Zoekresultaten

Characteristics and risk factors of sport injuries in physical education students

Chronic pain in hypermobility syndrome and Ehlers-Danlos syndrome (hypermobility type)

Generalized joint hypermobility (GJH) is highly prevalent among patients diagnosed with chronic pain. When GJH is accompanied by pain in ≥4 joints over a period ≥3 months in the absence of other conditions that cause chronic pain, the hypermobility syndrome (HMS) may be diagnosed. In addition, GJH is also a clinical sign that is frequently present in hereditary diseases of the connective tissue, such as the Marfan syndrome, osteogenesis imperfecta, and the Ehlers-Danlos syndrome. However, within the Ehlers-Danlos spectrum, a similar subcategory of patients having similar clinical features as HMS but lacking a specific genetic profile was identified: Ehlers-Danlos syndrome hypermobility type (EDS-HT). Researchers and clinicians have struggled for decades with the highly diverse clinical presentation within the HMS and EDS-HT phenotypes (Challenge 1) and the lack of understanding of the pathological mechanisms that underlie the development of pain and its persistence (Challenge 2). In addition, within the HMS/EDS-HT phenotype, there is a high prevalence of psychosocial factors, which again presents a difficult issue that needs to be addressed (Challenge 3). Despite recent scientific advances, many obstacles for clinical care and research still remain. To gain further insight into the phenotype of HMS/EDS-HT and its mechanisms, clearer descriptions of these populations should be made available. Future research and clinical care should revise and create consensus on the diagnostic criteria for HMS/EDS-HT (Solution 1), account for clinical heterogeneity by the classification of subtypes within the HMS/EDS-HT spectrum (Solution 2), and create a clinical core set (Solution 3).

Effects of reflex-based self-defence training on police performance in simulated high-pressure arrest situations

We investigated the effects of reflex-based self-defence training on police performance in simulated high-pressure arrest situations. Police officers received this training as well as a regular police arrest and self-defence skills training (control training) in a crossover design. Officers' performance was tested on several variables in six reality-based scenarios before and after each training intervention. Results showed improved performance after the reflex-based training, while there was no such effect of the regular police training. Improved performance could be attributed to better communication, situational awareness (scanning area, alertness), assertiveness, resolution, proportionality, control and converting primary responses into tactical movements. As officers trained complete violent situations (and not just physical skills), they learned to use their actions before physical contact for de-escalation but also for anticipation on possible attacks. Furthermore, they learned to respond against attacks with skills based on their primary reflexes. The results of this study seem to suggest that reflex-based self-defence training better prepares officers for performing in high-pressure arrest situations than the current form of police arrest and self-defence skills training. Practitioner Summary: Police officers' performance in high-pressure arrest situations improved after a reflex-based self-defence training, while there was no such effect of a regular police training. As officers learned to anticipate on possible attacks and to respond with skills based on their primary reflexes, they were better able to perform effectively.