One of the claims sometimes advanced in favour of anti-doping is that allowing doping would lead to a uniform increase in performance in comparison to no doping. The idea is that if all athletes wo...

Motor imagery is often used inducing changes in electroencephalographic (EEG) signals for imagery-based brain-computer interfacing (BCI). A BCI is a device translating brain signals into control signals providing severely motor-impaired persons with an additional, non-muscular channel for communication and control. In the last years, there is increasing interest using BCIs also for healthy people in terms of enhancement or gaming. Most studies focusing on improving signal processing feature extraction and classification methods, but the performance of a BCI can also be (...) improved by optimizing the user’s control strategies, e.g., using more vivid and engaging mental tasks for control. We used multichannel EEG to investigate neural correlates of a sports imagery task (playing tennis) compared to a simple motor imagery task (squeezing a ball). To enhance the vividness of both tasks participants performed a short physical exercise between two imagery sessions. EEG was recorded from 60 closely spaced electrodes placed over frontal, central, and parietal areas of 30 healthy volunteers divided in two groups. Whereas Group 1 (EG) performed a physical exercise between the two imagery sessions, Group 2 (CG) watched a landscape movie without physical activity. Spatiotemporal event-related desynchronization (ERD) and event-related synchronization (ERS) patterns during motor imagery (MI) tasks were evaluated. The results of the EG showed significant stronger ERD patterns in the alpha frequency band (8–13 Hz) during MI of tennis after training. Our results are in evidence with previous findings that MI in combination with motor execution has beneficial effects. We conclude that sports MI combined with an interactive game environment could be a future promising task in motor learning and rehabilitation improving motor functions in late therapy processes or support neuroplasticity. (shrink)

Using a longitudinal case study design, we have tracked the recovery of motor function following severe traumatic brain injury (TBI) through a multimodal neuroimaging approach. In 2006, Canadian Soldier Captain (retired) Trevor Greene (TG) was attacked with an axe to the head while on tour in Afghanistan. TG continues intensive daily rehabilitation, which recently included the integration of physical therapy (PT) with neuromodulation using translingual neurostimulation (TLNS) to facilitate neuroplasticity. Recent findings with PT+TLNS demonstrated that recovery of (...) motor function occurred beyond conventional time limits, currently extending past 14-years post-injury. To investigate whether PT+TLNS similarly resulted in associated cognitive function improvements, we examined event-related potentials (ERPs) with the brain vital signs framework. In parallel with motor function improvements, brain vital signs detected significant increases in basic attention (as measured by P300 response amplitude) and cognitive processing (as measured by contextual N400 response amplitude). These objective cognitive improvements corresponded with TG’s self-reported improvements, including a noteworthy and consistent reduction in ongoing symptoms of post-traumatic stress disorder (PTSD). The findings provide valuable insight into the potential importance of non-invasive neuromodulation in cognitive rehabilitation, in addition to initial indications for physical rehabilitation. (shrink)

New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion (...) template consisting of a series of adaptable questions for the patient–physician encounter based on the capability approach. The goal is to improve geriatric rehabilitation and thereby increase participation in social life and well-being. To achieve this goal, we first analyzed what is considered important for participation on basis of the capability approach, human rights, and ethics of care. Second, we conducted an ethical analysis of each of the four identified dimensions of participation: political, economic, socio-cultural, and care. To improve compliance with rehabilitation measures, health professionals must align rehabilitation measures in an open dialogue with the patient’s aspiration for participation in each dimension. A discussion template based on the capability approach allows for a proactive approach in patient information and stimulates a critical assessment of treatment alternatives while reducing the risk of imposing personal values. (shrink)

Rehabilitation medicine, aka Physical medicine and Rehabilitation , is the medical specialty which focuses on optimizing function, ability, participation and life satisfaction in the light of noncurable disability and/or chronic disease. It is primarily geared towards the “so what” than towards “what” . PM & R is holistic and patient-centred, thus comprising a well-suited arena for dialogue and patient participation. Many patients experience a severe crisis reaction in the aftermath of major trauma or disease. This “existential rupture” (...) calls for a fundamental revaluation of many aspects of daily life. Crisis management will not merely be a matter of mourning and then back to “business as usual,” as this often is either not possible or not the optimal choice given altered life circumstances. We propose that philosophical practice may be an important addition to the rehabilitation process, by facilitating “lifeworld analyses” and thereby making it possible for the patient to find sources of meaning in life despite disability. This “therapy for the sane” comprises PP rather than psychiatric or psychotherapeutic interventions, and may come to be seen as a key aspect in the training of future physiatrists and other rehabilitation specialists. (shrink)

The present work aims to efficiently carry out life-death education for college students, improve their psychological problems, and reduce suicide accidents by combining LDE with Dance Movement Therapy. DMT is a psychosomatic cross therapy that treats mental or physical diseases through dance or improvisation. Firstly, this paper introduces LDE and DMT and designs the activities of DMT intervention. Secondly, the relationship between DMT and LDE is analyzed. Finally, a questionnaire survey is conducted on the research objects. The (...) research objects are divided into the experimental group receiving DMT intervention, the control group participating in sports dance courses, and the benchmark group. The research data show no significant difference in interpersonal skills and emotional psychology among the three groups. The DMT intervention group has substantial changes in other factors except for the conflict control ability before and after the intervention. In addition, the questionnaire survey results after the intervention demonstrate that the DMT intervention group gets a significantly higher score in the interpersonal relationship, interpersonal relationship building ability, moderate rejection ability, self-disclosure ability, and emotional support ability. Therefore, DMT intervention positively impacts college students’ interpersonal relationships. After the sports dance course, there are differences in the total score of interpersonal ties and scores of interpersonal relationships building ability, self-disclosure ability, and emotional support ability in the control group, but with no significant difference in moderate rejection ability and conflict control ability. Therefore, compared with traditional psychotherapy methods, the DMT method reported here is conducive to releasing pressure and alleviating physical and mental anxiety. The research content provides new ideas for psychological education in colleges and universities and contributes to improving college students’ suicidal tendencies and helping college students grow up healthily. (shrink)

This article presents a study on the ethical dilemma of whistleblowing in physical therapy, and suggests some lines for further research on this topic as well as ways for integrating it in the physical therapy curriculum. The study examines the self-reported willingness of physical therapy students to report misconduct, whether internally or externally, to protect the patient's interests. Internal disclosure entails reporting the wrongdoing to an authority within the organisation. External disclosure entails reporting the (...) offence to an outside agency, such as the police, professional organisation, or press. The findings indicate that the students view the acts that are detrimental or cause injustice to the patient in a very serious light. In dilemma situations such as these, the students reported a willingness to act. The students also report considerably greater likelihood of whistleblowing internally than externally. The pattern reveals a desire to correct the misconduct coupled with a marked decline in the willingness to blow the whistle as this act moved from the workplace to an external authority. (shrink)

Compared to other health care professions such as medicine, nursing and pharmacy, few studies have been conducted to examine the nature of practice errors in occupational and physical therapy. In an ongoing study to determine root causes, typographies and impact of occupational and physical therapy error on patients, focus group interviews have been conducted across the United States. A substantial number of harmful practice errors and/or other patient safety events (deviations or accidents) have been identified. Often (...) these events have had moral dimensions that troubled the therapist involved. In this article, six of these transcribed cases are analyzed, using predominant bioethical theories, ethical principles and professional codes of ethics. The cases and their analyses are intended to be exemplary, improving the readers’ ability to discern and critically address similar such events. Several patient safety strategies are suggested that might have prevented the events described in these cases. (shrink)

A Case-Based Approach to Learning Ethics in Physical Therapy. Ethics in Physical Therapy utilizes a unique case-based approach to teach students and clinicians how to apply theoretical concepts to real-world situations. The cases were carefully selected to encourage thinking and discussion. The accompanying text provides a framework to answer the "should" questions, such as "What should I do?" and "How should I act?" The format provides the opportunity to move beyond the individual realm, when appropriate, resolving (...) issues within an institutional or societal perspective. The text is divided into two sections: "Ethics for the Physical Therapist" and "Types of Ethical Decisions: Case Analysis." They are designed to integrate with one another, but, each section can also be used separately. Part I provides more didactic, foundational material, while Part II strives to apply ethical decision-making tools to relevant cases in physical therapy practice, with the second section focusing on case analyses. The purpose of Ethics in Physical Therapy is to give students and clinicians a lens through which to analyze contemporary ethical challenges. Philosophical theory within the text is limited to that which can be applied practically in the clinical setting. This book is not intended to be a work on ethical behavior, rather, it is designed to provide students and clinicians with a framework in which to approach the uncertainty of ethical decision making with tools to aid their inherent judgment. (shrink)

To assess—from a qualitative perspective—the perceptions and attitudes of Spanish rehabilitation professionals (e.g. rehabilitation doctors, speech therapists, physical therapists) about Brain–Computer Interface (BCI) technology. A qualitative, exploratory and descriptive study was carried out by means of interviews and analysis of textual content with mixed generation of categories and segmentation into frequency of topics. We present the results of three in-depth interviews that were conducted with Spanish speaking individuals who had previously completed a survey as part of a (...) larger, 3-country/language, survey on BCI perceptions. 11 out of 15 of these Spanish respondents (survey) either strongly or somewhat accept the use of BCI in rehabilitation therapy. However, the results of our three in-depth interviews show how, due to a strong inertia of attitudes and perceptions about BCI technology, most professionals feel reluctant to use BCI technology in their daily practice (interview). (shrink)

BackgroundAn injury followed by surgery poses many challenges to an athlete, one of which is rehabilitation, with the goal of returning to sport. While total restoration of physical abilities is a primary goal for most athletes, psychosocial factors also play an important role in the success of an athlete's return to sport. The purpose of this review was to examine the effectiveness of exercise and psychosocial interventions on RTS rates, which might be one of the most important outcomes (...) for elite athletes.MethodsTo carry out this review, PubMed, SAGE Journals, Web of Science, SPORTDiscus, ScienceDirect, and Google Scholar databases were searched from inception to July 2022. The inclusion criteria consisted exercise or psychosocial intervention for athletes after anterior cruciate ligament reconstruction, with reporting RTS rates as an outcome.ResultsFrom 1032 identified articles, four reports met inclusion criteria, all of which examined the recovery after ACLR. The mean MINORS score for the included studies was 16.3 ± 6.1, of which non-comparative studies scored 11.0 ± 1.4, while comparative studies scored 21.5 ± 0.7. There were consistent findings for benefits of exercise and psychosocial interventions on RTS rates. Return to preinjury rates in the reviewed studies vary between 63 and 95% with lower % observed in female athletes and with shorter follow-up. Interventional studies reporting RTS rates with a larger sample size and longer follow-up are needed.ConclusionPhysical and psychological function, as well as social support can be influenced by appropriate interventions, indicating future work on rehabilitation programs for return to preinjury might consider taking the holistic approach addressing those. (shrink)

In recent decades, phenomenology has been utilized not only as a conceptual framework from which to understand medical encounters in healthcare settings, but also to guide medical professionals in providing care. In the realm of physical therapy, phenomenology has been touted as a philosophically-based avenue to aid in helping to understand what it means to be a patient. The works of Edmund Husserl and Martin Heidegger have been utilized as paths to approach phenomenologically-informed care in physical (...) class='Hi'>therapy. However, to our knowledge, no significant connection has been made in regard to the work of Hans-Georg Gadamer’s phenomenology and hermeneutics in the realm of physical therapy. The authors aim to close that gap by showing the ways in which Gadamer’s philosophy can help physical therapists provide phenomenologically-informed patient care. They begin by outlining some of the touchpoints between phenomenology and healthcare and then introduce Gadamer as a figure who deserves attention in the question of how to apply phenomenology to healthcare settings. Upon analyzing Gadamer’s account of what it means to experience an altered body, they outline Gadamer’s understanding of tact, practical knowledge, and good sense in order to show how to understand at a conceptual level what it means to empathize with patients on the path to building therapeutic alliance, that is, a cooperative working relationship. They then look closely at Gadamer’s hermeneutics and particularly his comments on how to cultivate a fusion of horizons in order to attempt to help guide physical therapists in theoretically understanding how to empathize with their patients. Ultimately, they argue that physical therapists who practice phenomenologically-informed care, which they call “hermeneutical healing,” are positioned well to form strong working relationships with their patients. (shrink)

Understanding the basics of ethics is essential for a physical therapist. Diagnostic skills, technical expertise, and knowledge of the body are insufficient; being a good clinician requires a moral education as well. Bioethics in Physical Therapy: A Reader helps students develop a deeper understanding of moral principles and their philosophical underpinnings. The text encourages readers to exercise their moral imaginations and prepares them to respond to professional conflicts in an ethical manner. The reader is organized in seven (...) units. The text begins with an introduction to classical moral theories, the fundamental philosophical pillars of biomedical ethics, and a history of ethics in physical therapy. Additional units explore such topics as moral distress and the choice to be ethical, acting with integrity in the face of uncertainty, and the importance of hope in the patient encounter. Students learn about moral courage, the broad reach of justice in the medical field, and the lived experience of illness. Each unit features an opening scenario, a section on cultivating professional values, introductions to the key topic and the readings, comprehension questions, and post-reading critical thinking questions that reference the opening scenario. Written to be engaging and accessible, Bioethics in Physical Therapy: A Reader is designed to help future therapists understand the importance of ethics in practice. It is an ideal resource for all courses in the discipline. (shrink)

Doping can be both of chemical and protein nature or may involve prohibited methods, such as illegal blood transfusions. The rapidly increasing number of genetic therapies as a promising new branch of regular medicine, has raised the issue whether these techniques might be abused in the field of sports. The risks involved in gene doping are several, and are related both to the vector protein used (DNA, chemical, viral) and to the encoded transgene. A concern in the athletic community (...) is that no one knows how easily gene doping can be detected. The DNA used for gene transfer is of human origin, and not different from that of the person applying gene doping. A combination of developing detection methods based on gene arrays or proteomics and a clear education program on the associated risks seems to be the most promising preventive method to counteract the possible application of gene doping. (shrink)

This article focuses on ethical concerns about modifying physical activities within a variety of education, recreation, rehabilitation and competition contexts. An ecological frame of reference common within current educational and rehabilitation theories is utilised for reflecting upon adapted physical activity practices. Ethical principles challenged in the article are (a) the utilitarian consequence to all participants; (b) professional paternalism; and (c) empowerment of individuals with a disability. Concerns arising with respect to these ethical principles in adapted (...) class='Hi'>physical activity practices are discussed across modifications in terms of (i) the tasks involved; (ii) the environmental conditions; (iii) the equipment used; (iv) the game rules; and (v) the instruction methods. (shrink)

Aphasia is a complex disorder, frequent after stroke (with an incidence of 38%), with a detailed pathophysiological characterization. Effective approaches are crucial for devising an efficient rehabilitative strategy, in order to address the everyday life and professional disability. Several rehabilitative procedures are based on psycholinguistic, cognitive, psychosocial or pragmatic approaches, including amongst those with a neurobehavioral approach the Melodic Intonation Therapy (MIT). Van Eeckhout’s adaptation of MIT to French language (Melodic-Rhythmic Therapy: MRT) has implemented the training strategy by (...) adding a rhythmic structure reproducing French prosody. The purpose of this study was to adapt MRT rehabilitation procedures to Italian language and to verify its efficacy in a group of six chronic patients (five males) with severe non-fluent aphasia and without specific aphasic treatments during the previous 9 months. The patients were treated 4 days a week for 16 weeks, with sessions of 30–40 min. They were assessed 6 months after the end of the treatment (follow-up). The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up. Albeit preliminary, these findings support the use of MRT in the rehabilitation after stroke. Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy. (shrink)

Background: The new human coronavirus that leads to COVID-19 has spread rapidly around the world and has a high degree of lethality. In more severe cases, patients remain hospitalized for several days under treatment of the health team. Thus, it is important to develop and use technologies with the aim to strengthen conventional therapy by encouraging movement, physical activity, and improving cardiorespiratory fitness for patients. In this sense, therapies for exposure to virtual reality are promising and have been (...) shown to be an adequate and equivalent alternative to conventional exercise programs.Aim: This is a study protocol with the aim of comparing the conventional physical therapy intervention with the use of a non-immersive VR software during COVID-19 hospitalization.Methods: Fifty patients hospitalized with confirmed diagnosis of COVID-19 will be divided in two groups under physiotherapy treatment using conventional or VR intervention: Group A: participants with COVID-19 will start the first day of the protocol with VR tasks in the morning and then in the second period, in the afternoon, will perform the conventional exercises and Group B: participants with COVID-19 will start the first day with conventional exercises in the morning and in the second period, in the afternoon, will perform activity with VR. All participants will be evaluated with different motor and physiologic scales before and after the treatment to measure improvements.Conclusion: Considering the importance of benefits from physical activity during hospitalization, VR software shows promise as a potential mechanism for improving physical activity. The results of this study may provide new insights into hospital rehabilitation.Trial Registration:ClinicalTrials.gov, identifier: NCT04537858. Registered on 01 September 2020. (shrink)

Introducción: la formación de profesionales competentes es una de las misiones esenciales de la Educación Médica Superior, esto exige que los tecnólogos posean habilidades comunicativas para un correcto desempeño laboral en aras del mejoramiento humano. Objetivo de la investigación: identificar las barreras que inciden en la comunicación tecnólogo - paciente en las carreras de Licenciatura en Traumatología, Podología, Terapia Física y Rehabilitación Social Ocupacional, en áreas de rehabilitación. Métodos: se presenta un estudio observacional, descriptivo longitudinal y retrospectivo entre junio de (...) 2008 y junio 2011 que consistió en la observación a exámenes estatales prácticos y a la educación en el trabajo, en las carreras de referencia, además se aplicó una encuesta a pacientes para la obtención de información acerca de las barreras que afectan el proceso de la comunicación entre tecnólogos y pacientes. Resultados: existen insuficiencias en la comunicación entre los futuros profesionales y pacientes. Conclusiones: se demuestra un insuficiente dominio de las habilidades comunicativas y por tanto barreras que interfieren en la comunicación como las semánticas y personales. Introduction: the training of competent professionals is one of the essential missions of higher medical education; this requires that technologists have communication skills in order to develop a proper job performance for the sake of human improvement. So the objective of the research is to identify barriers affecting technologist - patient communication in the careers of degree in Trauma, Podiatry, Physical Therapy, and Occupational Social Rehabilitation in areas of rehabilitation. Methods: an observational, longitudinal descriptive and retrospective study is presented between June 2008 and June 2011 that consisted on observation to practical state exams and training at work, in the reference degrees; in addition, a survey was applied to patients to obtain information about the barriers that affect the communication process between technologists and patients. Results: there are communication inadequacies between the future professionals and patients. Conclusions: An insufficient mastery of the communication skills is demonstrated and therefore barriers that interfere with communication as the semantic and personal barriers. (shrink)

Every cultural phenomenon is multifaceted and only with great difficulty can it fit into the framework of one general concept. The term ‘sport’ is such a broad concept, because the great wealth of...

Dynamic stability of the knee and weakness of the extensor muscles are considered to be the most important functional limitations after anterior cruciate ligament injury, probably due to changes at the central level of motor control rather than at the peripheral level. Despite general technological advances, fewer contraindicative surgical procedures, and extensive postoperative rehabilitation, up to 65% of patients fail to return to their preinjury level of sports, and only half were able to return to competitive sport. Later, (...) it becomes clear that current rehabilitation after knee surgery is not sufficient to address the functional limitations after ACL reconstruction even years after surgery. Therefore, new therapeutic tools targeting the central neural system, i.e., the higher centers of motor control, should be investigated and integrated into current rehabilitation practice. To improve motor performance when overt movement cannot be fully performed, several techniques have been developed to increase physical and mental activation without the need to perform overt movements. Among the most popular cognitive techniques used to increase physical performance are motor imagery and action observation practices. This review, which examines the available evidence, presents the underlying mechanisms of the efficacy of cognitive interventions and provides guidelines for their use at home. (shrink)

This paper describes how body regimes are effectuated in the prevailing treatment strategy of physiotherapy. The process of self‐mastering in the context of sports‐related injuries is highlighted. Through a Foucauldian perspective on body regimes the aim is to shed light on the process of individualization and self‐mastery in rehabilitation. The treatment of illness in the physiotherapy clinic does not characterize the patient as sick, and exempt the patient from daily duties and expectations. The empirical data include 17 qualitative (...) illness narratives and several years of fieldwork observing patients with anterior cruciate ligament (ACL) injuries in a physiotherapy clinic. The study demonstrates how the expectation that the patients be active and self‐mastering permeates the total process of treatment. The individual responsibility for personal well‐being is a recurrent phenomenon in public health services in general, and specifically prominent in the rehabilitation of sports injuries. (shrink)

Enhancement is a basic principle of modern sport. Their increase of achievement is usually attributed to the sportsmen’s natural assessment, their health, their training methods and their employment. In contrast, increase in output by pharmacological means is outlawed. The modern medical techniques created a whole range, by which sportsmen are supported. Consequently, sometimes difficult decisions with concrete medications develop. It is not always clearly to be differentiated whether something is a pharmacological interference, which serves the therapy or leads however (...) to the outlawed increase in output. At present Enhancement is in discussion, a phenomenon, which is related to doping in sports, but which concerns achievement-increasing use of medicines not only in sportsmen. -/- Leistungssteigerung ist ein Grundprinzip des modernen Sports. Gewöhnlich werden für die Steigerung der Leistung die natürliche Veranlagung der Sportler, ihre Gesundheit, ihre Trainingsmethoden und ihr Einsatzwille veranschlagt. Leistungssteigerung durch pharmakologische Mittel ist dagegen geächtet. Die modernen medizinischen Techniken haben einen ganzen Bereich geschaffen, durch den die Sportler bei der Erbringung ihrer Leistung und deren Erhalt unterstützt werden. Dabei entstehen mitunter schwierige Entscheidungsfragen bei konkreten Medikationen. Nicht immer ist klar zu unterscheiden, ob etwas ein pharmakologischer Eingriff ist, der der Therapie dient oder aber zur geächteten Leistungssteigerung führt. Gegenwärtig wird über Enhancement diskutiert, ein Phänomen, das mit dem Doping verwandt ist, aber leistungssteigernde Verwendung von Medikamenten bei Gesunden im Allgemeinen, also nicht nur bei Sportlern, betrifft. (shrink)

The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces.

Goal setting is an important professional method and one of the key concepts that structure a practical field such as physical rehabilitation. However, the actual use of goals in rehabilitation practice is much less straightforward than the general acceptance of the method suggests as goals are frequently unattained, modified or contested. In this paper, I will argue that the difficulties of goal setting in day-to-day medical practice can be understood by unravelling the normative assumptions of goal setting, (...) in this case three different tensions that come along with it. First, goals are developed for a future state that may require activities that clash with necessities of the present situation. Second, professionals in clinical rehabilitation centres elaborate goals for an environment that differs in terms of spatial and social characteristics from the environment in the centre, where people train for the accomplishment of goals. Finally, goal setting requires active patient participation and individual control that sometimes appears impossible, unrealistic, and undesirable. I will describe how professionals deal with these tensions in a creative and dynamic way. With my articulation of the assumptions of goal setting, I hope to contribute to the self-reflection of rehabilitation practitioners as well as to theoretical discussions of goal setting in contexts other than rehabilitation. (shrink)

Sports occupy an interesting ethical space from a pedagogic point of view, being included in physical education curricula in most Western countries. The approach of physical education to sports as vehicle for ethical education is too limited when it is restricted to their minimal functional, constitutive and regulatory goals. This essay’s aim is to argue the extent to which the ethical potential of physical education can embrace more than functional purposes, or whether that will be (...) neglected in terms of limited educational aspirations. We present data from nineteen exploratory interviews with experienced philosophy, sports and physical education researchers and teachers, from six different nations, concerning the ethical potentiality of physical education. We highlight five ethical themes: (i) the regulatory and normative structure of sports; (ii) the spirit of sports and its internal values; (iii) the right playing/doing of sports; (iv) the overcoming in sports; and (v) sports as an opportunity for a supererogatory ethics as fertile ground for future operationalization of the potential of physical education for ethical education through sports.El deporte ocupa un interesante espacio ético desde un punto de vista pedagógico, integrándose en los curricula de educación física en la mayoría de países occidentales. El planteamiento de la educación física como vehículo de la educación ética es limitado cuando restringido a sus objetivos mínimos funcionales, constitutivos y regulatorios. El objetivo de este estudio es discutir si el potencial ético de la educación física puede ir más allá de los propósitos funcionales, que considerados aisladamente constituyen un desperdicio de la experiencia pedagógica del deporte. Para conseguirlo, presentamos datos de diecinueve entrevistas exploratorias con experimentados investigadores y profesores de filosofía, deporte y educación física relacionadas con las potencialidades éticas de la educación física. La muestra incluye individuos de seis diferentes nacionalidades, cuyo trabajo demuestra preocupaciones con el tema. La argumentación resulta de cinco temáticas principales: (i) Estructura normativa y regulativa del deporte; (ii) El espírito del deporte y sus valores internos; (iii) El bien hacer deportivo; (iv) La superación deportiva; (v) El deporte como oportunidad de una ética supererogatoria como contexto fértil para la concretización del potencial ético de una educación deportiva. (shrink)

The standard therapy/enhancement distinction is usually related to health purposes and some sense of normality. In this paper, I will challenge the basis of the distinction arguing that only the first part of it is related to health and, consequently, the distinction should be better understood as differentiating between qualitative and quantitative consequences of interventions. As health and normality are broad concepts inside of which it is possible to make some ulterior distinctions, I will propose three different senses of (...) normality in order to more easily grasp the therapy/enhancement distinction. As with the distinction between therapy and enhancement, the difference between sports- and non-sports-persons is usually stated in terms of health and normality. I will challenge this assumption, too. In my opinion, the main difference between people, sportspeople and athletes should be related to the practice itself. Once the practice of a sport is taken seriously, along with its tough and demanding life... (shrink)

The author explains various types of rehabilitation in medical therapeutic praxis. Therewith he underlines the importance of the individual story and narrative interpretation of personal biography, especially in case of psychical illness and old-age. For this the study gives references to the »ars-moriendi« Iiterature and questions about her ethical implications for therapy. 285.

The debate about health insurance coverage and the related issue of unequal access to health care turn on fundamental questions of justice, but for an individual patient like DM, the abstract question about who is deserving of health insurance becomes a very concrete problem that has a profound impact on care and livelihood. DM's circumstances left him stuck in the hospital. A satisfactory discharge plan remained elusive; his insurance coverage severely limited the number and type of facilities that would accept (...) him; and his inadequate engagement in his own rehabilitation process limited discharge options even further. Despite extensive involvement with the psychiatry, social work, physical therapy, and occupational therapy teams, DM consistently made “bad” decisions. He repeatedly refused antibiotics and did not consistently work with rehab services to improve his strength and mobility. Although the clinicians wanted to provide him with the best care possible, he often seemed unwilling to do the things necessary to achieve this care—or perhaps his depression rendered him unable to do so. He also tended to take out his frustration on staff members caring for him. All of this was, in turn, very frustrating for the staff. It may be easy, however, to make too much of DM's role, to see his choices as more important than his circumstances. A major goal of the ethics consultants was to reframe DM's predicament for the staff members involved in his care. (shrink)

Rehabilitation mobility has become a new demand and travel mode for people to pursue active health. A large number of tourists choose to escape the cold in warm places to improve their health every winter. In this study, we collected the health index data of Seasonal Affective Disorder tourists from western China before and after their cold escape in Hainan Island in winter, aiming to compare whether rehabilitating cold escape can improve the Quality of Life of SAD tourists by (...) hierarchical analysis. Compared with previous studies, this paper has the following contributions: Firstly, the study samples were accurately screened according to the pathogenesis of SAD tourists and the confounding factors were strictly controlled; Secondly, the observational experimental method was used to conduct inter-group and intra-group control studies on 695 samples, and the results were more objective and reliable. Thirdly, the effect of treatment on the quality of life of 397 tourists in the rehabilitation mobility group was quantitatively evaluated from three factors including age, gender and sunshine exposure level by multivariate analysis of variance. Research results show that the rehabilitation environment brought by rehabilitation activities can help improve the health status of tourists. Therefore, this paper proposes the concept of “Tourism Therapy” and constructs a theoretical framework. The conclusion of this paper provides a scientific basis and reference for the study of tourism healing as a non-medical alternative therapy. (shrink)

The implications for the substantivalist–relationalist controversy of Barbour and Bertotti's successful implementation of a Machian approach to dynamics are investigated. It is argued that in the context of Newtonian mechanics, the Machian framework provides a genuinely relational interpretation of dynamics and that it is more explanatory than the conventional, substantival interpretation. In a companion paper (Pooley [2002a]), the viability of the Machian framework as an interpretation of relativistic physics is explored. 1 Introduction 2 Newton versus Leibniz 3 Absolute space versus (...) an affine connection 4 Anti-relationalist arguments 5 Rehabilitating relationalism 6 Dynamics on the relative configuration space 7 Intrinsic particle dynamics 8 Conclusion. (shrink)

The article attempts to show some limitations to reductive accounts in science and philosophy of body-mind relations, experience and skill. Extensive literature has developed in analytic philosophy of mind recently due to new technology and theories in the neurosciences. In the sporting sciences, there are also attempts to reduce experiences and skills to biology, mechanics, chemistry and physiology. The article argues there are three fundamental problems for reductive accounts that lead to an explanatory gap between the reduction and the conscious (...) experience. First, reductive accounts deal with objective observations; conscious experiences are subjective. Second, subjective experience seems difficult to identify with physical events described by chemistry, biology, mechanics or neurophysiology. Finally, sport involves knowing how and knowing how is also difficult to reduce to propositional knowledge, which is the reductive scientific/philosophical project. The article argues that sport provides an excellent platform to better understand what is wrong with reductive analysis in body-mind relations, since both conscious experience and knowing how are fundamental to sport performance. (shrink)

This article is written from the perspective of Josef Šmajs’ evolutionary ontology and considers physical activity in humans. It focuses in detail on a particular form—physical exercise. In the author’s opinion, current physical exercise (sport activity) and any other human form of activity is part of the internal autopoietic processes of the sociocultural system, which displays an ever-increasingly destructive tendency towards its natural environment—towards the host system of the biosphere. The author attempts to establish the degree and (...) manner to which the anti-nature activity of physical exercise varies, but also seeks to point out how they contribute to a potential biophilic transformation of culture. (shrink)

In this paper I address the topic of sport records and concentrate on the ontology of sport records. I argue that sport records are social facts in the sense that sport records not only depend on the physical facts of sport competitions, but also on the attitude we take towards the phenomenon—our attitude is partly constitutive of the phenomenon of sport records. In particular, the Mieto–Wassberg incident and the Larsson–McKee incident show that performance records should also be regarded as (...) social facts. Lastly, I show how my view sits with the view that sports are response-sensitive. I argue that the latter gives us further reason to believe that sport records, in particular performance records, are social facts. (shrink)

IntroductionThere is a need to maintain rehabilitation activities and motivate movement and physical activity during quarantine in individuals with Cerebral Palsy.ObjectiveThis paper sets out to evaluate the feasibility and potential benefits of using computer serious game in a non-immersive virtual reality implemented and evaluated completely remotely in participants with CP for Home-Based Telerehabilitation during the quarantine period for COVID-19.MethodsUsing a cross-sectional design, a total of 44 individuals participated in this study between March and June 2020, 22 of which (...) had CP and 22 typically developing individuals, matched by age and sex to the individuals with CP. Participants practiced a coincident timing game1 and we measured movement performance and physical activity intensity using the rating of perceived exertion Borg scale.ResultsAll participants were able to engage with the VR therapy remotely, reported enjoying sessions, and improved performance in some practice moments. The most important result in this cross-sectional study was the significant increasing in rating of perceived exertion in both groups during practice and with CP presenting a higher rating of perceived exertion.ConclusionChildren with CP enjoyed participating, were able to perform at the same level as their peers on certain activities and increased both their performance and physical activity intensity when using the game, supporting the use of serious games for this group for home therapy and interactive games.Clinical Trials Registrationhttps://Clinicaltrials.gov, NCT04402034. Registered on May 20, 2020. (shrink)

Considering the abysmal track record of orthodox drug rehabilitation programs, whereby a ten percent abstinence rate after one year of treatment is regarded as successful, a responsible introduction to viable alternative methodologies brings hope and promise along with new insight and information. Medical anthropologist H. K. Heggenhougen reviews the growing body of literature that describes and assesses traditional interventions rooted in other cultures , as well as therapies advanced through alternative achievements like acupuncture, biofeedback, and meditation. Besides exploring their (...) salient features and evaluating their efficacy, Dr. Heggenhougen comments authoritatively on their transferability to conventional American and European addiction programs, and supplies an annotated bibliography for use as an independent resource by theoreticians and practitioners in the fields of detoxification and rehabilitation. Exposure to the cross-cultural perspective, replete with potential for creative adaptation, enriches our understanding as it expands exponentially our repertoire of treatment options. (shrink)

My perspective in this paper is to look at sport and other physical activities as a way of exploring and experimenting with the environing world. The human being is basically the homo movens – born...

The conclusion of this paper will be that e-sports are not sports. I begin by offering a stipulation and a definition. I stipulate that what I have in mind, when thinking about the concept of sport, is ‘Olympic’ sport. And I define an Olympic Sport as an institutionalised, rule-governed contest of human physical skill. The justification for the stipulation lies partly in that it is uncontroversial. Whatever else people might think of as sport, no-one denies that Olympic (...) Sport is sport. This seeks to ensure that those who might wish to dispute my conclusion might stay with the argument at least for as long as possible. Secondly, the justification for the stipulation lies partly in its normativity—I have chosen an Olympic conception of sport just because it seems to me to offer some kind of desirable version of what sport is and might become. Thirdly, I give examples which show how prominent promoters of e-sports agree with my stipulation, as evidenced by their strenuous attempts to comply with it i... (shrink)

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the (...) brain — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation. (shrink)

Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. Virtual Reality (VR) based methods for stroke rehabilitation have mainly focused on motor rehabilitation but there is increasing interest toward the integration of cognitive training for providing more effective solutions. Here we investigate the feasibility for stroke recovery of a virtual cognitive-motor task, the Reh@Task, which combines adapted arm reaching, and attention and (...) memory training. 24 participants in the chronic stage of stroke, with cognitive and motor deficits, were allocated to one of two groups (VR, Control). Both groups were enrolled in conventional occupational therapy, which mostly involves motor training. Additionally, the VR group underwent training with the Reh@Task and the control group performed time-matched conventional occupational therapy. Motor and cognitive competences were assessed at baseline, end of treatment (1 month) and at a 1-month follow-up through the Montreal Cognitive Assessment, Single Letter Cancelation, Digit Cancelation, Bells Test, Fugl-Meyer Assessment Test, Chedoke Arm and Hand Activity Inventory, Modified Ashworth Scale, and Barthel Index. Our results show that both groups improved in motor function over time, but the Reh@Task group displayed significantly higher between-group outcomes in the arm subpart of the Fugl-Meyer Assessment Test. Improvements in cognitive function were significant and similar in both groups. Overall, these results are supportive of the viability of VR tools that combine motor and cognitive training, such as the Reh@Task. Trial Registration: This trial was not registered because it is a small clinical study that addresses the feasibility of a prototype device. (shrink)

By now, the laboratory tradition, crafting transportable knowledge that allows for comparison, has been amply studied. However, other knowledge traditions, notably that of the clinic, deserve further articulation. The authors contribute to this by unraveling some specificities of rehabilitation practice. How do laboratory and clinical traditions in rehabilitation relate to independence? The first seeks to quantify people's independence; the latter attends to qualitatively different ways of being independent. While measuring independence is a matter of aggregating scores on a (...) priori established dimensions, clinical rehabilitation concerns coordinating different ways of being independent. While independence scales map a linear development in time, rehabilitation participants juggle with time, including uncertain futures in their present. In clinical practice, then, independence is neither a single, coherent, fact nor a clear-cut, stable goal. Instead, professionals as well as patients work by creatively doctoring with the large variety of elements that are relevant to daily life with long-term disabilities. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed (...) by a critical assessment of some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

Die wissenschaftliche Auseinandersetzung mit ökologischen Problemen beim Sporttreiben ist weitgehend noch Neuland. Der vorliegende interdisziplinäre Sammelband greift die Diskussion um sportpädagogische und sportpraktische Lösungsansätze auf. Er fragt nach den spezifischen ökologischen Problemen des Breitensports und nach den Konsequenzen, die aus ökologisch unverträglichen Sportentwicklungen für die Sportpädagogik und die Sportlehrer-Ausbildung zu ziehen sind. Ein weiterer Schwerpunkt liegt auf dem Thema Sport und Gesundheit. Dabei kommen vor allem die präventiven und rehabilitativen Wirkungen gesundheits- und naturbewussten Sporttreibens in den Blick. Abschliessend werden die (...) besondere Stellung und Aufgabe des Hochschulsports, seine ökologischen Herausforderungen und seine Bedeutung für die Bewältigung des Lebens- und Berufsalltags thematisiert. (shrink)

@FP= Although rehabilitation is often considered a type of punishment for criminal offenders, its objectives are therapeutic rather than punitive. While some theories of punishment claim that criminals deserve to suffer for their crimes, the rehabilitative ideal views criminal behavior more like a disease that should be treated with scientific methods available to cure the offender. Many convicts suffer from mental and physical illness, drug addiction, and limited opportunities for economic success and these problems increase the likelihood that (...) they will engage in criminal activity. If we simply incarcerate the convict while she “pays her debt to society,” she will likely reenter it with all of the obstacles that drove her to crime still in place. She will also need to contend with additional difficulties: a criminal record will impact her employment opportunities, she will be older and still without marketable skills or education, her social relationships may have deteriorated while she was in jail, and she may have become further acclimated to criminal culture. Thus incarcerating offenders could actually make them more likely to commit offenses after they are released, and recidivism rates attest to this. A rehabilitative approach would attempt to treat the underlying cause of her transgressions so that she can return to society to become a full and productive citizen. In other words, instead of exacting revenge against criminals and making their lives worse, rehabilitation tries to help them. (shrink)