and Polish sports associations, to facilitate training for athletes with disabilities. Furthermore, there were issues concerning the rights and obligations of athletes qualified to the national team and their coaches, with whom athletes with disabilities would like to cooperate. Respondents also considered how to promote and develop sport for the disabled and how athletes might comply with the training requirements of Polish sports associations. The organisational and substantive preparations of Polish sports associations were also highlighted in terms of assuming responsibility for athletes with disabilities who train in individual sporting disciplines. Finally, the differences in training for people with disabilities in Polish sports associations and organizations dealing exclusively with sports for the disabled were also analysed.Celem przeprowadzonych badań, które posłużyły do opracowania Ekspertyzy dla potrzeb Ministerstwa Sportu i Turystyki, było przedstawienie opinii na temat stanu i zachodzących zmian w polskim sporcie niepełnosprawnych, jakie mają miejsce w procesie integracji polskich środowisk sportowych, po wejściu w życie ustawy o sporcie z dnia 25 czerwca 2010 roku. Badaniami objęto łącznie 895 osób (177 kobiet, 718 mężczyzn), które stanowiły 95,9% respondentów zaplanowanych do badań z dwóch środowisk sportowych. Pierwsza grupa – 573 osoby (115 kobiet, 458 mężczyzn) – to reprezentanci stowarzyszeń i związków prowadzących szkolenie sportowe wyłącznie dla zawodników z niepełnosprawnościami. Druga grupa – 322 osoby (62 kobiety, 260 mężczyzn) – to przedstawiciele polskich związków sportowych, funkcjonujących w jednej określonej dyscyplinie, zarówno na rzecz zawodników pełnosprawnych jak i z niepełnosprawnościami. Ogólnie w badaniach uczestniczyło: 613 sportowców (142 kobiety, 471 mężczyzn) z dysfunkcją narządu wzroku lub narządu ruchu kadry narodowej, ze wszystkich dyscyplin uprawianych w Polsce, 143 trenerów (16 kobiet, 127 mężczyzn) reprezentacji Polski współpracujących ze sportowcami, 120 członków zarządów (18 kobiet, 102 mężczyzn) oraz 19 prezesów (1 kobieta, 18 mężczyzn) z ogólnopolskich organizacji sportowych, w których na co dzień trenują osoby z niepełnosprawnościami. We wszystkich badaniach posłużono się metodą sondażu diagnostycznego, wykorzystując autorski kwestionariusz ankiety pt. „Proces integracji polskich środowisk sportowych”. Badania obejmowały następujące obszary tematyczne: integrację sportu niepełnosprawnych ze środowiskiem sportowym osób pełnosprawnych, pozytywne aspekty i problemy występujące w sporcie, a także formy pomocy oczekiwane ze strony stowarzyszeń, związków i polskich związków sportowych, które ułatwiłyby uprawianie sportu zawodnikom z niepełnosprawnościami. Poza tym w sferze zainteresowania pojawiły się zagadnienia poświęcone prawom i obowiązkom sportowców powoływanych do reprezentacji narodowej oraz trenerów, z jakimi chcieliby współpracować zawodnicy z niepełnosprawnościami. Rozpatrywane były również działania podejmowane w zakresie upowszechniania i rozwoju sportu niepełnosprawnych oraz możliwości podporządkowania się zawodników do wymagań procesu szkolenia, jaki obowiązuje w polskich związkach sportowych. Zwrócono też uwagę na przygotowania organizacyjne i merytoryczne polskich związków sportowych pod względem przejmowania zawodników z niepełnosprawnościami, trenujących poszczególne dyscypliny sportowe. Ponadto kwestią analizy były różnice występujące w szkoleniu sportowców w polskich związkach sportowych, a organizacjach zajmujących się wyłącznie sportem niepełnosprawnych