Therapeutic Sessions Research Articles

Therapeutic Patient Education after Anterior Cruciate Ligament Reconstruction: Evaluation of the Knowledge and Certitudes with a Self-Report Questionnaire.

Therapeutic education aims to help patients acquire skills and knowledge, and to improve psychosocial aspects to manage chronic disease. After anterior cruciate ligament reconstruction (ACLR), only 35 to 60% of the patients are able to go back to their previous sport. Return to sport depends on the motivation of the patient. No therapeutic education has already been proposed. We aimed to evaluate the effect of therapeutic education sessions on knowledge improvement during inpatient rehabilitation after ACLR, compared to patients operated with the same surgical technic, but who had no therapeutic education because of outpatient rehabilitation. Sessions were performed by a multidisciplinary team. The evaluation of the knowledge was performed with a true or false 12-items self-report questionnaire. Fifty-four patients were studied and compared to 54 patients with no therapeutic education. The educated and the non-educated groups were comparable. The number of correct answers increased from 73% before therapeutic education to 95% at the end of the hospitalization (p < 0.001). This improvement persisted over time with 91.5% of correct answers at four months (p = 0.94). The non-educated group had 70% of correct answers. This was significantly lower than the results obtained from the educated group at four months (p < 0.001). It was comparable to the result obtained before therapeutic education (p = 0.91). Therapeutic patient education performed during hospitalization for rehabilitation enables patients to have a better knowledge of the stages from rehabilitation to return to sport and the risks of complication after ACLR.

Assessment of the effectiveness of physiotherapy in children with cerebral palsy in the opinion of the parents

Abstract&#x0D; Many specialists have studied cerebral palsy. Currently, the most accurate definition is that proposed by Bax, who defines cerebral palsy as a disorder of posture and movement caused by damage to the brain. The factors that predispose to the development of this disorder include: pre-contraceptive, prenatal, perinatal and postnatal. Symptoms indicating the possibility of cerebral palsy can be observed already in the neonatal period, therefore it is important to follow pediatric visits, and in case of alarming symptoms, consult a neurologist. Early diagnosis of the disorder will allow the introduction of quick, individualized child physiotherapy, which may strengthen the child's psychomotor development.&#x0D; Aim of the research: to assess the effectiveness of physiotherapy in children with cerebral palsy in the opinion of the parents. Material and methods: the proprietary questionnaire and two certified scales were used: Gross Motor Classification System to determine the degree of motor disorders and Manual Ability Classification System to check the degree of manual skills. Results: 67% of parents support the high effectiveness of physiotherapy. Therapeutic sessions most often take place 3-5 times a week (51%); moreover, 97% of children perform rehabilitation exercises at home. Conclusions: Physiotherapy is an effective form of exercise therapy for children with cerebral palsy. The most popular of the methods used in working with children is NDT-Bobath. The desirability of early diagnosis of cerebral palsy is associated with the possibility of quick therapeutic sessions, which translates into benefits in psychomotor development and significantly improves the quality of life.

Specific dopaminergic genetic variants influence impulsivity, cognitive deficit, and disease severity of Indian ADHD probands.

Impulsivity (Imp), being one of the cardinal symptoms of Attention Deficit Hyperactivity Disorder (ADHD), often leads to inappropriate responses to stimuli. Since the dopaminergic system is the primary target for pharmaceutical intervention in ADHD, we investigated the association between ADHD-related Imp and functional gene variants of the dopamine transporter (SLC6A3) and catechol-O-methyltransferase involved in dopamine clearance. Indo-Caucasoid families with ADHD probands (N = 217) were recruited based on the Diagnostic and Statistical Manual of Mental Disorders (DSM). Imp of the probands was assessed using the Domain Specific Imp Scale for Children and DSM. Peripheral blood was collected after obtaining informed written consent for participation, genomic DNA was isolated, and target sites were genotyped by DNA sequencing. The association of genetic variants with Imp was examined by the Quantitative trait analysis (QTA) and Analysis of variance (ANOVA). Post-Hoc analysis following QTA and ANOVA showed significant associations of rs2254408, rs2981359, and rs2239393 with different domains of Imp (P < 0.05). Various haplotypic combinations also showed statistically significant associations with Imp (P < 0.05). Multifactor dimensionality reduction models revealed strong effects of the variants on Imp. ADHD probands harboring the risk alleles exhibited a deficit in performance during cognitive assessment. Longitudinal follow-up revealed a significant association of rs2254408 with trait persistence. The present study indicates the influence of the studied genetic variants on ADHD-associated imp, executive deficit, and disease persistence. Thus, these variants may be helpful as predictors for the success of individual therapeutic sessions during cognitive training.

Risk of cutaneous carcinogenesis with phototherapy in Indian subpopulation: A 10‐year analysis and a review of literature

Phototherapy is an extremely effective and established therapeutic modality in a variety of dermatological disorders. However, there has been a constant concern with respect to its long-term usage as some of the studies have identified the risk of cutaneous malignancy associated with phototherapy. The carcinogenic potential of PUVA has been demonstrated in most US studies; however, the studies done on Asian and Arabian-African population have not corroborated similar findings, thus suggesting that the darker skin may confer protection against the development of cutaneous malignancy following phototherapy. The main aim of the present study was to assess the safety of phototherapy (bath PUVA and NBUVB) in Indian population (Fitzpatrick skin types IV and V) with respect to its carcinogenic potential and to determine the maximum cumulative dose that our patients could tolerate without developing any untoward complications such as cutaneous malignancy. All patients who received phototherapy between January 2006 and October 2016 were enrolled in the study. Details such as cumulative dose, number of phototherapy sessions received, indication for phototherapy, adverse effects such as pigmentary changes, new growths on the skin surface following the therapeutic sessions were entered in a predesigned proforma. This ambispective study had 1300 patients who had received phototherapy over a period of 10 years. A total of 929 patients had received PUVA, and the remaining 371 patients had received NBUVB for various dermatological indications. The average follow-up period for PUVA was 3 years and 6.5 years for NBUVB. The maximum cumulative dose of UVA and UVB that could be safely administered in our patients was 2085 J/cm2 and 1985 mJ/cm2, respectively. None of our patients developed any features of cutaneous malignancy during their follow-up. Both bath-PUVA and NBUVB are safe and efficacious in treating patients of darker skin types (IV and V). The risk of developing cutaneous malignancy is negligible in this subset of patients. However, more studies need to be done on the Asian population to substantiate the same.

Hippotherapy as a way of improving motor performance in juveniles with infantile cerebral palsy

Animals have accompanied man for thousands of years and their role in human life has seriously evolved. Man had power over domesticated animals and decided about their fate, they were used as a means of transport and helped humans with the farming. There is a group of animals, known as companion animals, which are ranked high in human life. Nowadays, animals are more frequently utilized in different animal-assisted therapies. Hippotherapy as a therapeutic intervention exerts serious influence on those participating in its sessions, and it affects all interpenetrating spheres of human life. Therapeutic effects of horse-riding were already known in 400 B.C. Hippocrates claimed that horse-riding exerted positive effect on treating certain health conditions.&#x0D; Equine therapists, over the years, have noticed significant benefits to their clients resulting not only from the nature of a horse but also from its unique ambulation. One can say that a horse during a therapeutic session becomes a precise stimulator of movement.&#x0D; Thanks to a similar way of ambulation in man and in a horse, during a horse riding session the rider’s pelvis, trunk and the shoulder girdle are made to move according to the physiological pattern of human ambulation, so a person with motor disorders has a chance to learn proper human gait pattern without walking.

Heart rate variability biofeedback intero-nociceptive emotion exposure therapy for adverse childhood experiences.

Background: Psychiatric patients with adverse childhood experiences (ACE) tend to have dysfunctions in the interoceptive part of their emotional experience. The integration of interoceptive emotional activity in the insular and cingulate cortices is linked to the regulation of sympathovagal balance. This makes heart rate variability (HRV) an ideal measure for providing feedback on emotion regulation in real-time. Methods: A sample of one hundred (n=100) outpatients was evaluated. Participants underwent eight 30-minutes ACE exposure sessions during which patients were guided to experience bodily sensations related to ACE while their HRV was monitored using a commercial biofeedback device. Results: Comparing the results of the first to last therapeutic session, a significant decrease in heart rate and an increase in HRV at the onset of the session were observed. Conclusions: This study suggests a physiological impact of therapeutic interventions on autonomic balance and underlines the interest in HRV biofeedback as clinical practice.

The impact of the COVID-19 pandemic on physical therapy practice for people with multiple sclerosis: A multicenter survey study of the RIMS network

BackgroundThe impact of the COVID-19 pandemic on physical therapy services for people with multiple sclerosis (pwMS) is unknown. Therefore, the Special Interest Group for Mobility (SIG Mobility) of the European Network for Best Practice and Research in Multiple Sclerosis Rehabilitation (RIMS) has undertaken the initiative to examine the impact of the COVID-19 outbreak on physical therapy services and physical activity participation in pwMS across Europe, Israel and Australia. ObjectiveTo describe the impact of the COVID-19 outbreak on physical therapy practice from the perspective of the therapist. MethodsAn online survey was developed and conducted from December 2020 to July 2021. The survey (50 questions), included multiple-choice questions and open-ended responses. ResultsIn total, 215 physical therapists (PT's) from 9 countries (Australia, Belgium, the Czech Republic, Ireland, Israel, Italy, Norway, Spain, and Turkey) participated in the study. The therapy most affected during the pandemic was aerobic training/conditioning exercises; 33.5% reported that these activities were either reduced or unavailable. In contrast, 15% of the PTs reported increased use of relaxation/mind body techniques and/or fatigue management programs during the pandemic. PTs reported a mixture of positive and negative feelings about the therapeutic sessions offered during the pandemic. Most reported positive feelings included “positive” (26.5%), and “optimistic” (24.7%). Negative feelings most frequently reported included “worried” (30.7%), and “hesitant” (20.9%). The PTs reported a 10% decrease in the use of hands-on techniques and a 10% increase in the use of oral instructions when treating moderately and severely pwMS during as compared to before the pandemic. ConclusionThe COVID-19 pandemic has affected physical therapy services in pwMS internationally in terms of content, frequency of use and format.

Critical Competences for the Management of Post-Operative Course in Patients with Digestive Tract Cancer: The Contribution of MADIT Methodology for a Nine-Month Longitudinal Study.

There is a high postoperative morbidity rate after cancer surgery, that impairs patients’ self-management, job condition and economic strength. This paper describes the results of a peculiar psychological intervention on patients undergoing surgery for esophageal, gastric and colorectal cancer. The intervention aimed to enhance patients’ competences in the management of postoperative daily life. A narrative approach (M.A.D.I.T.—Methodology for the Analysis of Computerised Text Data) was used to create a questionnaire, Health and Employment after Gastro-Intestinal Surgery—Dialogical Questionnaire, HEAGIS-DQ, that assesses four competences. It was administered to 48 participants. Results were used as guidance for specific intervention, structured on patients’ competence profiles. The intervention lasted nine months after surgery and was structured in weekly to monthly therapeutic sessions. Quality of Life questionnaires were administered too. At the end of the intervention, 94% of patients maintained their job and only 10% of patients asked for financial support. The mean self-perception of health-related quality of life was 71.2. The distribution of three of four competences increased after nine months (p < 0.05). Despite economic difficulties due to lasting symptoms after surgery, and to the current pandemic scenario, a structured intervention with patients let them to resume their jobs and continue activities after surgery.

Alienated and unsafe: Experiences of the first national UK COVID-19 lockdown for vulnerable young people (aged 11-24years) as revealed in Web-based therapeutic sessions with mental health professionals.

BackgroundThe COVID‐19 pandemic and subsequent lockdowns have disproportionately affected young people, and those who are vulnerable are disadvantaged further. Here, we seek to understand the experiences of vulnerable young people accessing Web‐based therapeutic support during the pandemic and early lockdown, as revealed through the observations of mental health professionals.MethodsFour focus groups with 12 professionals from a digital mental health service were conducted to understand the experiences of vulnerable young people during the pandemic lockdown. Workshops with young people with diverse experiences resulted in the co‐design of the focus group topic guide and the interpretation and validation of analysis. The experiential inductive–deductive framework of thematic analysis was used to analyse the workshop transcripts.ResultsFour main themes and subsequent subthemes were identified: escalation of risk; the experience and consequence of loss; feeling supported and empowered; and feeling separate and isolated.ConclusionsFindings reflect early data that suggest that those with existing vulnerability face an increased risk of poor outcomes through the pandemic and the restrictions of lockdown, but evidence is also provided of positive outcomes from lockdown and its function as a catalyst for change. Results reinforce the need for focused support for vulnerable young people as we emerge from lockdown, and point to supportive and protective factors of relevance to online and offline support provision.

Efficacy of think-aloud strategy on the cocktail party effect of pupils with auditory processing disorders

Objective This study was done to determine the effects of think-aloud strategy on the cocktail party effect of pupils with a single profile of APD against no-treatment group. The study also sought to develop a means of managing pupils with auditory processing disorders using the intervention package. Design Participants were randomly selected to each group (intervention group and no-intervention group). A therapeutic intervention session on the cocktail party effect was carried out for 8 weeks which lasted 30 min three times per week in the school environment. Study sample The study consisted of 40 pupils (8–12 years) with a single profile of APD. Results: The treatment was effective in enhancing the cocktail party effect of pupils with APD and there was no significant main effect of gender in the cocktail party effect of the participants. Conclusion The pupils with APD in the intervention group benefitted from the treatment process, therefore treatment should be adopted by teachers of pupils with APD.

An exploratory study of facilitator adherence to a School-Based Filial Therapy programme

ABSTRACT Filial therapy is a play therapy intervention where significant individuals who are not clinicians facilitate therapeutic play sessions with children. In School-Based Filial Therapy (SBFT), the direct treatment role is performed by specially trained education professionals. Concerns about fidelity in filial therapy have been raised historically; however, investigation has been limited. This mixed-methods study explored factors impacting facilitator adherence to SBFT. The qualitative component involved semi-structured interviews with eight facilitators. Quantitative data were gathered from: a visual analogue scale of facilitator stress and discomfort, the Differentiation of Self – Short Form and a SBFT observation form rating adherence. Overall, relationship processes occurring within the therapeutic system of the facilitator-child dyad were found to impact facilitator adherence via factors both internal and external to the facilitator. Practice implications include enhancing training and supervision processes for facilitators.

Precursors of Openness to Provide Online Counseling: The Role of Future Thinking, Creativity, and Innovative Behavior of Future Online Therapists.

The outbreak of the COVID-19 pandemic has accelerated the need for online counseling to preserve therapeutic processes that have begun face to face and to provide service to others in need during lockdowns. Previous studies underscored the importance of providing updated training as counselors frequently hesitate to use technological advances in therapeutic sessions. This study aims at reducing such barriers by revealing personal characteristics of future professionals that might inhibit or encourage their openness toward providing online counseling. To this end, this study is focused on several precursors of openness to provide online counseling: preference to communicate emotions online, identification of emotional expressiveness advantages in providing online counseling, innovative behavior, creativity, and future problem-solving thinking skills. The question at focus is which constructs would be found contributive to students’ openness to provide online counseling. The sample included 277 undergraduate students (future counselors) who filled out questionnaires. Data were analyzed using Partial Least Squares Structural Equation Modeling. Our findings pointed to the centrality of students’ preference to communicate their emotions online in explaining their openness to conducting online counseling. This study might help pinpointing the adjustments curriculum designers should address to better reflect the intensive changes within the counseling field that necessitate transferring face-to-face skills to online settings.

An overview of the effects of whole-body vibration on individuals with cerebral palsy

The purpose of this review is to examine how whole-body vibration can be used as a tool in therapy to help improve common physical weaknesses in balance, bone density, gait, spasticity, and strength experienced by individuals with cerebral palsy. Cerebral palsy is the most common movement disorder in children, and whole-body vibration is quickly becoming a potential therapeutic tool with some advantages compared to traditional therapies for individuals with movement disorders. The advantages of whole-body vibration include less strain and risk of injury, more passive training activity, and reduced time to complete an effective therapeutic session, all of which are appealing for populations with physiological impairments that cause physical weakness, including individuals with cerebral palsy. This review involves a brief overview of cerebral palsy, whole-body vibration's influence on physical performance measures, its influence on physical performance in individuals with cerebral palsy, and then discusses the future directions of whole-body vibration therapy in the cerebral palsy population.

COMPUTER-AIDED THERAPY USING AUTOMATIC SPEECH RECOGNITION TECHNIQUE FOR DELAYED LANGUAGE DEVELOPMENT CHILDREN

Objectives: This study aims to develop a computer-aided therapy (CAT) application to help children who suffer from delayed language development (DLD) improve their language, especially during the COVID-19 pandemic. Methods: The implemented system teaches the children their body parts using the Egyptian dialect. Two datasets were collected from healthy children (2800 words) and unhealthy children (236 words) who have DLD at the clinic. The model is implemented using a speaker-independent isolated word recognizer based on a discrete-observation hidden Markov model (DHMM) classifier. After the speech signal preprocessing step, K-means algorithm generated a codebook to cluster the speech segments. This task was completed under the MATLAB environment. The graphical user interface was implemented successfully under the C# umbrella to complete the CAT application task. The system was tested on healthy and DLD children. Also, in a small clinical trial, five children who have DLD tested the program in an actual trial to monitor their pronunciation progress during therapeutic sessions. Results: The max recognition rate was 95.25% for the healthy children dataset, while 93.82% for the DLD dataset. Conclusion: DHMM was implemented successfully using nine and five states based on different codebook sizes (160, 200). The implemented system achieved a high recognition rate using both datasets. The children enjoyed using the application because it was interactive. Children who have DLD can use speech recognition applications.

A Preliminary Study of the Efficacy of Transcranial Direct Current Stimulation in Trigeminal Neuralgia.

The purpose of this study is to assess the efficacy of transcranial direct current stimulation (tDCS) in patients with treatment-refractory trigeminal neuralgia (TN) and examine the utility of neuroimaging methods in identifying markers of such efficacy. Six patients with classical TN refractory to maximal medical treatment, underwent tDCS (three cases inhibitory/cathodic and three cases excitatory/anodic stimulation). All patients underwent pre- and posttreatment functional magnetic resonance imaging (fMRI) during block-design tasks (i.e., Pain, Pain + tDCS, tDCS) as well as single-shell diffusion MRI (dMRI) acquisition. The precise locations of tDCS electrodes were identified by neuronavigation. Five therapeutic tDCS sessions were carried out for each patient with either anodic or cathodic applications. The Numeric Rating Scale of pain (NRS) and the Headache Disability Index (HDI) were used to score the subjective efficacy of treatment. Altered activity of regional sites was identified by fMRI and associated changes in the spinothalamocortical sensory tract (STCT) were measured by the dMRI indices of fractional anisotropy (FA) and mean diffusivity (MD). Fiber counts of the bilateral trigeminal root entry zone (REZ) were performed as an added measure of fiber loss or recovery. All patients experienced a significant reduction in pain scores with a substantial decline in HDI (P value < 0.01). Following a course of anodic tDCS, the ipsilateral caudate, globus pallidus, somatosensory cortex, and the contralateral globus pallidus showed a significantly attenuated activation whereas cathodic tDCS treatment resulted in attenuation of the thalamus and globus pallidus bilaterally, and the somatosensory cortex and anterior cingulate gyrus contralaterally. dMRI analysis identified a substantial increase (>50%) in the number of contralateral sensory fibers in the STCT with either anodic or cathodic tDCS treatment in four of the six patients. A significant reduction in FA (>40%) was observed in the ipsilateral REZ in the posttreatment phase in five of the six patients. Preliminary evidence suggests that navigated tDCS presents a promising method for alleviating the pain of TN. Different patterns of activation manifested by anodic and cathodic stimulation require further elaboration to understand their implication. Activation and attenuation of responses at various sites may provide further avenues for condition treatment.

Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal.

Therapeutic plasmapheresis is a therapeutic procedure in which the patient's blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit. An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded. Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresissession due to complications related to the patient. Therapeutic plasmapheresis is an urgent procedure that can reduce morbidity and mortality in critically ill patients. This justifies that 37% of patients started the technique before the diagnostic confirmation. The indications for plasmapheresis and the choice of replacement solution were in agreement with the guidelines. Despite the risk of bleeding, no haemorrhagic complications were recorded. Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.

The effectiveness of a proposed cognitive-behavioral treatment program to reduce depression among mothers of children with congenital anomalies: فاعلية برنامج علاجي معرفي سلوكي مقترح لتخفيف الاكتئاب لدى أمهات الأطفال المصابين بتشوهات خلقية

The study aims to identify the effectiveness of the cognitive behavioral therapy in decreasing the depression of the mothers of the children who have birth defects and registered in the Future Palestine Association in the Gaza strip, in addition to know the extent of the continuing of this effectiveness after the follow- up period for one month after the end of the application of the therapeutic sessions. The sample of the study consists of (30) of the mothers of the children who have birth defects and registered in the Future Palestine Association in the Gaza strip. The sample is divided into two groups, the first one is the experimental group which consists of 15 mothers and the second is the control group which also consists of 15 mothers. The sample is selected from the children mothers' who are registered in the Future Palestine Association and they are selected in an intentional way. The study used the following measures to examine the hypotheses of the study: Beck depression measure, the proposed program which prepared by the researcher and the special forms of the cognitive- behavioral therapy. The study used the experimental method by using two equivalent groups which are the cognitive behavioral therapy The study found the following results: There are statistical significant differences in the depression level between the experimental group and the control group in the medium measure during the application of the behavioral cognitive therapy program. There are statistical significant differences in the depression level between the experimental group and the control group in the post measure. There are statistical significant differences in the depression level of the experimental group in the medium and pre measures. There are statistical significant differences in the depression level of the experimental group in the pre and the post measures. There are no statistical significant differences in the depression level of the experimental group in the post and the iterative measures، Among the most important recommendations of the study: encouraging mothers and fathers to participate in counseling programs and to receive the necessary rehabilitation services for their children, given the positive impact of those programs on them and their children.

Évaluation de l’impact de consultations pharmaceutiques à l’instauration d’un traitement par émicizumab chez les patients hémophiles A sévères sans inhibiteurs

Since 2019, severe haemophilia A without inhibitors can be treated with emicizumab. Its action, route of administration and management justified the creation of new tools for therapeutic education sessions addressed to patients. The main objective of our work was to assess the knowledge and skills acquired by patients after therapeutic education. The various documents created were a video, a slideshow, clinical cases in form of cards, and summary sheets intended for patients. At treatment beginning, a pharmaceutical consultation was proposed to all patients. Two months later, an evaluation was carried out and a second pharmaceutical consultation aimed to consolidate the achievements of patients. Simultaneously, a clinical self-evaluation by the patients was carried out. Thirty-six patients were included in the study. Theoretical items: method of manufacture, mechanism of action and regimen, are known for more than ¾ of patients. Practical skills, such as administration modalities, management of missed doses or bleeding, are familiar for more than 8 out of 10 patients. Sixteen (44.4%) patients presented an up-to-date haemophilia card. The assessment of the knowledge and skills of patients is encouraging since most of the items are acquired. These result highlights the interest of the new tools developed for the therapeutic education sessions.

Emotion focused therapy with injured athletes: Conceptualizing injury challenges and working with emotions

Athletes’ emotional responses to injuries may include feeling sad, angry, anxious, frustrated, helpless, irritated, and confused about their identity as athletes. Emotions are central in athletes’ sport injury experiences, yet most therapeutic approaches described in the sport psychology literature are grounded in cognitive-behavioural traditions and strategies may tend to emphasize controlling or suppressing emotions. Emotion Focused Therapy (EFT) is a robust, empirically-supported therapeutic approach grounded in experiential therapy and emotion theory that can be used to help athletes deal with injury-related difficulties. This position paper presents a rationale for using EFT in working with injured athletes. We review foundational principles of EFT and the conceptualization of emotions, emotion regulation, and dysregulation from an EFT perspective. Drawing on EFT theory, we present a conceptualization of five challenges and conflicts that arise within athletes’ injury experiences: (a) attending to the body and listening to the body; (b) tending to the pain versus pushing through pain; (c) interpersonal challenges and conflicts with others; (d) injuries as a challenge to athlete identity; and (e) concerns about time left in career and falling behind. Examples of ‘in vivo’ interactions between therapists and athletes are also presented to bring to life the use of EFT strategies and techniques, and we conclude with directions for future research and suggestions for practitioners to advance the use of EFT within the field of sport psychology. Lay summary: Emotion Focused Therapy (EFT) is a process-experiential, person-centered therapeutic approach that holds promise for clinicians and therapists working with injured athletes. EFT could be used to evoke and experience emotions in therapeutic sessions in order to develop greater acceptance, awareness, and understanding about one’s emotions to facilitate healing and support athletes’ ongoing performance and sport careers.

MANAGEMENT OF PERIPHERAL VASCULAR MALFORMATIONS BY ABSOLUTE ALCOHOL

Objective: According to ISSVA 2014 classification, peripheral vascular malformations are divided to fast and slow flow. In spite of clear diagnosis, management is still challenging because of low rate of getting rid of lesions and high risk of complications. Endovascular management is first choice in daily practice, but cured rate is maximum about 30%. Combined treatment increases rate of success to get rid of malformations, especially surgical remvoving after endovascular management. There are many embolized materials, but absolute alcohol seem to be effective, but highly complications. Study and method: A prospective intervened study without case control. 89 patients satisfied standard are collected from 06/2016 to 06/2020. We evaluated clinical response, imaging improvement and effectiness of absolute alcoholic management. Results: Of 89 patients, female is majority with 62.9%, older than 18 is about 42.9%, mean age is 23.1. Sessions, method of approaching, volume of alcohol, combined treatment are significantly remarkable different between fast and slow flow malformations (p value = 0.021). Treatment are seem to be more effective in slow flow (p = 0.023),but fast flow malformations are curable in clinical and imaging studies. Major complications is indifferent between two groups. Conclusion: Venous malformations are majority amongst vascular malformations in our study. Because of complex scenario, difficulty of management in fast flow lesions, follow up is prolonged, volume of alcohol is increased, therapeutic sessions is repeated many times compared to slow flow. Successful treatment is higher in slow flow malformations than fast flow, but latter one is able to be cured. There are no difference between two group in field of complications. However, glycemia is negative correlation with minor complications, natremia is also reverse correlation to postoperational pain. Pain scale, symptom’s onset and APTT are positive correlations with complications. Key words: fast flow malformations, slow flow malformations, absolut alcohol, major complications, minor complications.