Patient-defined meaningfulness within chronic pain rehabilitation: A concept analysis

Background: As the problem of chronic pain grows worldwide, rehabilitation is critical to improved patient well-being. There is thus a need for rehabilitation-focused research. It appears that outcomes are improved when patients perceive the rehabilitation process to be meaningful. However, there is no empirical evidence determining how this would be achieved. An important first step is to identify and describe the concept of meaningfulness as it is used in the chronic pain rehabilitation literature. Objective: This paper reports the findings of a structured concept analysis to define meaningfulness from the patient perspective in chronic pain rehabilitation. Methodology: In consultation with a medical librarian, a search strategy was developed and articles retrieved. The Walker and Avant concept analysis method was used to analyze the data, identify the defining attributes of meaningfulness, develop contrary, borderline, and model cases, and identify its antecedents and consequences. Results: The search revealed extensive use of the terms ‘meaningfulness’ and ‘meaningful’ within the chronic pain rehabilitation literature from the healthcare provider and system perspective. However, only ten articles met the inclusion criteria, and used the terms meaningful or meaningfulness from the patients’ perspective. Given the paucity of relevant studies, it was not possible to retrieve a clear definition of meaningfulness specific to the context of chronic pain rehabilitation, nor to identify specific outcome measures used to confirm whether rehabilitation is meaningful for people with chronic pain. Conclusions: There is a worrisome gap in the chronic pain rehabilitation literature regarding the application of the concept of ‘meaningfulness’ as perceived by the patient. This study lays the foundation to further the conceptual clarity required for rigorous research to determine potential benefits of personally meaningful chronic pain rehabilitation. Further work is required to define and operationalize the concept, develop valid assessment tools, and build the evidence base regarding relationships between patient-defined meaningfulness and positive outcomes in rehabilitation

SOUTH EAST ASIAN (SEA) GAMES BIOMECHANICS PROJECT

Introduction: The 19th SEA Games were held in Jakarta, Indonesia in October 1997 and presented an ideal opportunity for much needed kinematic data to be collected from the track and field athletes representing the ten South East Asian countries. The quantitative data obtained from high speed video cameras will be used to provide coaches and athletes with information to further improve their performance. Methods: Two- and three-dimensional video data was collected at 50 and 200 frames/sec using two Peak Motus motion analysis systems. The men’s javelin, hammer throw and discus events were recorded using a fixed 3-camera system, while the women’s and men’s 100 m sprints, 110 m hurdles and triple jump events were recorded using a two camera pan and tilt system. As an example of the data collected, the men’s hammer throw gold medalist was analyzed. The three cameras were placed to provide a rear, lateral and left-frontal view, with the reference origin being the center of the throwing circle: X (anterior-posterior), Y (medio-lateral), Z (vertical). The position of the hammer, resultant velocity and angle of projection (with respect to the horizontal) were measured at the instant of release. Results: The hammer was thrown distances ranging from 53.22m to 58.00m by the gold medalist. At the point of release the position of the hammer ranged from 0.75-0.88 m (X), -2.02-(-1.58) m (Y) and 1.62-1.90 m (Z), with a resultant velocity of 23.3-24.3 m/s and an angle of projection of 41.0-44.2 degrees. Conclusions: The major difference observed when comparing the SEA Games gold medalist with world class throwers was the lower release velocity of the SEA Games athletes. As a practical research project the major problem encountered were obtaining access to the field for video recording, transport of equipment, ensuring stable power supply and equipment failure

The experience of meaningful rehabilitation as perceived by people with chronic pain: A phenomenological study

BACKGROUND: People with chronic pain may seek rehabilitation to reduce pain and restore productivity and valued roles. Theoretically, a biopsychosocial approach makes rehabilitation more meaningful, however, the limited research on meaningful rehabilitation predominantly describes the perspective of therapists and researchers. The client\u27s perspective of meaningfulness in rehabilitation is lacking. OBJECTIVE: To investigate the experience of meaningfulness in rehabilitation from the perspective of people with chronic pain. METHODS: Qualitative, semi-structured interviews were conducted with Australian adults who had chronic pain and recent experience of occupational therapy or physiotherapy. Sampling continued until thematic saturation occurred. Transcripts were coded and analyzed using theory-driven and data-driven thematic analysis. RESULTS: Ten participants (four males; six females) were interviewed. Pain histories ranged from nine months to 20+ years, with conditions such as fibromyalgia or trauma. Three themes from a prior concept analysis were upheld, and a further three data-driven themes emerged. Results indicate that people with chronic pain seek a genuine connection ; from a therapist who is credible ; and can become a guiding partner , and they find rehabilitation meaningful when it holds personal value ; is self-defined ; and relevant to their sense of self-identity . CONCLUSIONS: The genuine connection and guiding partnership with a credible therapist, that is sought by people with chronic pain, may be at odds with aspects of contemporary rehabilitation. Client-defined meaningfulness is an important construct to engage clients in treatment and improve work and other occupational outcomes for people with chronic pain

Pilot study on the reliability of the coach\u27s eye: Identifying talent throughout a 4-day cadet judo campp

A typical assumption found in talent identification literature is that different coaches, given the same athletes and circumstances, will identify the same subset of athletes as “talented”. However, while coaches play a major role during talent identification in practical sport settings, there is limited empirical research exploring the processes which underpin this. The purpose of this study was to explore the reliability of “the coach\u27s eye” during the assessment of talent in a group of athletes. Specifically, this project compared inter-coach agreement between nine judo coaches (ages 35.8 ± 10.6 years) with varying levels of experience (12.9 ± 8.9 years) in the evaluation of 24 talented cadet judo athletes (13–15 years) at seven timepoints throughout a 4-day development training camp. Without discussion of their scores with other coaches, coaches provided a single score representing each athlete\u27s “potential for future performance” on an 11-point Likert scale at each timepoint. Scores from each coach were converted into rankings from 1 to 24 to create a normalized scale to facilitate comparison of athletes. Based on their rankings at each timepoint, athletes were placed into one of three evenly distributed groups (high, medium, and low rank). Inter-coach agreement at each timepoint was determined by the number of coaches who ranked each athlete in the same group, categorized at three levels: 50, 75 or 100% agreement. Overall results showed that at completion of the camp, coaches reached 100% agreement on only two athletes, both of whom were in the high rank group. When inter-coach agreement was set at 50%, 15 athletes (62.5%) were placed into like groups. The first timepoint at which coaches were able to differentiate between the majority of athletes was Timepoint 3 (end of day 2). The findings suggest that, in isolation, coaches do not agree on the talent or potential of athletes. This indicates that the “coach\u27s eye” is subjective and variable, and, given the same context, there is poor inter-coach agreement in the identification of talented athletes. In turn, these findings may have significant implications for both future talent identification research and athlete selection processes by sport organizations

Cross-sectional survey of sleep practices of Australian university students

Background and Aim: Sleep insufficiency is often associated with the life of a university student, yet it is well known that inadequate sleep can have a negative impact on physical and mental health and be detrimental to cognitive skills for learning. The aim of this study was to replicate a Canadian study to survey university student sleep practices, the way in which students address any sleep issues, and the students’ preferred method to receive targeted sleep information. Methods: An anonymous on-line survey was promoted to all enrolled students at one Australian University in August 2017. Results: In total, 601 students responded to the survey. One third indicated that they had insufficient sleep (less than 6.5 hrs). Almost two thirds reported a perception of not getting sufficient sleep. There was a significant association between the reported number of sleep hours, and the perception of high-quality sleep. Strategies to get to sleep included the use of social media which is counter to best practice in sleep hygiene. Conclusion: The study supports the need for education about sleep health coupled with stress management to better the demands of student life

A Range of Service Delivery Modes for Children with Developmental Coordination Disorder Are Effective: A Randomized Controlled Trial

Purpose: To investigate whether the environment and personnel providing intervention to children with developmental coordination disorder make a difference in motor outcomes and perceived competency. Methods: Ninety-three children (66 males), aged 5 years 1 month to 8 years 11 months, with developmental coordination disorder were randomized to receive a 13-week group-based task-oriented intervention, either at school by a school assistant or physical therapist, or in a health clinic by a physical therapist. The Movement Assessment Battery for Children (MABC) assessed motor skills pre- and postintervention. Self-perception and cost-effectiveness were also assessed. Results: Participants demonstrated a significant improvement in motor skills following intervention for all modes of delivery up to 6 months postintervention, MABC mean difference 7.20 (95% confidence interval, 5.89-8.81), effect size = 0.98. Conclusion: Group intervention programs for developmental coordination disorder can be run by either a health professional or a school assistant (supported by physical therapist) in either the school or clinic environment and provide successful outcomes

Technical attributes of Australian youth soccer players: Implications for talent identification

Objectives: To determine whether the technical ability of Australian youth soccer players could distinguish between various playing levels. Design: A cross-sectional observational design was used with each player required to complete four technical tests. Methods: Sixty-two participants were representatives of three cohorts of youth soccer in Australia: national elite (n¼18), state elite (n¼22) and sub-elite (n¼22). The technical tests used were Loughborough Short Passing Test (LSPT), long passing test (LPT), shooting test and speed dribbling, with all players familiarised with the tests prior to data collection. Differences between cohorts were analysed using a multiple analysis of variance test with follow-up analyses of variance and Tukey Honest Significant Difference post-hoc test, which were subsequently used to inform a sensitivity analysis, more specifically a bootstrapped receiver operating curve to determine cut-off scores for each variable. Results: The national elite cohort scored better than state- and sub-elite cohorts on the LSPT, however, the state elite produced the fastest time before penalties. The sub-elite cohort scored less points on the LPT compared to both national- and state elite cohorts, on both feet. In regards to speed dribbling, national elite players were faster than both the state- and sub-elite cohorts. Shooting accuracy and velocity were able to discriminate the national- and sub-elite cohorts on the dominant foot, with shooting velocity on the nondominant foot being faster for the national elite compared to both the state- and sub-elite cohorts. Conclusions: A number of differences in technical ability were identified between varying levels of Australian youth soccer players. Youth soccer coaches and sports scientists should use the cut-off scores for the technical tests in the talent identification and development process, with aspiring players aiming to reach these levels

Tactical skill in Australian youth soccer: Does it discriminate age-match skill levels?

Objectives Football Federation Australia (FFA) has identified that Australian athletes are proficient physically, however often lack the technical and tactical skills to excel internationally. The aim of the current study was to assess if a video-based decision-making test could discriminate different age-matched skill levels of talent in Australian soccer. Design Cross-sectional observational. Methods Sixty-two youth male soccer players completed a video-based decision-making test. Results An ANOVA test showed that the video-based test significantly discriminated between all three groups, with the national elite athletes selecting more correct responses than the state elite (65.3 ± 8.1%; 56.0 ± 9.1%, respectively). The state elite were more accurate than the sub-elite (45.9 ± 8.8%). Conclusions Results suggest that a video-based test may be a suitable tool to use in the selection of athletes as a measure of decision-making skill. The low accuracy scores, even for the national elite cohort, suggest that decision-making skill at the youth level has room for improvement and should be prioritised as an area for development

The use of skill tests to predict status in junior Australian football

This study examined whether skill tests were predictive of status in junior Australian football. Players were recruited from the 2013 under 18 (U18) West Australian Football League competition and classified into two groups: elite (state U18 squad representative; n = 25; 17.9 ± 0.5 years) and subelite (nonstate U18 squad representative; n = 25; 17.3 ± 0.6 years). Both groups completed the Australian football kicking (AFK) and Australian football handballing (AFHB) tests, assessing kicking accuracy/ball speed and handballing accuracy on dominant and nondominant sides. A multivariate analysis of variance (MANOVA) modelled the main effect of "status", whilst logistic regression models were built for the predictive analysis using the same test parameters. Between-group differences were noted across all parameters, with the combination of kicking accuracy and ball speed on the dominant and nondominant sides being the best predictor of status for the AFK test (wi = 0.25, AUC = 89.4%) and the combination of accuracy on the dominant and nondominant sides being the best predictor of status for the AFHB test (wi = 0.80, AUC = 88.4%). The AFK and AFHB tests are predictive of status, suggesting that their use is warranted as a means of talent identification in junior Australian football

Physical and anthropometrical attributes of Australian youth soccer players

Objectives To determine whether Australian youth soccer players of varying levels could be distinguished based on their anthropometrical and physical attributes. Design A cross-sectional observational design was used, involving six anthropometrical and physical tests for each player. Methods Participants represented three youth levels of competition, namely national elite (n = 18), state elite (n = 22) and sub-elite (n = 22). Anthropometrical and physical tests included standing height; body mass; 5, 10, 30 m sprint and 20 m ‘flying start’ sprint; zig-zag agility test; vertical jump and Yo-Yo Intermittent Recovery test level 1. A multiple analysis of variance for the main effect of cohort, with a follow-up ANOVA and Tukey\u27s Honest Significant Difference were used to discern which attributes differed between each cohort. Receiver operating characteristic curves were calculated, providing cut-off values between cohorts. Results The national elite cohort was significantly taller than the state elite cohort (ES = 0.94) and faster than the sub-elite athletes across 30 m (ES = 0.79) and 20 m with a flying start (ES = 0.77) (P \u3c 0.05). The national elite cohort had a significantly higher level of intermittent endurance, compared to the state elite athletes who also performed better than the sub-elite cohort. The discrepancy between groups in the Yo-Yo Intermittent Recovery test level 1 was exemplified by the receiver operating characteristic with 94.1% of national elite players running further than 1980 m, while 95.7% of state elite and 100% of sub-elite players failed to reach this distance (ES = 0.88–1.77). Conclusions It is evident that anthropometrical and physical attributes differ between youth cohorts, particularly intermittent endurance. It is important to use this knowledge to enhance the current processes used to identify future talent for success in Australian soccer