RESUMEN
Hand function is important in every aspect of our lives. Across a wide range of neuromuscular disorders-inherited ataxias, motor neuron diseases, polyneuropathies, and myopathies-people can experience losses in hand strength, tone, movement, dexterity, joint range, and sensation. Such changes can adversely affect function and independence in daily activities, reducing participation and quality of life. People with neuromuscular disorders (pwNMD) known to involve the hand should be assessed at regular intervals for changes both clinically and using impairment, performance, function, and patient-reported outcome measures as appropriate. A patient-centered approach to management is recommended, with clinicians partnering with the individual, their caregivers and the interprofessional teams to create personalized solutions that can overcome barriers to participation and best meet the goals of individuals affected by neuromuscular disorders. Management strategies should be multifaceted, and may include exercise, orthoses, assistive devices, technological solutions, environmental or task adaptations, medications, and/or surgery. Exercise recommendations and orthoses should be individualized and evolve based on disease progression, impairments, and functional limitations. While medications and surgery have a small role for specific clinical situations, there is a plethora of assistive and technological solutions to assist with basic and instrumental activities of daily living, work/education, and leisure for pwNMD with reduced hand function. In addition, clinicians should advocate for appropriate accommodations for reduced hand function at work/school, and the development of and adherence to legislation supporting accessibility and inclusion.
RESUMEN
Introduction: As individuals with occupational status and power, sport leaders (e.g., coaches and athletic administrators) are responsible for enforcing cultures of inclusion within institutions of athletics. Yet, sport leaders who possess LGBTQ+ sexual identities are frequently marginalized and stigmatized by entities within and outside of athletics (e.g., athletes, parents of athletes, colleagues). Therefore, LGBTQ+ sport leaders are often faced with a challenging set of circumstances: negotiate the authenticity of their sexual orientation in the context of sport, or leave the profession entirely. Methods: The purpose of this study was to conduct a systematic review of research related to LGBTQ+ sport leader experiences. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), research across six countries (China/Taiwan/Hong Kong, Italy, New Zealand, Norway, United Kingdom, United States) between 1997 and 2021 was analyzed. Results: Themes across included studies (N = 34) describe intrapersonal experiences of LGBTQ+ sport leaders, interpersonal studies examining stakeholder attitudes (i.e., parents and athletes) toward LGBTQ+ sport leaders, and sport manager attitudes toward LGBTQ+ topics. Discussion: Findings convey that sport leaders continue to face marginalization due to the presence of heterosexism and heteronormativity in athletics. Future research should continue to explore LGBTQ+ sport leader experiences, behaviors, attitudes, and identities to determine their impact on fostering inclusion and belonging within athletic spaces.