RESUMO
Purpose: For children with blindness and visual impairment (BVI) of all ages, disability sport and/or regular Physical Activity (PA) are deemed beneficial, promoting physical and mental health as well as increasing wellbeing and life satisfaction. In this regard, Physical Education (PE) serves as a foundation to regular and lifelong participation in PA, mainstream and/or disability sport. Research points towards manifold participation barriers for children with BVI in PE, which so far have mainly been investigated in inclusive settings and from the perspectives of sighted parents, teachers and peers. Consequently, people with BVI frequently consider PE a missed opportunity for lifelong PA. As transitioning from general to special schooling deems the only alternative to continue their education, questions arise in how far and in which ways specialized schools manage to accommodate their needs in PE. To address these gaps in literature, we investigated BVI students' perceived opportunities and barriers to participation in PE within a specialized school setting and their imaginations for possible (digital) improvements and solutions. Materials and methods: Within the framework of Inclusive and Youth Participatory Action Research, we adopted the Mosaic Approach to investigate a sample of 19 students aged 14-20 at lower and upper secondary level in a specialized school in Austria. Data material included audio-recordings of interviews, student-guided school tours, photographs of significant places and objects and field protocols. The analysis was conducted with Interpretative Phenomenological Analysis. Results and conclusion: Through the analysis, we identified three themes. The data material firstly revealed the complex intricacies of how PE teachers can act as facilitators and gatekeepers to autonomous PA. Secondly, material norms function not only as barriers to participation even in a specialized school setting, but also constitute the basis for social hierarchies between students with various degrees of visual impairment. Thirdly, students imagined manifold digital solutions to enhance participation derived from their perceived barriers. The findings contribute to amplifying BVI individuals' voices and provide revealing insights in how participation in PA is enabled and prohibited for students with BVI which can not only help to improve specialized but also inclusive settings.
RESUMO
BACKGROUND: We compare the clinical and radiographic outcomes of the interdigital approach vs the medial transarticular approach for lateral release combined with scarf osteotomy. METHODS: Seventy-seven feet with moderate to severe hallux valgus underwent scarf osteotomy and lateral soft tissue release, using an interdigital approach (n = 36) vs medial transarticular approach (n = 41). The clinical measurements (range of motion, American Orthopaedic Foot & Ankle Society [AOFAS] score) and radiographic data were evaluated preoperatively and at final follow-up (93-124 months postoperatively). Additionally, the numeric pain rating scale and Foot and Ankle Outcome score [FAOS] were assessed postoperatively. RESULTS: The AOFAS score improved from 60 (q1 = 54, q3 = 70) to 93 (q1 = 85, q3 = 98) in the transarticular group, and from 59 (q1 = 50, q3 = 64) to 95 (q1 = 85, q3 = 100) in the interdigital group. The hallux valgus angle improved from 35.7±6.5 degrees to 15.5±7.6 degrees in the transarticular group, and from 36.0±6.8 degrees to 12.9±13.0 degrees in the interdigital group. The intermetatarsal angle improved from 16.5±2.5 degrees to 6.5±2.7 degrees within the transarticular group and from 17.2±2.5 degrees to 7.3±4.3 degrees in the interdigital group. None of the clinical or radiographic parameters showed any significant differences between the treatment groups. CONCLUSION: Comparison of outcomes between the interdigital approach and the transarticular approach for lateral soft-tissue release with scarf osteotomy are equally successful. The transarticular approach can thus be considered safe and effective, with the additional benefits of just one scar as opposed to 2. LEVEL OF EVIDENCE: Level III, therapeutic.