Psihološki odgovor sportaša na ozljedu

The aim of this research was to investigate the causes of the emergence of sports injuries and to explain the differences in psychological response with regard to the severity of the injury. We examined 68 competing Slovene athletes with surgically treated knee injury. The estimated time of rehabilitation of the more severely injured athletes was six months, while those who sustained less severe injuries faced a monthlong rehabilitation. We measured the athletes’ personality traits, their athletic identity, coping with pain, rehabilitation beliefs, motivation and social support provided by their family and their coach as well as their colleagues. The results showed that the group of more severely injured athletes demonstrated behaviour that is less inhibited in response than the group of athletes with less severe injuries. The psychological response proved to be almost the same in both groups, except for the higher levels of catastrophizing, and a higher individual coping response found in the group of more severely injured athletes. Furthermore, masculinity was found to predict self-efficacy and the individual coping response, the strength of athletic identity predicted motivation and rehabilitation value, while emotional lability predicted catastrophizing and self-efficacy. Athletes with lower athletic identity, lower masculinity and higher emotional lability are more exposed to adjustment difficulties after sustaining an athletic injury. In our opinion, the strategies for successful rehabilitation after a sports injury should be aimed at the identification of athletes with personality traits that pose a higher risk of experiencing adjustment difficulties, at promoting adequate motivation, increasing coach support and at the application of cognitive-behavioural strategies.Cilj je ovog istraživanja bio utvrditi uzroke nastajanja sportskih ozljeda te objasniti razlike u psihološkom odgovoru na ozljede različite težine. Istražili smo 68 slovenskih natjecatelja koji su bili podvrgnuti kirurškoj operaciji koljena. Procijenjeno vrijeme rehabilitacije za teže ozlijeđene sportaše iznosilo je šest mjeseci, dok je za one ispitanike s manje teškim ozljedama ono iznosilo jedan mjesec. Mjerili smo sportaševe osobine ličnosti, njihov sportski identitet, sposobnost suočavanja s boli, povjerenje u rehabilitacijski proces te motivacijsku i sociološku potporu koju su sportaši dobivali od svoje obitelji, trenera i kolega. Rezultati su pokazali da je grupa ispitanika koja je bila teže ozlijeđena pokazala oblik ponašanja koji je manje inhibirao reakciju na ozljedu no što je to slučaj s grupom ispitanika koji su bili lakše ozlijeđeni. Psihološki odgovor bio je gotovo isti u obje grupe, s iznimkom veće razine katastrofiziranja i individualnog suočavanja u grupi ispitanika koji su bili teže ozlijeđeni. Nadalje, pokazalo se da razina muškosti objašnjava samoučinkovitost i razinu individualnog suočavanja, snaga sportskog identiteta predviđa motivaciju i rehabilitacijsku vrijednost, dok je emocionalna nestabilnost predviđala razinu katastrofiziranja i samoučinkovitosti. Sportaši s nižom razinom sportskog identiteta, muškosti i većom razinom emotivne nestabilnosti bili su više izloženi poteškoćama u prilagodbi nakon ozljeđivanja. Prema našem mišljenju, strategije za uspješnu rehabilitaciju nakon sportske ozljede trebale bi biti usmjerene na identifikaciju sportaša s osobinama ličnosti koje predstavljaju veći rizik za doživljavanje poteškoća u prilagodbi na trenutačno stanje, zatim na poticanje odgovarajuće motivacije, povećavanje potpore trenera te primjenu kognitivno-bihevioralnih strategija

HIP ARTHROSCOPY

Artroskopija kuka intenzivno se razvija posljednjih desetak godina te ubrzano preuzima primat u liječenju raznih ozljeda i oštećenja i u samom kuku i u njegovoj neposrednoj blizini. Osnovna prednost artroskopske kirurgije kuka prema klasičnoj otvorenoj metodi operacijskog liječenja jest u izbjegavanju otvorene dislokacije kuka čime se smanjuje morbiditet bolesnika te ubrzavaju rehabilitacija i povratak svakodnevnim aktivnostima. Uspješnost artroskopskog zahvata ovisi o pravilnoj indikaciji za zahvat, iskustvu i vještini operatera, pravilno provedenoj rehabilitaciji te suradljivosti bolesnika, kao i o njegovim realnim očekivanjima. Osnovnim indikacijama za artroskopiju kuka danas se smatraju ozljede i oštećenja acetabularnog labruma i/ili zglobne hrskavice, femoroacetabularni sindrom sraza, ozljede i oštećenja ligamenta glave femura, slobodna i strana zglobna tijela te različite bolesti sinovijalne membrane (sinovijalna hondromatoza, pigmentirani vilonodularni sinovitis i druge upalne artropatije poput reumatoidnog artritisa). U ovom članku opisujemo indikacije, tehniku, komplikacije, kao i perspektivu artroskopije kuka, uz detaljan pregled suvremenih literaturnih podataka.In the last ten years, hip arthroscopy has been developing intensively and it is rapidly gaining primacy in the treatment of various injuries and damages to the hip itself and its immediate vicinity. The basic advantage of hip arthroscopy surgery versus classic open surgery is avoiding an open dislocation of the hip and, thus, reducing patient’s morbidity and accelerating his/her rehabilitation, which leads to a quicker return to everyday activities. The success of arthroscopic surgery depends on the correct indication for the surgery and on the experience and the skill of the operator. It also depends on the properly conducted rehabilitation and the patient’s compliance, as well as on the patient’s realistic expectations. Indications for hip arthroscopy today are the following: injury and damage to acetabular labrum and/or articular cartilage, femoroacetabular impingement syndrome, injuries and damages to the ligament of the femoral head, loose and foreign joint bodies as well as different conditions of synovial membrane (synovial chondromatosis, pigmented villonodular synovitis and other inflammatory arthropathy such as rheumatoid arthritis). In this article we describe the indications, technique, complications and the prospect of hip arthroscopy, with a detailed overview of contemporary literature data

Short–Term Preconditioning With Blood Flow Restricted Exercise Preserves Quadriceps Muscle Endurance in Patients After Anterior Cruciate Ligament Reconstruction

Surgical ACL reconstruction performed with a tourniquet induces compression and ischemic stress of the quadriceps femoris (QF) muscle which can accelerate postoperative weakness. Given that low-load blood flow restricted (BFR) exercise is potent in enhancing muscle oxygenation and vascular function, we hypothesized that short-term preconditioning with low-load BFR exercise can attenuate QF muscle endurance deterioration in the postoperative period. Twenty subjects undergoing arthroscopic ACL reconstruction performed 5 exercise sessions in the last 8 days prior to surgery. They were assigned into either BFR group, performing low-load BFR knee-extension exercise, or SHAM-BFR group, replicating equal training volume with sham occlusion. Blood flow (near-infrared spectroscopy) and surface EMG of QF muscle during sustained isometric contraction at 30% of maximal voluntary isometric contraction (MVIC) torque performed to volitional failure were measured prior to the intervention and again 4 and 12 weeks after surgery. There was an overall decrease (p = 0.033) in MVIC torque over time, however, no significant time-group interaction was found. The time of sustained QF contraction shortened (p = 0.002) in SHAM-BFR group by 97 ± 85 s at week 4 and returned to preoperative values at week 12. No change in the time of sustained contraction was detected in BFR group at any time point after surgery. RMS EMG amplitude increased (p = 0.009) by 54 ± 58% at week 4 after surgery in BFR group only. BFm increased (p = 0.004) by 52 ± 47% in BFR group, and decreased (p = 0.023) by 32 ± 19% in SHAM-BFR group at week 4 after surgery. Multivariate regression models of postoperative changes in time of sustained QF contraction revealed its high correlation (R2 = 0.838; p < 0.001) with changes in BFm and RMS EMG in the SHAM-BFR group, whereas no such association was found in the BFR group. In conclusion, enhanced endurance of QF muscle was triggered by combination of augmented muscle fiber recruitment and enhanced muscle perfusion. The latter alludes to a preserving effect of preconditioning with BFR exercise on density and function of QF muscle microcirculation within the first 4 weeks after ACL reconstruction

Biomechanical analysis of the periacetabular hip osteotomy

We determined biomechanical parameters (magnitude of the resultant hip force, its inclination with respect to the vertical, contact hip stress, position of the stress pole, size of the load bearing area, functional angle of the load bearing area and stress gradient index) in a single patient before and after the periacetabular osteotomy. The operation was performed due to hip dysplasia. We used two mathematical models to determine the resultant hip force in the one legged stance: the HIPSTRESS model (1) and the one-muscle model (2). Stress was calculated by using the HIPSTRESS model for contact stress (2). The geometrical parameters needed for calculation of biomechanical parameters were assessed from standard anteroposterior radiograms taken from the archive. Before operation, both hips were dysplastic according to the HIPSTRESS method criterion. We found considerable improvement of the contact stress distribution in the operated hip, however, contact hip stress became less favorable in the contralateral hip after the operation. After the operation, the operated hip became normal while at the contralateral side, the degree of the dysplasia has increased

Artroskopija kuka [Hip arthroscopy]

In the last ten years, hip arthroscopy has been developing intensively and it is rapidly gaining primacy in the treatment of various injuries and damages to the hip itself and its immediate vicinity. The basic advantage of hip arthroscopy surgery versus classic open surgery is avoiding an open dislocation of the hip and, thus, reducing patient's morbidity and accelerating his/her rehabilitation, which leads to a quicker return to everyday activities. The success of arthroscopic surgery depends on the correct indication for the surgery and on the experience and the skill of the operator. It also depends on the properly conducted rehabilitation and the patient's compliance, as well as on the patient's realistic expectations. Indications for hip arthroscopy today are the following: injury and damage to acetabular labrum and/or articular cartilage, femoroacetabular impingement syndrome, injuries and damages to the ligament of the femoral head, loose and foreign joint bodies as well as different conditions of synovial membrane (synovial chondromatosis, pigmented villonodular synovitis and other inflammatory arthropathy such as rheumatoid arthritis). In this article we describe the indications, technique, complications and the prospect of hip arthroscopy, with a detailed overview of contemporary literature data

Psihološki odgovor sportaša na ozljedu

The aim of this research was to investigate the causes of the emergence of sports injuries and to explain the differences in psychological response with regard to the severity of the injury. We examined 68 competing Slovene athletes with surgically treated knee injury. The estimated time of rehabilitation of the more severely injured athletes was six months, while those who sustained less severe injuries faced a monthlong rehabilitation. We measured the athletes’ personality traits, their athletic identity, coping with pain, rehabilitation beliefs, motivation and social support provided by their family and their coach as well as their colleagues. The results showed that the group of more severely injured athletes demonstrated behaviour that is less inhibited in response than the group of athletes with less severe injuries. The psychological response proved to be almost the same in both groups, except for the higher levels of catastrophizing, and a higher individual coping response found in the group of more severely injured athletes. Furthermore, masculinity was found to predict self-efficacy and the individual coping response, the strength of athletic identity predicted motivation and rehabilitation value, while emotional lability predicted catastrophizing and self-efficacy. Athletes with lower athletic identity, lower masculinity and higher emotional lability are more exposed to adjustment difficulties after sustaining an athletic injury. In our opinion, the strategies for successful rehabilitation after a sports injury should be aimed at the identification of athletes with personality traits that pose a higher risk of experiencing adjustment difficulties, at promoting adequate motivation, increasing coach support and at the application of cognitive-behavioural strategies.Cilj je ovog istraživanja bio utvrditi uzroke nastajanja sportskih ozljeda te objasniti razlike u psihološkom odgovoru na ozljede različite težine. Istražili smo 68 slovenskih natjecatelja koji su bili podvrgnuti kirurškoj operaciji koljena. Procijenjeno vrijeme rehabilitacije za teže ozlijeđene sportaše iznosilo je šest mjeseci, dok je za one ispitanike s manje teškim ozljedama ono iznosilo jedan mjesec. Mjerili smo sportaševe osobine ličnosti, njihov sportski identitet, sposobnost suočavanja s boli, povjerenje u rehabilitacijski proces te motivacijsku i sociološku potporu koju su sportaši dobivali od svoje obitelji, trenera i kolega. Rezultati su pokazali da je grupa ispitanika koja je bila teže ozlijeđena pokazala oblik ponašanja koji je manje inhibirao reakciju na ozljedu no što je to slučaj s grupom ispitanika koji su bili lakše ozlijeđeni. Psihološki odgovor bio je gotovo isti u obje grupe, s iznimkom veće razine katastrofiziranja i individualnog suočavanja u grupi ispitanika koji su bili teže ozlijeđeni. Nadalje, pokazalo se da razina muškosti objašnjava samoučinkovitost i razinu individualnog suočavanja, snaga sportskog identiteta predviđa motivaciju i rehabilitacijsku vrijednost, dok je emocionalna nestabilnost predviđala razinu katastrofiziranja i samoučinkovitosti. Sportaši s nižom razinom sportskog identiteta, muškosti i većom razinom emotivne nestabilnosti bili su više izloženi poteškoćama u prilagodbi nakon ozljeđivanja. Prema našem mišljenju, strategije za uspješnu rehabilitaciju nakon sportske ozljede trebale bi biti usmjerene na identifikaciju sportaša s osobinama ličnosti koje predstavljaju veći rizik za doživljavanje poteškoća u prilagodbi na trenutačno stanje, zatim na poticanje odgovarajuće motivacije, povećavanje potpore trenera te primjenu kognitivno-bihevioralnih strategija

Psychological Factors of Rehabilitation of Athletes After Knee Injury

Izhodišča. Večina raziskav s področja športnih poškodb se nanaša na specifične značilnosti, ki sprožijo, napovedujejo ali preprečujejo športne poškodbe. Raziskava preučuje možnost napovedovanja uspešnosti rehabilitacije na osnovi psiholoških značilnosti poškodovanih športnikov, in sicer spoprijemanja z bolečino, vedenja v procesu rehabilitacije (SIRBS), motivacije za rehabilitacijo, tesnobe kot stanja in socialne opore. Metode. V raziskavo je bilo vključenih 68 športnikov po operaciji kolena zaradi resne poškodbe, definirane na osnovi izbranega sistema (1). Rehabilitacijski proces je trajal en mesec ali šest mesecev. Udeleženci so bili psihološko obravnavani pred procesom rehabilitacije in po njem. Rezultati. Rezultati so pokazali, da je uspešnost rehabilitacije večja, če se zmanjša anksioznost in poveča dojemljivost ter zaznata samoučinkovitost in katastrofiziranje. Le za 10 % športnikov lahko rečemo, da je bila pri njih rehabilitacija uspešna. Zaključki. Na osnovi raziskave lahko rečemo, da se konstruktivna vedenja, povezana z rehabilitacijo, povezujejo s psihološko rehabilitacijo poškodovanih športnikov

In vitro characterization of the human skeletal stem cell-like properties of primary bone-derived mesenchymal stem /stromal cells in patients with late and early hip osteoarthritis

Human skeletal stem cells (hSSCs) were recently identified as podoplanin (PDPN)/CD73/CD164-positive and CD146-negative cells that decline with age, and play a role in the pathogenesis of osteoarthritis (OA). The aim of this study was to identify the hSSC-like properties of bone-derived mesenchymal stem/stromal cells (MSCs) of patients with late and early OA. Methods: First, we performed gene expression profiling for the hSSC markers in 32 patients with late and early OA, and donors without OA. Having identified the low expression of hSSC markers in late OA patients, we further performed trilineage differentiation and immunophenotyping for hSSC makers in the selected subsets from each donor group. Results: Our results show no differences in osteogenesis, chondrogenesis, and adipogenesis between the MSCs from the three groups. However, the immunophenotyping shows lower CD164 in MSCs from early OA patients in comparison with late and no OA subjects (p = 0.002 and p = 0.017). Conclusions: Our study shows that the in vitro hSSC-like properties of bone-derived MSCs are similar in patients with early and late OA, and in donors without OA. However, the lower percentage of CD164-positive MSCs in early OA patients indicates the potential of CD164 as a marker of the onset of OA