Loneliness and Coping Styles Among Athletes With Disabilities During the COVID-19 Pandemic.

The study aimed to assess loneliness experiences among athletes with disabilities (AWD) during the different phases of the pandemic and to understand its relationship with coping styles. Ninety-one AWD participated in a longitudinal study spanning 10 months, covering three time points: April (A), June (Time B), and November (Time C) 2021. The study used the Coping Inventory for Stressful Situations and the revised University of California Los Angeles Loneliness Scale-Revised (UCLA-R) to measure coping mechanisms and feelings of loneliness, respectively. Loneliness levels peaked during the most intense phase of the pandemic, showing significant differences between consecutive time points (χ2 = 20.29, p < 0.001, d = 0.24). The most robust regression models were built in Time B, using the "intimate contacts" dimension of loneliness as the dependent variable and "emotion-oriented coping", "avoidance-oriented coping", and "impairment" as independent variables, explaining 44% of the variance (p < 0.001). Loneliness among Paralympic athletes fluctuated during various phases of the pandemic. The findings highlight the significant influence of coping styles, particularly emotional styles which heightened perceived loneliness, and task-oriented styles which reduced it, on athletes' experiences of loneliness. These results underscore the need for longitudinal studies to delve deeper into the relationship between loneliness and mental health. Moreover, they stress the importance of developing tailored interventions that promote effective coping mechanisms in AWD during challenging times amid to COIVID-19.

The usefulness of balance test in preseason evaluation of injuries in amputee football players: a pilot prospective observational study.

Background: Low balance ability is generally associated with an increased risk of ligament injuries. It seems that assessing the level of stability in amputee football players can help evaluate the accompanying risk of sports injuries. Thus, the study aimed to examine the usefulness of the balance test in preseason evaluation by calculating between-group differences in stability parameters between injured and non-injured amputee players. Methods: The study was designed as a pilot prospective observational study. Twenty-five elite amputee football players representing the Polish National Team and the highest division in Polish League completed one-leg preseason balance tests on the Biodex Balance System before the start of the football season. All players in this study were male, with an average age of 29 years (SD = 7.9), a stature of 174.2 cm (SD 5.2) and a body mass of 80.1 kg (SD = 13.1). Then, players were prospectively observed over one football season, and lower leg injury data were prospectively collected through the nine months. The between-group differences were tested using the non-parametric Mann-Whitney U test for players who sustained an injury (yes) and those who did not within the analysed season (no). Overall (OSI), medial-lateral (MLSI), and anterior-posterior stability index (APSI) were analysed as primary outcomes. Results: The preseason values of the balance tests were not predictive (p > 0.05) regarding sustaining an injury during the season. No between-group differences were noted for any analysed outcomes (p values ranged from 0.093 to 0.453). Conclusions: Although static balance tasks offer a chance to make a preliminary assessment of injury prediction in amputee footballers, in overall, the balance test results cannot be regarded as the sole predictive injury risk factor in amputee football.

Pandemic-specific coping, anxiety, and depression across multiple waves of COVID-19 in elite athletes with disabilities.

Objectives: Competitive athletes have faced many of the same mental health challenges experienced by the general population during the COVID-19 pandemic. The purpose of the current study was to examine the extent to which pandemic-specific coping predicted anxiety and depression over and above general coping styles in elite athletes with disabilities across multiple waves of the COVID-19 pandemic. Methods: Participants were 91 athletes (60 men and 31 women) in the Polish Paralympic Preparation Program before the 2020 Tokyo Summer Paralympic Games and 2022 Beijing Winter Paralympic Games. The Coping Inventory for Stressful Situations and an open-ended item asking participants to describe coping resources they had used to overcome stressful situations caused by the pandemic were administered in April 2021, and the Hospital Anxiety and Depression Scale was administered in April, July, and November of 2021. Results: General coping styles were not significantly associated with pandemic-specific coping, anxiety, or depression in the July and November 2021 assessments. Pandemic-specific coping was related prospectively to both anxiety and depression across the July and November 2021 assessments when controlling for age, gender, general coping styles, and April 2021 anxiety and depression, respectively. Conclusion: The findings suggest that elite athletes with disabilities may cope with pandemic-related stress differently from how they cope with stress in general and that pandemic-specific coping may be relevant to mental health outcomes during the COVID-19 pandemic. This information may be useful in the development of interventions to assist elite athletes with disabilities cope with pandemics and other atypical stressors.

Relationship between secondary health conditions and life satisfaction in persons with spinal cord injury: study across twenty-one countries.

PURPOSE: To determine the relationships between impact of secondary health conditions (SHCs), treatment of SHCs, and life satisfaction (LS) following spinal cord injury (SCI) across 21 countries. Hypotheses were as follows: (1) Persons with SCI and fewer SHCs report higher LS and (2) Persons who receive treatment for SHCs report higher LS than those who do not receive treatment. METHODS: Cross-sectional survey, including 10,499 persons with traumatic or non-traumatic SCI aged 18 years or older and living in the community. To assess SHCs, 14 items adapted from the SCI-Secondary Conditions Scale were used (range 1-5). SHCs index was calculated as the mean of all 14 items. LS was assessed using a selection of 5 items from the World Health Organization Quality of Life Assessment. LS index was calculated as the mean of these 5 items. RESULTS: South Korea, Germany, and Poland exhibited the highest (2.40-2.93) and Brazil, China, and Thailand the lowest (1.79-1.90) impact of SHCs. Indexes for LS and SHCs were inversely correlated (- 0.418; p < 0.001). Mixed Model Analysis showed that the fixed effect (key predictors of the study) of SHCs index (p < 0.001) and the positive interaction between SHCs index and treatment (p = 0.002) were significant determinants of LS. CONCLUSION: Persons with SCI across the world are more likely to perceive better LS if they experience fewer SHCs and receive treatment for SHCs, in comparison to those who do not. Prevention and treatment of SHCs following SCI should be a high priority in order to improve the lived experience and enhance LS.

One World Project's Wheelchair Skills Training Camp in Morocco - effects of a community peer-based programme.

PURPOSE: The aim of this study was to assess wheelchair skills of persons with physical disabilities who attended the first Wheelchair Skills and Empowerment Camp in Morocco and their satisfaction with manual wheelchairs provided for the camp activities. MATERIALS AND METHODS: 19 persons (13 male and 6 female) with physical disabilities took part in the project. The average time since injury or illness was 24 years. To assess wheelchair skills/user satisfaction, the researchers used the Queensland Evaluation of Wheelchair Skills test and the Quebec User Evaluation of Satisfaction with assistive Technology. RESULTS: Study participants improved their overall wheelchair mobility skills (p = 0.002; d = 0.20), especially their ability to ascend and descend a ramp (p = 0.012; d = 0.67). The participants reported significantly greater satisfaction with the new provided wheelchairs in comparison to their own wheelchairs in regard to five satisfaction items; i.e., ease in adjusting (p = 0.011; d = 0.96), safety and security (p = 0.014; d = 0.97), durability (p = 0.037; d = 0.81), ease to use (p = 0.045; d = 0.87), and comfort (p = 0.006; d = 1.03). CONCLUSIONS: Findings of this study indicate that persons with physical disabilities in Morocco need structured training in wheelchair skills and better-quality wheelchairs. The study also confirmed that community peer-based programmes in low-resource countries can play a significant role in rehabilitation of persons with physical disabilities, even many years after their injury or illness.IMPLICATIONS FOR REHABILITATIONThe One World project educated local persons with disabilities and government officials about the need for buying appropriate wheelchairs and for providing them according to the World Health Organization guidelines.19 persons who use wheelchairs participated in 6-days of wheelchair skills training sessions, which were led by three peer mentors who use a wheelchair: two with spinal cord injury, and one with polio complications.The 19 participants, who had lived with their disabilities on average for 24 years, advanced their general wheelchair mobility skills, which was assessed through a practical test.The results confirmed that community peer-based programmes in low-resource countries are important for improving wheelchair skills not only when beginning rehabilitation but even after individuals live many years with a disability.

Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review protocol.

PURPOSE: Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries. METHODS: This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized. IMPLICATIONS AND DISSEMINATION: The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators' Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal.Implications for RehabilitationA comprehensive examination of wheelchair service provision education could help develop strategies to address the unmet need for wheelchair services globally.Findings for this review will facilitate the planning and development of an evidence-based education package that could bridge the existing knowledge gaps related to safe and effective wheelchair service provision among health professionals involved.This review will also inform the potential barriers and enablers for effective integration and implementation of wheelchair service provision education worldwide.

Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review.

PURPOSE: This review aimed to collate and summarize available research literature about wheelchair service provision education available to healthcare professional students, healthcare personnel and educators across low- to high-resourced settings. METHODS: The Joanna Briggs Institute methodological steps for scoping reviews were followed. Included studies were mainly sourced from Medline, Embase, CINAHL, Scopus, Academic Search Complete and ProQuest. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. All screening and extraction were performed independently by two authors. A thematic approach was used to synthesize results. Data extracted from included studies were charted according to a template that we created. The study quality was also appraised. RESULTS: A total of 25 articles were included (11, 36% from high-income settings) with 12 (48%) observational studies and 13 (52%) experimental studies. The literature addressed three main topics: (1) assessing wheelchair service provision knowledge, (2) implementing training interventions using in-person, online and/or hybrid learning approaches and (3) describing current wheelchair service provision education globally. The most frequently reported training programs used were the Wheelchair Skills Program and the World Health Organization Wheelchair Service Training Package - Basic Level. CONCLUSION: Limited information has been published about the integration of wheelchair content into the curricula of professional rehabilitation programs. Efforts to build international partnerships, improve the quality and currency of training programs and build resources that can assist educators in the integration of wheelchair-related content into professional rehabilitation programs should be prioritized.Implications for RehabilitationThis is the first review that examined and synthesized the current state of wheelchair service provision education for rehabilitation students and personnel across low- to high-income countries.Findings from this review indicate that there is limited information about the integration of wheelchair-related content into professional rehabilitation programs.Efforts to build international partnerships, standardize wheelchair service provision content and evaluation and integrate training into professional rehabilitation programs worldwide should be prioritized.

Coping with the COVID-19 pandemic by Paralympic athletes preparing for elite sport events: A longitudinal study.

INTRODUCTION: This study investigates the impact of the COVID-19 pandemic on mental health, coping styles and their relationship, and training opportunities in elite athletes with disabilities (AwD) preparing for national and international sport events during a ten-month observation period. METHODS: The study covered four time points in 3-month intervals, one retrospective, and three times during the 10 months of the pandemic period with diversified numbers of average new infections per day: A-pre-pandemic, B-third wave of the pandemic (mean = 15 681), C-decrease of the pandemic (mean = 102), and D-fourth wave of the pandemic (mean = 22 591). Main outcome measures included the Coping Inventory for Stressful Situations and the Hospital Anxiety and Depression Scale. RESULTS: The models regarding changes in anxiety (F(3,72)  = 22.43; p < 0.001; partial η2 = 0.48) and depression (F(3,72)  = 23.82; p < 0.001; partial η2  = 0.50) over the four time points of examination were significant. The pattern of relationship between coping styles and mood changes during COVID-19 pandemic periods, that is, a sudden increase in anxiety during dynamic growth of infections (waves of a pandemic) and a steady increase in depression over the course of the pandemic was not found. The difference in planned and actual training decreased significantly over time (p < 0.001). CONCLUSIONS: During the transitionary times of the COVID-19 pandemic, both mental health and training opportunities of AwD were at increased risk. Individual coping styles used by AwD were insufficient resources to cope with the extreme stress caused by the COVID-19 pandemic. Their mental health should be monitored in pandemics and similar situations to ensure appropriate and timely organizational and psychological intervention.

Sports Injuries Among Players of The Polish National Team in Amputee Football in The Annual Training Cycle.

The aim of the study was to determine the frequency, type and origin of the occurrence of injuries in amputee football. The studied group comprised all members of the Polish national amputee football team (n = 25). During the 9-month observation period, 13 players incurred 22 injuries. The incidence proportion was 48.0 per 100 athletes (95% Cl, 28.4-67.6) and the incidence rate was 5.73 per 1000 athlete-days (95% Cl, 3.33-8.12). The study showed that 32.8% of the injuries were to the thigh, 13.6% to the ankle, and 9.1% to the knee. The obtained results indicate that amputee football players rather frequently incur play-related injuries, but a single athlete incurs relatively few of them, with the lower limb being most commonly injured.

Mental Health Status of People with Multiple Sclerosis during the COVID-19 Pandemic.

OBJECTIVE: This study assesses and compares the mental health status of people with multiple sclerosis (PwMS) in Poland during the second wave of the Coronavirus Disease 2019 (COVID-19) pandemic (November 2020) to a similar group whose mental health status was examined in November 2017. It also analyzed the psychological resources such as self-efficacy and health locus of control (HLC) and their relationship to mental health in both groups. METHODS: Cross-sectional study included two groups of PwMS with 113 respondents each. The respondents completed the General Health Questionnaire-12 and questionnaires for assessing self-efficacy and HLC. The clinical and demographic data of participants were also collected. RESULTS: No differences in mental health status were observed between the studied groups. A hierarchical regression model of the group studied in 2020 revealed that general self-efficacy (ß = -0.21, p = 0.032), HLC-internal (ß = -0.21, p = 0.035), and education (ß = -0.18, p = 0.048) explained 18% of the variance in the mental health of PwMS, whereas according to the model of the group assessed in 2017 self-efficacy (ß = -0.31, p < 0.001), HLC-chance (ß = 0.45, p < 0.001), and HLC-internal (ß = -0.37, p < 0.001) explained 48% of the variance. CONCLUSIONS: Study results suggest that the pandemic and the related lockdown had no effect on the mental health status of PwMS. At the same time, it was noted that well known determinants of mental health such as self-efficacy and HLC seemed to retain their prominent role for mental functioning in the pandemic.

Comparison of Life Satisfaction in Persons With Spinal Cord Injury Living in 22 Countries With Different Economic Status.

OBJECTIVE: To analyze and compare life satisfaction (LS) in persons with spinal cord injury (SCI) living in 22 countries participating in the International Spinal Cord Injury (InSCI) community survey. The study tested the hypothesis that there are differences in LS across InSCI countries according to the countries' economic status specified as gross domestic product per capita purchased power parity (GDP-PPP). DESIGN: Cross-sectional survey. SETTING: Community setting (22 countries representing all 6 World Health Organization regions). PARTICIPANTS: Persons (N=12,108) with traumatic or nontraumatic SCI aged at least 18 years, living in the community and able to respond to one of the available language versions of the questionnaire. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: LS measured by 5 items selected from the World Health Organization Quality of Life Assessment-BREF: satisfaction with overall quality of life, health, daily activities, relationships, and living conditions. LS index was calculated as the mean of these 5 items. RESULTS: The highest level of LS was reported by persons with SCI living in the United States, Malaysia, and Switzerland (mean range, 3.76-3.80), and the lowest was reported by persons with SCI living in South Korea, Japan, and Morocco (mean range, 2.81-3.16). There was a significant cubic association between LS index and GDP-PPP. Regression tree analysis revealed the main variables differentiating LS index were GDP-PPP and monthly income, followed by time since injury and education. CONCLUSIONS: Life satisfaction reported by persons with SCI related mainly to their country economic situation expressed by GDP-PPP and monthly income. The results of this study underscore the need for policy dialogues to avoid inequalities and improve the life experience in persons with SCI.

Impact of COVID-19 pandemic on athletes with disabilities preparing for the Paralympic Games in Tokyo.

OBJECTIVE: The main aim of the study was to assess the impact of COVID-19 pandemic on athletes preparing for the Tokyo 2021 Paralympic Games during 1 month of lockdown in Poland. The study involved 166 athletes (106 male, 66 female), members of either the Polish Paralympic Committee or the Polish Sports Association for the Disabled'Start', two organizations responsible for managing and regulating sports played by persons with disabilities in Poland. RESULTS: Athletes with disabilities have been strongly affected by the pandemic and the resultant lockdown. The majority of respondents reported that they trained at home (88.6%), whereas 60.2% of athletes trained outdoors, and 12% suspended their training regimens altogether. Only 5.4% of athletes had some access to sport facilities. The athletes reduced their weekly training time by almost half (9.4 h/week vs. 5.3 h/week), a statistically significant difference (t = 16.261, p < 0.001).

Leisure time physical activity in persons with spinal cord injury across the seasons.

OBJECTIVES: The main goal of this study was to assess the level of leisure-time physical activity (LTPA) and its differentiation across the seasons among persons with spinal cord injury (SCI). The additional aim was to determine whether socio-demographical, injury, and seasonal factors are determinants of LTPA. METHODS: This study included 51 adults with SCI, who completed the LTPA questionnaire for persons with SCI during a calendar year in the middle of four seasons, and demographic questionnaire. A multiple regression analysis was used to examine the role of socio-demographical, injury, and seasonal variables, as determinants of LTPA. RESULTS: The levels of LTPA were differentiated throughout the seasons. Three models containing variables related to LTPA were created. All models were significant, for mild LTPA (F = 10.01, r 2 = 0.21), moderate LTPA (F = 5.24, r 2 = 0.9), and heavy LTPA (F = 7.09, r 2 = 0.6). Age at the time of study, lack of employment, tetraplegia, and shorter time since injury were significantly, negatively associated with LTPA. CONCLUSION: LTPA in persons with SCI differs significantly in relation to the seasons throughout a year. The season of the year should be considered in future studies and interventions on LTPA in adults with SCI.

Life satisfaction in persons with spinal cord injury across the seasons.

STUDY DESIGN: Longitudinal study. OBJECTIVES: This study aimed to examine level and variations of life satisfaction (LS) across the seasons in persons with spinal cord injury (SCI). SETTING: Polish sample of persons with SCI. METHODS: The study included 56 persons with SCI, who repeatedly completed the Life Satisfaction Questionnaire (LiSaT-9), and a study-specific questionnaire across the four seasons in a calendar year. Mixed model analyses were performed to: (1) examine seasonal changes in LS; (2) explore the possible moderating factors on seasonal changes in LS. RESULTS: There were significant seasonal trends in overall and domain-specific LS scores; yet, these changes differed in terms of shape (i.e. linear vs. quadratic). In general, the highest LS scores occurred in spring across all domains, followed by a significant reduction in summer; yet, there were u-shape trends in LS domain scores for life as a whole, vocational, and financial situation and partner relations (P-for-quadratic trends ≤0.05). Five individual characteristics, i.e. place of living, education, gender, physical activity, and time since injury significantly moderated seasonal trends in LS scores (P's for interaction ≤ 0.05). CONCLUSION: Life satisfaction in persons with SCI differs significantly in relation to different seasons throughout a year. The season of the year should be considered in future studies on LS and included in evaluating and projecting healthcare interventions or programs for persons with SCI.

Psychological factors associated with self-management in multiple sclerosis.

OBJECTIVE: Patient's engagement in their own treatment has been shown to improve clinical outcomes. A better understanding of the association between self-management in multiple sclerosis (MS) and potentially modifiable psychological factors may provide clinicians with strategies to design and stimulate better patient activation for self-managing health. Therefore, in this study, we examined whether cognitive factors, namely self-efficacy, acceptance of illness, optimism, and health locus of control (HLC), are associated with self-management in MS. METHODS: This is a cross-sectional study. A total of 382 patients with MS who completed the MS Self-Management Scale-Revised and the questionnaires that measure self-efficacy, optimism, illness acceptance, and HLC were included in the study. RESULTS: A hierarchical multiple regression revealed that power of others' HLC (b = 0.42, P ≤ .001), optimism (b = 0.27, P ≤ .01), internal HLC (b = -0.11, P = .017), and self-efficacy (b = 0.11, P = .031), together with control variables (longer disease duration and higher disability), explained 30% of the variance in the dependent variable. CONCLUSIONS: In the case of MS, self-management is associated with patient's perception that healthcare professionals control their health, higher self-efficacy, optimism, and, surprisingly, lower internal HLC. The results of this study indicate the vital role of the healthcare staff in encouraging the patients with MS toward activities related to self-management and provide new insights on the psychological intervention aimed at improving self-management by patients.

INTERnational Project for the Evaluation of "activE Rehabilitation" (inter-PEER) - a protocol for a prospective cohort study of community peer-based training programmes for people with spinal cord injury.

BACKGROUND: Active Rehabilitation (AR) is a community peer-based concept for people with spinal cord injury (SCI) that is primarily delivered through brief residential training programmes. Despite a plethora of positive anecdotal evidence of AR programmes as life-changing experiences, the effects of AR-programmes have not been evaluated scientifically. Here, we present the protocol of the INTERnational Project for the Evaluation of "activE Rehabilitation" (inter-PEER) aiming to evaluate the effects of AR training programmes on community-dwelling individuals with SCI. METHODS: International prospective cohort study that recruits consecutive participants in AR training programmes. Evaluation is conducted through a web-based survey at 3 time-points: at the commencement and completion of the training programme, and 3 months after the end of the training programme. Evaluation also includes a practical wheelchair skills test at the first two time-points. The primary outcome measures are the Spinal Cord Independence Measure Self-report (SCIM-SR), the Queensland Evaluation of Wheelchair Skills test (QEWS), the Wheelchair Skills Test Questionnaire (WST-Q) and the Moorong Self-Efficacy Scale (MSES). The secondary outcome measures are the 11-item Life Satisfaction Questionnaire (LiSat-11), the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation), the Leisure Time Physical Activity Questionnaire for people with SCI (LTPAQ-SCI) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). We piloted the implementation of the protocol in Sweden in 7 participants with diverse SCI and sociodemographic characteristics and collected feedback from participants and peer-mentors about study procedures through interviews, a workshop and field observations. DISCUSSION: Inter-PEER is the first initiative to propose a systematic evaluation of the effects of AR training programmes among individuals with SCI. The project is a collaborative work of multiple stakeholders, including researchers, clinicians, peer mentors with SCI, and administrators of organisations providing AR programmes. The inter-PEER uses standardised outcome measures relevant to the AR context, it will facilitate quality evaluations of community peer-based programmes, stimulate international collaborations, and inform the design of randomised controlled trials on the effects of AR training programmes.

Active Rehabilitation for persons with spinal cord injury in Botswana - effects of a community peer-based programme.

STUDY DESIGN: Prospective cohort study with a repeated measures analysis. OBJECTIVES: To measure the effects of the Active Rehabilitation (AR) training programme for community-dwelling individuals with spinal cord injury (SCI) in Botswana on physical independence, wheelchair mobility, self-efficacy, life satisfaction, level of physical activity and community participation. SETTING: The inaugural AR training programme in Botswana, a community peer-based programme for people with SCI. The 10-day residential programme in Botswana was led by an international team of peer mentors and health professionals. METHODS: Participants with SCI (on average 4 years after injury) completed a survey comprising a battery of standardised outcome measures at three timepoints: at the start, on completion and at 5 months after the programme (n = 14). Participants also completed a practical wheelchair skills test at start and completion of the programme (n = 17). RESULTS: Participants improved in the mobility subscale of the Spinal Cord Independence Measure Self Report on completion (p = 0.011, d = 0.85) and at 5-month follow-up (p = 0.005, d = 0.93) as compared to baseline. They also achieved moderate improvement in self-efficacy to manage their condition (physical function domain of Moorong Self-Efficacy Scale) and large improvements in wheelchair mobility as assessed through the Queensland Evaluation of Wheelchair Skills test and the Wheelchair Skills Test Questionnaire. All positive results were retained at 5-month follow-up. CONCLUSIONS: Findings indicate that the peer-based programme AR can play an important role in promoting physical independence, wheelchair mobility and injury-management self-efficacy in community-dwelling individuals with SCI in Botswana.

Meaning of Self in Multiple Sclerosis: Implications for Treatment and Rehabilitation.

Low participation of multiple sclerosis (MS) patients in the therapeutic process is considered a primary area in research on the management of this condition. One of the key research directions is the role of self and self-involvement in MS patients. Clinical symptoms of MS and unpredictability of this condition may affect patients' attitude to their self and self-involvement. Self-image and self-appraisal of one's abilities to cope with the disease exert significant effects not only on patient's emotional status but also on their behavior. This assumption is consistent with the cognitive-behavioral paradigm according to which emotions and behaviors of an individual reflect specific self-interpretation, self-assessed situational context and self-perceived ability to cope with a given situation. Enforcement of self-esteem and self-efficacy may promote self-management and thus, increase patients' participation in the therapeutic process. In this paper, we briefly review recent advances in research on the role of self in treatment and rehabilitation of MS patients.

Health-related quality of life in multiple sclerosis: role of cognitive appraisals of self, illness and treatment.

PURPOSE: Health-related quality of life (HRQoL) is considered an important measure of treatment and rehabilitation outcomes in multiple sclerosis (MS) patients. In this study, we used multivariate regression analysis to examine the role of cognitive appraisals, adjusted for clinical, socioeconomic and demographic variables, as correlates of HRQoL in MS. METHODS: The cross-sectional study included 257 MS patients, who completed Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale (a part of Berlin Social Support Scale) and Socioeconomic Resources Scale. Demographic and clinical characteristics of the participants were collected with a self-report survey. Correlation and regression analyses were conducted to determine associations between the variables. RESULTS: Five variables, illness identity (ß = 0.29, p ≤ 0.001), self-esteem (ß = -0.22, p ≤ 0.001), general self-efficacy (ß = -0.21, p ≤ 0.001), disability subgroup "EDSS" (ß = 0.14, p = 0.006) and age (ß = 0.12, p = 0.012), were significant correlates of HRQoL in MS. These variables explained 46 % of variance in the dependent variable. Moreover, we identified correlates of physical and psychological dimensions of HRQoL. CONCLUSIONS: Cognitive appraisals, such as general self-efficacy, self-esteem and illness perception, are more salient correlates of HRQoL than social support, socioeconomic resources and clinical characteristics, such as type and duration of MS. Therefore, interventions aimed at cognitive appraisals may also improve HRQoL of MS patients.

Sports Injuries in Wheelchair Rugby - A Pilot Study.

The aim of the study was to analyze etiology and the incidence of sports injuries among wheelchair rugby players. Moreover, we verified if the levels of aggressiveness and anger presented by the athletes and their roles in the team influenced the incidence and severity of the injuries. The study involved 14 male players, members of the Polish National Wheelchair Rugby Team. During a 9-month period, the athletes participated in up to 9 training camps and 4 Wheelchair Rugby tournaments. The study was based on the Competitive Aggressiveness and Anger Scale, registry of sports injuries consulted and non-consulted with a physician and a demographic questionnaire. The following observations were made during the 9-month period corresponding to a mean of 25 training and tournament days: 1) wheelchair rugby players experienced primarily minor injuries (n=102) that did not require a medical intervention, 2) only four injuries needed to be consulted by a physician, 3) sports injuries occurred more frequently among offensive players than in defensive players, 4) offensive players showed a tendency to higher levels of anger and aggressiveness than defensive players. It can be concluded that wheelchair rugby is a discipline associated with a high incidence of minor injuries that do not require a medical intervention. The incidence rate of injuries during the analyzed period was 0.3 per athlete per training day.