{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:38:18Z","timestamp":1776724698347,"version":"3.51.2"},"reference-count":43,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Spinal cord injury (SCI) affects every aspect of human life: medical, psychological, social, material. People with SCI face a variety of secondary conditions (e.g., chronic pain, urinary tract infections, cognitive impairment) that place a significant emotional burden, resulting in an increased risk of depression and reduced quality of life. The purpose of this study was to better understand the coping strategies and to identify factors that promote or hinder the successful adjustment of elite athletes after SCI. Individual semi-structured interviews were conducted with eight top athletes after spinal cord injury. The interviews were recorded, transcribed, and then thematically analyzed using MAXQDA software. Thematic analysis identified the following categories: coping, athletic identity, and adjustment. The results of the study indicate that loss of functional ability does not cause loss of athlete identity. Elite athletes live a life consistent with this identity, attempting to maintain it despite the loss of physical fitness. Involvement in sports provides meaning and is a positive factor in the process of disability acceptance, which is essential in the process of adjustment to injury and also provides group belonging.<\/jats:p>","DOI":"10.3390\/ijerph19148441","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T03:46:08Z","timestamp":1657511168000},"page":"8441","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Restored Life of Elite Athletes after Spinal Cord Injury"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1795-4367","authenticated-orcid":false,"given":"Grzegorz","family":"Zurek","sequence":"first","affiliation":[{"name":"Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0490-6574","authenticated-orcid":false,"given":"Agata","family":"Goraczko","sequence":"additional","affiliation":[{"name":"Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland"},{"name":"Clinic of Neurorehabilitation, 54-519 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-3516","authenticated-orcid":false,"given":"Alina","family":"\u017burek","sequence":"additional","affiliation":[{"name":"Institute of Psychology, University of Wroclaw, 50-527 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Lachowicz","sequence":"additional","affiliation":[{"name":"Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5408-1921","authenticated-orcid":false,"given":"Katarzyna","family":"Kujawa","sequence":"additional","affiliation":[{"name":"Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland"},{"name":"Clinic of Neurorehabilitation, 54-519 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Goraczko, A., Zurek, A., Lachowicz, M., Kujawa, K., and Zurek, G. (2021). Is Self-Efficacy Related to the Quality of Life in Elite Athletes after Spinal Cord Injury?. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182010866"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1038\/sc.2016.46","article-title":"Pain, Spasticity and Quality of Life in Individuals with Traumatic Spinal Cord Injury in Denmark","volume":"54","author":"Andresen","year":"2016","journal-title":"Spinal Cord"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1016\/j.apmr.2003.12.038","article-title":"Aging with a Spinal Cord Injury: Factors Associated with the Need for More Help with Activities of Daily Living","volume":"85","author":"Liem","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1038\/sc.2008.82","article-title":"The Relationship between Quality of Life and Disability across the Lifespan for People with Spinal Cord Injury","volume":"47","author":"Barker","year":"2009","journal-title":"Spinal Cord"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.apmr.2014.08.016","article-title":"Prevalence of Depression After Spinal Cord Injury: A Meta-Analysis","volume":"96","author":"Williams","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"489","DOI":"10.2340\/16501977-2241","article-title":"Chronic Pain, Depression and Quality of Life in Individuals with Spinal Cord Injury: Mediating Role of Participation","volume":"49","author":"Landmann","year":"2017","journal-title":"J. Rehabil. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ko, H.-Y. (2022). Current Epidemiology of Spinal Cord Injuries. Management and Rehabilitation of Spinal Cord Injuries, Springer Nature.","DOI":"10.1007\/978-981-19-0228-4_12"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1038\/sc.2013.135","article-title":"Estimating the Global Incidence of Traumatic Spinal Cord Injury","volume":"52","author":"Fitzharris","year":"2014","journal-title":"Spinal Cord"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1017\/S0317167100014530","article-title":"Global Incidence and Prevalence of Traumatic Spinal Cord Injury","volume":"40","author":"Furlan","year":"2013","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/10790268.2016.1138601","article-title":"Spinal Cord Injury Research Evidence Team Epidemiology of Sport-Related Spinal Cord Injuries: A Systematic Review","volume":"39","author":"Chan","year":"2016","journal-title":"J. Spinal Cord Med."},{"key":"ref_11","first-page":"304","article-title":"The Psychological, Social, and Vocational Adjustment to Spinal Cord Injury","volume":"1","author":"Trieschmann","year":"1980","journal-title":"Annu. Rev. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1016\/S0277-9536(99)00045-3","article-title":"Integrating Response Shift into Health-Related Quality of Life Research: A Theoretical Model","volume":"48","author":"Sprangers","year":"1999","journal-title":"Soc. Sci. Med."},{"key":"ref_13","unstructured":"Lazarus, R.S., and Folkman, S. (1984). Stress, Appraisal, and Coping, Springer."},{"key":"ref_14","unstructured":"Craig, A., and Tran, Y. (2008). Psychological Aspects Associated with Spinal Cord Injury Rehabilitation: New Directions and Best Evidence, Nova Science Publishers."},{"key":"ref_15","unstructured":"Craig, A., Tran, Y., and Middleton, J. (2017). Theory of Adjustment Following Severe Neurological Injury: Evidence Supporting the Spinal Cord Injury Adjustment Model, Nova Science Publishers."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1038\/sj.sc.3101238","article-title":"Linkages between Coping and Psychological Outcome in the Spinal Cord Lesioned: Development of SCL-Related Measures","volume":"40","author":"Kreuter","year":"2002","journal-title":"Spinal Cord"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1037\/a0018415","article-title":"Resilience in the Face of Coping with a Severe Physical Injury: A Study of Trajectories of Adjustment in a Rehabilitation Setting","volume":"55","author":"Quale","year":"2010","journal-title":"Rehabil. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1037\/a0029256","article-title":"Trajectories of Resilience, Depression, and Anxiety Following Spinal Cord Injury","volume":"57","author":"Bonanno","year":"2012","journal-title":"Rehabil. Psychol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1348\/135910707X197046","article-title":"A Longitudinal Analysis of Emotional Impact, Coping Strategies and Post-Traumatic Psychological Growth Following Spinal Cord Injury: A 10-Year Review","volume":"12","author":"Pollard","year":"2007","journal-title":"Br. J. Health Psychol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1038\/sc.1994.109","article-title":"A Longitudinal Investigation into Anxiety and Depression in the First 2 Years Following a Spinal Cord Injury","volume":"32","author":"Craig","year":"1994","journal-title":"Spinal Cord"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Tedeschi, R., and Calhoun, L. (1995). Trauma & Transformation: Growing in the Aftermath of Suffering, Sage.","DOI":"10.4135\/9781483326931"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/s41393-018-0215-7","article-title":"Basic Hope and Posttraumatic Growth in People with Traumatic Paraplegia\u2014The Mediating Effect of Acceptance of Disability","volume":"57","author":"Byra","year":"2019","journal-title":"Spinal Cord"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1179\/2045772313Y.0000000169","article-title":"Post-Traumatic Growth Following Spinal Cord Injury","volume":"37","author":"Kalpakjian","year":"2014","journal-title":"J. Spinal Cord Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2174\/1875399X00801010045","article-title":"A Review on Transitional Implications for Retiring Elite Athletes: What Happens When the Spotlight Dims?","volume":"1","author":"Smith","year":"2009","journal-title":"Open Sports Sci. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/10790268.2009.11760762","article-title":"Influence of Sport Participation on Community Integration and Quality of Life: A Comparison between Sport Participants and Non-Sport Participants with Spinal Cord Injury","volume":"32","author":"McVeigh","year":"2009","journal-title":"J. Spinal Cord Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Szeliga, E., Brzozowska-Mago\u0144, A., Borys, R., Wolan-Nieroda, A., and Walicka-Cupry\u015b, K. (2022). The Relationship between Physical Activity Level and Functional Status of Subjects with High Spinal Cord Injury. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031787"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1038\/sc.2017.40","article-title":"Association among Practice Frequency on Depression and Stress among Competitive US Male Wheelchair Rugby Athletes with Tetraplegia","volume":"55","author":"Silveira","year":"2017","journal-title":"Spinal Cord"},{"key":"ref_28","first-page":"81","article-title":"Sport in People with Tetraplegia: Review of Recent Literature","volume":"20","author":"Tasiemski","year":"2013","journal-title":"Trends Sport Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.physio.2013.09.006","article-title":"Considering How Athletic Identity Assists Adjustment to Spinal Cord Injury: A Qualitative Study","volume":"100","author":"Hawkins","year":"2014","journal-title":"Physiotherapy"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.socscimed.2005.01.011","article-title":"Men, Sport, Spinal Cord Injury, and Narratives of Hope","volume":"61","author":"Smith","year":"2005","journal-title":"Soc. Sci. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e020890","DOI":"10.1136\/bmjopen-2017-020890","article-title":"Quality of Life among Individuals with Rugby-Related Spinal Cord Injuries in South Africa: A Descriptive Cross-Sectional Study","volume":"8","author":"Badenhorst","year":"2018","journal-title":"BMJ Open"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2954","DOI":"10.1111\/jan.13031","article-title":"Systematic Methodological Review: Developing a Framework for a Qualitative Semi-Structured Interview Guide","volume":"72","author":"Kallio","year":"2016","journal-title":"J. Adv. Nurs."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1038\/bdj.2008.192","article-title":"Methods of Data Collection in Qualitative Research: Interviews and Focus Groups","volume":"204","author":"Gill","year":"2008","journal-title":"Br. Dent. J."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"van Diemen, T., van Nes, I.J.W., van Laake-Geelen, C.C.M., Spijkerman, D., Geertzen, J.H.B., and Post, M.W.M. (2021). SELF-SCI Group Learning Self-Care Skills after Spinal Cord Injury: A Qualitative Study. BMC Psychol., 9.","DOI":"10.1186\/s40359-021-00659-7"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"526","DOI":"10.12968\/bjon.2020.29.9.526","article-title":"The Meaning of Hope for Individuals with Spinal Cord Injury in Brazil","volume":"29","author":"Zuchetto","year":"2020","journal-title":"Br. J. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1177\/1097184X02004003003","article-title":"Sport, Spinal Cord Injuries, Embodied Masculinities, and Narrative Identity Dilemmas","volume":"4","author":"Sparkes","year":"2002","journal-title":"Men Masc."},{"key":"ref_37","unstructured":"Booth, R. (The Guardian, 2008). \u201cHe Wasn\u2019t Prepared for a Second-Class Life\u201d: Why Injured Rugby Star Went to Switzerland to Die, The Guardian."},{"key":"ref_38","first-page":"233","article-title":"Athletic Identity, Sport Participation, and Psychological Adjustment in People with Spinal Cord Injury","volume":"28","author":"Tasiemski","year":"2011","journal-title":"Adapt. Phys. Act. Q."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1177\/104973239800800506","article-title":"Athletic Identity: An Achilles\u2019 Heel to the Survival of Self","volume":"8","author":"Sparkes","year":"1998","journal-title":"Qual. Health Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.psychsport.2012.04.011","article-title":"I Act, Therefore I Am: Athletic Identity and the Health Action Process Approach Predict Sport Participation among Individuals with Acquired Physical Disabilities","volume":"13","author":"Perrier","year":"2012","journal-title":"Psychol. Sport Exerc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.3109\/09638288.2011.631684","article-title":"Factors Influencing Acceptance of Disability in Individuals with Spinal Cord Injury in Neiva, Colombia, South America","volume":"34","author":"Nicholls","year":"2012","journal-title":"Disabil. Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.dhjo.2014.09.009","article-title":"Sport Participation among Individuals with Acquired Physical Disabilities: Group Differences on Demographic, Disability, and Health Action Process Approach Constructs","volume":"8","author":"Perrier","year":"2015","journal-title":"Disabil. Health J."},{"key":"ref_43","first-page":"311","article-title":"Psychological Adjustment to Spinal Cord Injury as Related to Manner of Onset of Disability","volume":"22","author":"Athelstan","year":"1979","journal-title":"Rehabil. Couns. Bull."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/14\/8441\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:47:46Z","timestamp":1760140066000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/14\/8441"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,11]]},"references-count":43,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["ijerph19148441"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19148441","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,11]]}}}