Article

The role of psychological factors in sport injury rehabilitation outcomes

March 2010
International Review of Sport and Exercise Psychology 3(1):40-61

Authors:

Springfield College

Although physical factors have ascended to a position of primacy in explaining and guiding treatment toward attaining sport injury rehabilitation outcomes, psychological factors may also play an important role in the rehabilitation process. This review examines correlational studies (N=26) in which significant relationships between psychological factors have been found and experimental studies (N=14) in which the effects of psychological factors on sport injury rehabilitation outcomes have been assessed. A variety of personal, cognitive, affective, and behavioral factors associated with sport injury rehabilitation outcomes have been identified and several interventions have been found effective in enhancing sport injury rehabilitation outcomes. Theoretical, empirical, and practical considerations for developing a research agenda to explicate the role of psychological factors in sport injury rehabilitation outcomes are discussed.

Reducing the fear of re-injury during rehabilitation through mental imagery as a mental health strategy in sport and exercise

Article

Full-text available

Oct 2023

Returning to sport and exercise following injury requires the athlete to become more confident in the ability to gradually explore the use of the injured area in increasingly complex and challenging ways. Emotional responses, such as fear of re-injury, are a key mental health barrier to a performer’s return to sport and exercise. To navigate such psychological responses, performers need well-developed psychological strategies, like mental imagery (MI), to facilitate a successful return to pre-injury levels of sport and exercise. MI is a well-established strategy for dealing with negative symptoms associated with injury, providing a safe and less intimidating environment to practice movements that may be perceived as risky and otherwise performed within physical training due to the fear of causing further injury. This paper aims to provide sport psychologists with recommendations on how to utilize MI to reduce fear of re-injury during the rehabilitation process to successfully facilitate return to sport and exercise. Specific examples are also outlined and discussed.

YOZGAT GENÇLİK VE SPOR İL MÜDÜRLÜĞÜ ÇALIŞANLARININ YÖNETİM SÜRECİNDE ALGILANAN ÖRGÜTSEL DESTEK DÜZEYİNİNİN İNCELENMESİ

Chapter

Full-text available

Aug 2022

A Brief Online Video-Based Intervention to Promote Mental Health Help-Seeking in the Context of Injuries for Athletes: A pilot study

Article

Aug 2022
PSYCHOL SPORT EXERC

In the athletic population, sports injuries are often associated with mental health decline. Despite the availability of services, athletes frequently do not seek help for mental health problems. A range of barriers to help-seeking in athletes have been proposed, including poor mental health literacy and limited help-seeking knowledge. To address this, the current study piloted a newly designed online intervention that aimed to increase help-seeking attitudes, intentions, and mental health literacy (specifically depression literacy) in an athletic population. Using a pre-test post-test design, a total of 207 athletes were recruited using online convenience sampling from across Australia. Athletes were from a range of sports and competition levels and were provided a brief online intervention comprising three short educational videos with content addressing: (1) the athlete’s response to injury; (2) help-seeking and social support; and (3) signs/symptoms of depression. Participants completed pre- and post-intervention surveys which measured attitudes and intentions towards mental health help-seeking, and depression literacy. Data were analysed using RM-MANOVA, which demonstrated significant within-group improvement from pre-to post-intervention for help-seeking intentions, particularly when seeking help from mental health professionals, F(1, 93) = 24.64, p < .001, and online/phone services, F(1, 93) = 29.75, p < .001. Two separate paired samples t-test demonstrated a significant increase from pre-to post-intervention for both help-seeking attitudes, t(206) = 9.04, p < .001, d = 0.628, and depression literacy, t(203) = 8.66, p < .001, d = 0.606. The current study shows promise for brief video-based interventions that provide information targeting help-seeking during times of injury. However, further research using a rigorous randomised controlled trial design is needed. Additionally, more work is required to explore if an improvement in attitudes or intentions corresponds with increased help-seeking behaviour.

The Role of Optimism and Psychosocial Factors in Athletes Recovery From ACL Injury: A Longitudinal Study

Article

Full-text available

Oct 2020

Despite a growing interest into the role of psychosocial factors during the recovery period following sports injuries, there remains a paucity of longitudinal studies examining the indirect relationships between psychosocial factors, psychological responses, and recovery outcomes. The purpose of this study was to construct and test a conceptual model which examined the indirect relationships between optimism, psychosocial factors, rehabilitation adherence, and perceived knee function up to 12 months post anterior cruciate ligament (ACL) surgery. A prospective, longitudinal, and repeated measures design was employed, wherein 81 injured athletes (M age 26.89, SD = 7.52) completed measures of optimism, psychosocial factors, rehabilitation adherence, and perceived knee function on seven occasions (pre-surgery to 1 year post-surgery). Bayesian structural equation modeling evaluated the hypothesized indirect relationships proposed within the conceptual model. The main findings from this study was empirical support for a time-ordered, conceptual model which demonstrated that pre-surgery optimism had a significant overall indirect effect on perceived knee function at 12 months post-surgery (sum of indirect; αβ = 0.08, post. SD = 0.05, CI [0.01, 0.04]), as well as a specific indirect effect through secondary appraisal at 1 month post-surgery, efficacy at 2 months post-surgery, and rehabilitation adherence at 6 months post-surgery (αβ = 0.03, post. SD = 0.03, CI [0.00, 0.10]). Collectively, this study provides support for a number of previously hypothesized, but not empirically examined, indirect relationships between optimism, psychosocial factors and recovery outcomes. In doing so, we provide a conceptual model which has the potential to help guide individualized treatment recommendations, as well as identify individuals at risk of compromised recovery outcomes following ACL surgery.

Can Preinjury Adversity Affect Postinjury Responses? A 5-Year Prospective, Multi-Study Analysis

Article

Full-text available

Jun 2019

Informed by and drawing on both the integrated model of response to sport injury (Wiese-Bjornstal et al., 1998) and the biopsychosocial model of challenge and threat states (Blascovich, 2008), this multi-study paper examined whether preinjury adversity affected postinjury responses over a 5-year time period. Study 1 employed a prospective, repeated measures methodological design. Non-injured participants (N = 846) from multiple sites and sports completed a measure of adversity (Petrie, 1992); 143 subsequently became injured and completed a measure of coping (Carver et al., 1989) and psychological responses (Evans et al., 2008) at injury onset, rehabilitation, and return to sport. MANOVAs identified significant differences between groups categorized as low, moderate, and high preinjury adversity at each time phase. Specifically, in contrast to low or high preinjury adversity groups, injured athletes with moderate preinjury adversity experienced less negative psychological responses and used more problem- and emotion-focused coping strategies. Study 2 aimed to provide an in-depth understanding of why groups differed in their responses over time, and how preinjury adversity affected these responses. A purposeful sample of injured athletes from each of the three groups were identified and interviewed (N = 18). Using thematic analysis, nine themes were identified that illustrated that injured athletes with moderate preinjury adversity responded more positively to injury over time in comparison to other groups. Those with high preinjury adversities were excessively overwhelmed to the point that they were unable to cope with injury, while those with low preinjury adversities had not developed the coping abilities and resources needed to cope postinjury. Practical implications and future research directions are discussed.

A meta-analysis of mental imagery effects on post-injury functional mobility, perceived pain, and self-efficacy

Article

Sep 2018
PSYCHOL SPORT EXERC

Objectives: A meta-analysis was employed to examine the effects of mental imagery (MI) on bio-psychological variables, namely functional mobility, perceived pain, and self-efficacy. Method: Ten studies were included in the meta-analytical review. Cohen's d effect sizes (ES) and Hedge's g weighted mean ES (WMES) were computed for all dependent variables. Results: The analysis revealed non-significant effects of imagery interventions that were (1) small and positive for functional mobility (g ¼ 0.16), (2) large and negative for perceived pain (g ¼ À0.86), and (3) large and positive for self-efficacy (g ¼ 0.99). These effects were all non-significant, probably because the interventions administered and populations sampled in the studies were mostly heterogeneous. The observed null results might also reflect that existing studies on injury lack power. Hence, the effects of MI on bio-psychological variables warrant continued empirical investigation. Conclusions: Given the observed statistical trends, MI interventions might be beneficial for athletes recovering from injury. However, more experimental work in needed before one claims with certainty that MI enhances bio-psychological functioning in injured athletes.

A meta-analysis of mental imagery effects on post-injury functional mobility, perceived pain, and self-efficacy

Article

Full-text available

Oct 2018
PSYCHOL SPORT EXERC

Athletes’ lived experiences recovering from and returning to sport following a sport-related concussion: a meta-synthesis of qualitative studies

Article

Nov 2024

A small, but growing body of qualitative studies have explored athletes’ lived experiences with sport-related concussions (SRCs). For this meta-synthesis, we reviewed and synthesized qualitative, peer-reviewed studies on athletes’ lived experiences during recovery from and/or return to sport following SRC. Following PRISMA guidelines, we initially identified 5062 articles through PsycINFO, Embase, MedLine, SportDiscus, and Web of Science. After eliminating duplicates, screening titles, abstracts and full texts, 33 peer-reviewed articles matched our inclusion criteria. Subsequently, the authors appraised the quality of the included articles using the Critical Appraisal Skills Program. We followed guidelines for thematic synthesis, in which we initially developed 16 descriptive themes, each rooted in the original data extracted from the 33 articles. Subsequently, we developed four analytical themes that were informed by the descriptive themes and existing models and frameworks in the sport and exercise literature: (a) SRC characteristics: Identifying SRC features, (b) SRC consequences: Understanding the impact of the injury, (c) SRC outcomes: Discovering paths to recovery, and (d) In=uential factors: Exploring the contextual factors affecting SRC consequences and outcomes. Our findings offer a comprehensive description of qualitative evidence on athletes’ lived experiences with SRC, including gaps in knowledge and insights for future research in the field.

Diseño y validación de contenido del cuestionario de rehabilitación psicológica de lesión deportiva (PsyReSport)

Chapter

Full-text available

Jul 2023

El estudio pretende revisar y validar el cuestionario de rehabilitación psicológica de lesión deportiva (PsyReSport), una herramienta que ayudará a profesionales de las ciencias del deporte a tomar decisiones apropiadas para incrementar la probabilidad de éxito en el retorno del deportista lesionado. Con la versión preliminar de Rodríguez et al. (2017), constituida por 122 ítems, se condujo un estudio piloto que incluyó el juicio de expertos, entrevistas cognoscitivas y una aplicación a 20 deportistas. Así se obtuvo la versión final de 70 ítems, insumo del estudio dos. A través de jueces expertos se evidencia validez de contenido, con puntajes superiores a 0.8 en la V de Aiken en todos los criterios de análisis, un alto porcentaje de acuerdo de jueces y puntajes significativos en la Kappa de Fleiss. Se concluye que la prueba final de 70 ítems es un instrumento con una adecuada validez de contenido para medir rehabilitación psicológica de lesión deportiva.

Comparative study of role of physiotherapy alone versus physiotherapy combined with yoga in rehabilitation after a sports injury. What can a primary physician offer?

Article

Full-text available

Jan 2022

Background: Posttraumatic rehabilitation of sports injuries involves physiotherapy. Additionally, nonsurgical treatment of sports injuries involves regular physiotherapy as a major treatment therapy. This study aimed to evaluate the effects of yoga in addition to regular physiotherapy on these patients. Materials and methods: In the present comparative study, we evaluated the effects of regular physiotherapy alone versus physiotherapy combined with yoga on 212 patients following various knee injuries treated nonsurgically. The study was conducted after obtaining hospital ethical, committee clearance, and written informed consent from patients. The patients were assigned into two groups: group C (Conventional) and group Y (Yoga group). The patients in the regular group received physiotherapy rehabilitation program, whereas the yoga group received additional yoga once every day by a yoga expert during their hospital stay. We provided written guidelines and photographs of the yoga asanas and instructed to perform them 3 days/week once they were home. The data on WOMAC score were collected at 6 weeks, 3 months, and at 6 months from the day of discharge from the hospital. Results: We noted that the yoga group patients showed a significant improvement (P < 0.05) in all modalities like pain, stiffness, and function subscales of the WOMAC scale. They experienced significant reduction in pain and stiffness compared with the regular or conventional group on the seventh postinjury day, 6 weeks, 3 months, and 6 months after the initial injury. Conclusion: In this study, a combination of regular physiotherapy and yoga provided better functional outcomes than physiotherapy alone.

Psychology of Return to Play After Anterior Cruciate Ligament Injury

Chapter

Jan 2019

Physiotherapists’ Perspectives on the Importance of Psychological Impact in Sports Injury Rehabilitation: Psychological Impact in Sports Injury Rehabilitation

Article

Full-text available

Sep 2024

Background: Psychological factors significantly impact the recovery of athletes undergoing sports injury rehabilitation. Recognizing and managing these factors is essential for effective rehabilitation outcomes.Objective: To investigate physiotherapists' perspectives on the importance of psychological impacts in sports injury rehabilitation.Methods: A cross-sectional survey was conducted among 39 physiotherapists from various universities, hospitals, and clinics in Faisalabad and Lahore using purposive sampling. Participants included physiotherapists with a minimum of three years of clinical experience. Data were collected through the Liz Hussey Physiotherapy and Sports Psychology Questionnaire (PSPQ), which assessed psychological conditions, coping behaviors, and the use of psychological techniques. Descriptive statistics were analyzed using SPSS version 25.Results: The study found that 58.3% of physiotherapists believed athletes are psychologically affected by physical injuries. The most common conditions were exercise addiction (49.35%) and stress/anxiety (48.71%). Compliance with treatment was reported as the most successful coping behavior (17.9%). Techniques frequently used included encouraging positive self-thoughts (63.46%) and communication skills (63.00%).Conclusion: Physiotherapists recognize the significant psychological impact of injuries on athletes and the need for psychological skills in rehabilitation. Training in sports psychology should be enhanced for better outcomes.

Translation, Cross-Cultural Adaptation, and Validation of the Italian Version of the Shoulder Instability—Return to Sport After Injury (SI-RSI) Scale

Article

Sep 2024

Objective : To culturally adapt and validate the Italian version of the Shoulder Instability—Return to Sport after Injury (SI-RSI-I) scale. Methods : The SI-RSI-I was developed by adapting the Anterior Cruciate Ligament—Return to Sport Index—Italian version and replacing the term “knee” with “shoulder.” Subsequently, it underwent validation following COSMIN recommendations. The study involved athletic participants who experienced SI. They completed the SI-RSI-I together with other measurement instruments: Western Ontario Shoulder Instability Index, Kerlan-Jobe Orthopedic Clinic Score, EuroQol-5D-5L, and Numeric Pain Rating Scale. The following psychometric properties were investigated: structural validity, internal consistency, test–retest reliability, measurement error, and construct validity. Results : The study included 101 participants (age mean [SD] 28.5 [7.4] y; 83 males, 18 females). The SI-RSI-I showed a single-factor structure, excellent internal consistency ( α = .935), and excellent test–retest reliability (ICC = .926; 95% CI, .853–.964). The standard error of measurement was 6.1 points, and the minimal detectable change was 17.0 points. Furthermore, SI-RSI-I demonstrated moderate to strong correlations with all reference scales, confirming 8 out of 9 (88.0%) hypotheses, thus establishing satisfactory construct validity. Conclusion : The SI-RSI-I has demonstrated robust internal consistency, reliability, validity, and feasibility as a valuable scale for assessing psychological readiness to return to sport in Italian athletes with SI.

Determinants and definitions of re-injury anxiety, fear of re-injury and kinesiophobia: a systematic review

Article

Mar 2024
Staps

Objectives : While reinjury anxiety has been identified as responsible for higher probability of injury among athletes returning to sport, the literature also highlights two other “analogous” concepts: fear of reinjury and kinesiophobia. However, differences with reinjury anxiety remain unclear. Thus, the aim of this study is (1) to conduct a systematic literature review to identify the determinants of reinjury anxiety, fear of reinjury and kinesiophobia, and (2) to clarify the similarities and differences according to their definition. Methods: The systematic review was conducted using the: “Medline”, “PsycINFO”, “PsycARTICLES”, “Psychology and Behavioral Sciences Collection”, “SPORTDiscus” and “SocIndex” databases. The keywords applied identified 3408 articles, 29 of which met the inclusion criteria and were consequently analyzed. Results: Reinjury anxiety is primarily associated with psychological factors and with the specific nature of the injury. Fear of reinjury and kinesiophobia are mainly associated with sociodemographic and medical factors. While the definitions of reinjury anxiety and kinesiophobia are consensual, several different definitions are reported for fear of reinjury. Conclusion: Differences between reinjury anxiety, fear of reinjury and kinesiophobia are discussed in order to clarify their definition: reinjury anxiety is considered as the cognitive and emotional reaction caused by anticipation of the negative consequences of the injury as perceived by the athlete; fear of reinjury is viewed as the emotional reaction caused by the athlete being exposed to an effective threat of physical injury, while kinesiophobia is the fear of performing painful movements or movements that might lead to a physical injury.

Yoga as Part of Sports Medicine and Rehabilitation

Article

Full-text available

Nov 2023

Manjunath Nandi Krishnamurthy

Re-Thinking Concussion Support: From Psychological and Social Needs to Leveraging Mental Performance Consultants

Thesis

Feb 2023

Cassandra Seguin

The overarching purposes of this research were to (a) explore an under-acknowledged and under-emphasized aspect of the sport-related concussion experience: psychosocial factors of the injury experience and (b) identify possible intervention opportunities to support the associated psychological and social needs. A collaborative inquiry (Bray et al., 2000) was employed to generate data on the psychosocial experience of concussions in elite sport and to co-develop support strategies from a sport psychology lens. This qualitative research project involved three phases during which psychological and social needs, as well as psychosocial factors that facilitated and/or hindered the concussion recovery process, were discussed through two lenses. The first lens was an experiential one, whereby elite athletes who became concussed as a result of their sport engagement shared their experiences (Phase A). The second lens was that of professional expertise, whereby mental performance consultants who work in elite sport and deliver psychosocial support to concussed elite athletes shared their perspectives and clients’ experiences (Phase B). Following the sharing of these perspectives, a community of practice (Wenger et al., 2002) of mental performance consultants was formed to collaboratively discuss how mental performance consultants might be able to support the aforementioned psychological and social needs, and ultimately, concussion recovery (Phase C). Phase A. Ten elite athletes (as defined by Swann et al., 2015) participated in semi-structured focus groups (Smith & Sparkes, 2016). Athletes discussed their experiences of injury, challenges, facilitators and barriers to recovery, support mechanisms, support that was lacking but desired, and what they would do to help someone else with a concussion. The transcripts from these focus groups (n = 5, M = 58.1 min, Range: 46-88 min), follow-up questions, and informal conversations were analyzed using thematic narrative analysis (Smith, 2016), contributing to an understanding of the athletes’ lived experiences. Phase B. Nine mental performance consultants from the Canadian Sport Psychology Association and/or Association for Applied Sport Psychology who were working in high-performance sport participated in three focus groups (M = 79 min, Range = 66-98 min). Mental performance consultants were asked about their time in the field and other aspects of their consulting experience (e.g., sports, integrated within teams or not), the types of interventions they have done with concussed athletes, their perceptions of psychosocial support during the phases of concussion management, and challenges to effective service delivery. Verbatim transcripts of these focus groups were sent to the consultants and member reflections were requested (Smith & McGannon, 2018). The generated data were thematically analyzed using a six-phase cyclical and iterative approach (Braun et al., 2016). Phase C. Eight mental performance consultants from various sport contexts formed a community of practice (Wenger et al., 2002; E. Wenger-Trayner & Wenger-Trayner, 2021). The group met over a period of four months (n = 8 meetings, M = 80 min, Range = 60-90 min). These meetings were intended to address the identified interests of the members of the community regarding support for concussed elite athletes. Concussion symptomatology, management efforts, and research were discussed; and professional scope of practice and intervention opportunities were explored through best practice discussions, client case studies, and engagements with two external experts. Mental performance consultants completed individual reflections (i.e., weekly reflective questions, value creation stories, personal value narratives; Wenger et al., 2011; E. Wenger-Trayner & Wenger-Trayner, 2015) resulting in 34 single-spaced pages of generated data, which were analyzed using the Value Creation Framework (E. Wenger-Trayner & Wenger-Trayner, 2015; 2021). The results of this multi-phase collaborative inquiry are presented in four articles. The first article offers a multi-systems perspective (Bronfenbrenner, 1977; 1979; 1992) on athletes’ concussion experiences by exploring two collaboratively created narratives (Wertz, 2011; Willis, 2019) from the engagements with athletes in Phase A. Five themes (i.e., athletic identity, (dis)trust in relationships, concussion protocols, sport culture, and timing related to major events and recovery) are discussed. The second article combines the perspectives of athletes from Phase A and mental performance consultants in Phase B to identify psychological and social needs across the concussion recovery process. Four psychological needs (i.e., acceptance, normality, confidence, self-efficacy) and two social needs (i.e., trust in relationships, social support) were identified by both populations. The third article was collaboratively written to practically present how and where mental performance consultants can support concussed athletes across the phases of the injury based on the discussions in Phase C. Scope of practice, collaboration opportunities, and intervention strategies are discussed across four phases of injury (i.e., pre-injury, injury onset, rehabilitation, return to sport). The fourth article reflects the mental performance consultants’ participatory experiences in Phase C by exploring the value of the community of practice as a professional development and knowledge translation tool. Positive value was experienced across all eight cycles of the Value Creation Framework. Through the general discussion and practical implications sections of this dissertation, these results are situated within the landscapes of concussion research and practice to highlight opportunities for transforming concussion protocols and broadening the overall lens through which the concussion experience can be examined.

Spor Yaralanmaları Psikolojisinin Görsel Haritalama Üzerinden Bibliyometrik AnaliziBibliometric Analysis of Sports Injuries Psychology through Visual Mapping

Article

Full-text available

Dec 2022

Çiğdem ÖNER

Yaralanma, sportif performans olgusunun temel gerçekliklerinden biridir. Bu gerçeklik, spor insanlarını bedensel ve ruhsal travmalar ile karşı karşıya bırakmaktadır. Yaralanma sonucu belirginleşen duygu yükleri sporcuların iyileşme süreçlerinde etkendir ve çok yönlü destek programlarının inşasını gerektirir. Bu gereklilik, kuramsal ve deneysel araştırmalara dayalı nitelikli yayınların artışına yön vermektedir. Artan yayınların ortaya koyduğu tablonun ana hatlarının belirlenmesi düşüncesi ile bu çalışmada, spor yaralanmaları psikolojisi araştırmalarının görsel haritalama üzerinden bibliyometrik analizi amaçlanmıştır. Bu amaçla, Web of Science veritabanında tanımlı atıf indekslerinden Social Sciences Citation Index (SSCI), Science Citation Index Expanded (SCIE), Emerging Sources Citation Index (ESCI) ve Arts & Humanities Citation Index (AHCI)’in 1985-2022 tarihli yayınları incelenmiştir. Bu yayınlar arasından araştırma makalesi olduğu belirlenen 200 yayın çalışma kapsamına alınmıştır. Bibliyometrik verilerin görselleştirmelerinde VOSviewer 1.6.18 kullanılmıştır. Çalışmada, yayım yılı, yazar, atıf sayısı, yayımlayan dergi dağılımları incelenmiştir. Yazarlar, kurumlar ve ülkelerarası ilişkiler sorgulanmış, anahtar kelime analizi, bibliyometrik eşleştirme ve ortak atıf ağ analizleri yapılmıştır. Bulgular, en fazla yayının 38 makale ile 2019-2022’de yapıldığını göstermiştir. Atıf analizlerine göre, Wiese-Bjornstal vd. en fazla atıf alan yazar, Journal of Applied Sport Psychology en çok atıf alan dergi, Springfield College en fazla atıf alan kurum, ABD en fazla atıf alan ülkedir. Sonuçlar, araştırmalarda öne çıkan anahtar kelime kümelerinin rehabilitasyon, psikoloji, sosyal destek ve atletik yaralanma, stres ve geri dönüş olduğunu teyit etmektedir. Araştırma özetleri bağlamında yapılan analizde; dört ana anahtar kelime kümesinin belirginleştiği, bu kümelerin psikoloji, rehabilitasyon, yaralanma ve spor yaralanması olduğu görülmüştür.

Psychological readiness to return to sports practice and risk of recurrence: Case studies

Article

Full-text available

Sep 2022

Returning to sport after the sports injury is a difficult decision because it’s multicausal and the fact that a rash decision can result in numerous negative consequences. Given the importance of psychological variables for the correct rehabilitation of the injured athlete and his or her optimal return to sports practice, there seems to be little information on this subject. In this sense, the objective is to determine the relationship between the subjective psychological disposition of the athlete in the process of Return to Play (RTP) with the type of mood profile and his mental health. This is based on the fact that each athlete evaluates his or her recovery differently and has different levels of anxiety, depression, and stress. For this purpose, four athletes participated in the study. Two males and two females from the sports of indoor soccer and soccer, who had just returned to sports after a moderate or severe injury. The average age was 24.25 years. Various measurements were taken after practices and after matches, to assess mood, psychological readiness, anxiety, stress, and depression. The results confirm Morgan’s iceberg profile and the influence that subjective psychological perceptions and assessed emotional states have on athletes’ incorporation into their sports practice with a guarantee of success.

Goal setting in sport injury rehabilitation: a systematic review

Article

Full-text available

Dec 2021

Goal setting is an essential component of any modern approach to rehabilitation. It provides a framework through which rehabilitation professionals and their patients can work together to improve the physical autonomy of the client and their psychological well-being, generating an important reference for rehabilitation achievements, and fosters both the effort and perseverance of the athletes. The aim of this paper is review and analyse the investigations that have employed goal setting in the framework of sports injuries rehabilitation. A systematic review was conducted, within the PsycINFO, SPORTDiscus, CINAHL Complete, MEDLINE, Academic Search, EMBASE, Dialnet, ISI Web of Knowledge and Sciente Direct databases. Ten studies have analysed the effect of goal setting during the rehabilitation process, or have used the technique in conjunction with other intervention procedures. Significant effects on rehabilitation were confirmed. The main findings confirm a faster recovery because of goal setting, psychological discomfort reduction and increased motivation, mood improvements, greater focus and effort of athlete in treatment, and performance improvements with challenging goals. It also resulted in a greater treatment adherence, greater adherence to rehabilitation sessions and compliance with homework, high scores on self-satisfaction and self-efficacy, and a very high percentage of athletes who achieve their self-selected functional goals. It is concluded that goal setting is shown as an intervention strategy and technique with important benefits at a psychological and physical level, and is positively valued by athletes, coaches and physiotherapists. It is necessary to implement techniques and programs that address the cognitive and behavioral aspects of the injured, and that motivate and focus their efforts to full recovery.

Models of injury and practical tips for using imagery in rehabilitation

Article

Full-text available

Nov 2021

Athletes' reactions to injuries are varied and involve not only physical, but also mental responses. The perception of injury and individual differences can influence the results of rehabilitation. This article presents four models that show these relationships. Special attention is paid to the difficulties faced by athletes when returning to sport after injury. Imagery is a mental training technique recommended in the rehabilitation process. Correct application of this method is thought to be important in recovery. There are several main factors that are considered to affect the effectiveness of imagery training. Real examples of the use of the technique by injured athletes are useful for understanding what to pay attention to. Our purpose is to show that imagery training can help in an injury situation.

An Interactive Cognitive-Behavioural Multimedia Program Favourably Affects Pain and Kinesiophobia During Rehabilitation After Anterior Cruciate Ligament Surgery: An Effectiveness Trial

Article

Jun 2021

Psychological interventions have been found effective in helping athletes cope with the challenges associated with knee surgery. In this investigation, an interactive cognitive-behavioural multimedia program was evaluated as a means of delivering psychological interventions to individuals experiencing anterior cruciate ligament (ACL) surgery in a field trial with 69 ACL surgery patients (30 women and 39 men; 24 competitive athletes, 41 recreational athletes, and 4 nonathletes; Mage = 35.01, SD = 11.98 years). Results indicated that compared to participants who received standard care, participants who received the multimedia program reported greater preoperative confidence in ability to cope, lower postoperative pain and kinesiophobia, and greater use and perceived utility of patient education materials. The findings suggest that the multimedia program has promise as an economical and effective means of educating and delivering psychological interventions to people experiencing ACL surgery and rehabilitation.

The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee

Article

Full-text available

Jan 2021

PurposeThe purpose of this study is to evaluate the reasons why athletes do not return to play (RTP) following anterior cruciate ligament (ACL) reconstruction from a large single-centre database.Methods The institutional ACL registry was screened for patients that had undergone a primary ACLR and had RTP status reported at 24-month follow-up. The reasons that patients were unable to RTP at 24 months were evaluated. The ACL-Return to Sport Index (ACL-RSI) was evaluated at baseline and 24-month follow-up to evaluate psychological ability to RTP.ResultsAt 2 years, 1140 patients returned to play, and 222 had not returned to play. The most common reasons athletes were unable to return was fear of reinjury (27.5%), lack of confidence in performance on return (19.4%) and external life factors (16.6%), i.e. work commitments and family reasons. Other reasons for athletes not returning to play were residual knee pain (10%) and subsequent injury (5%). The ACL-RSI score was significantly lower at diagnosis (40.3 vs. 49.3; p = 0.003) and 2 years (41.8 vs. 78.7; p < 0.0001) in athletes who did not return to play vs. those that did RTP.Conclusion The majority of patients that report they have not returned to play do so due to external life and psychological factors associated with their injury, including fear of reinjury and lack of confidence in performance. A small minority of patients were unable to return due to residual knee symptoms or reinjury. Pre-operative psychological assessment and intervention may identify those less likely to RTP and provide an opportunity for targeted interventions to further improve RTP outcomes.Level of evidenceIII.

The Evolution of Psychological Response to Athlete Injury Models for Professional Sport

Article

Full-text available

Dec 2020

Elite competitive sport is linked with a unique collection of stressors distinct from the general population. While there have been advancements in understanding the role that stressors play within the elite sporting environment, uncertainty still exists around a clear process for measuring stressors, and their specific relationship to injury. A number of models have been proposed as useful frameworks for investigating and describing the role of stress and its interaction with the psychological response to athletic injury. While these models provide evolving points of view drawing on different theoretical backgrounds regarding their interpretation of athletic stress and injury, they offer little application to the applied elite sporting environment, and no detail of how they these models support athletes, and high performance staff in the applied setting. This narrative review will present two popular theoretical psychological models of sports injury rehabilitation. We argue that these models could be better applied in the current sporting environment if they utilized biological markers such as cortisol measures of personality. Extending from the Biopsychosocial model of injury, we present an updated model of injury quantifying the psychophysiological response for athletes [1]. This model is aligned with the current applied sporting landscape, incorporating the implementation of measurement practice guidelines, and offering high-performance staff an example that can be applied to their unique setting by assessing individuals' distinct measures of cortisol and personality in response to stress and injury.

On determining factors affecting injury and recovery in athletes

Article

Full-text available

Aug 2020

Mohammad Reza Parish

p> The aim of the study is to develop a comprehensive model on the risk factors of injury/re-injury and factors affecting the recovery process. Material and methods. Systematic analysis and scientific generalization of the latest theoretical and analytical studies on the factors affecting risk of injury, assessment, prevention and recovery of injuries in athletes. Results. The conducted comprehensive analysis allowed to build a theoretical model on the injury-recovery cycle. The model includes 3 main groups of factors affecting the risk of injury, namely: internal, caused by physiological processes; external, caused by training conditions and equipment; fear, which is related to the personal psychological and emotional characteristics and external surroundings. At the same time, implementation of preventive measurements can reduce the risk of injuries. The model highlighted the positive impact of social support and interactions between a patient and a therapist in the process of injury recovery. Conclusions. In order to minimize the risk of injury and stimulate the recovery process in athletes the following recommendation should be taken in place: to promote the spreading of information on possible ways of injury prevention; to provide educational services for those who are involved in sports and other physical activities; to spread the information about the main types of injury and the treatment approaches to make athletes familiar with that, which can increase their competence and reduce the fear of injury; to encourage communication and interaction between teammates, with their trainers and coaches during the period of recovery to eliminate the level of isolation of injured athletes.</p

Re-injury worry, confidence and attention as predictors of a sport re-injury during a competitive season

Article

Full-text available

Nov 2020
Res Sports Med

Rehabilitation from sport injury involves not only physical, but also psychological considerations. Re-injury worry, confidence and attention are characteristics that may affect athletes’ returning to competition after a sport injury. The study aimed to describe the predictive ability of the re-injury worry, confidence, and attention to the total of re-injuries at the new competitive season. The sample was 80 male athletes with at least three years of competitive experience who had a sport musculoskeletal injury in the last 8 months and had followed properly their physiotherapy program. They were ready for re-entry into competitive sport. They completed on returning to competition: (a) the Causes of the Re-Injury Worry Questionnaire, (b) the Sport Confidence Questionnaire of Rehabilitated Athletes Returning to Competition and (c) the Attention Questionnaire of Rehabilitated Athletes Returning to Competition. The three valid and reliable instruments predict the total of re-injuries at the beginning and at the middle of the competitive season. Future research should be conducted to examine the relationship between the physical and psychological characteristics in re-injury’s prediction from different contact sports.

Challenging the Status Quo of Sport Injury Psychology

Chapter

Full-text available

Oct 2020

Ross Wadey

I’ve never experienced a meaningful sport injury. Yet, I find myself sat at my desk at home writing this introduction, for a book on ‘sport injury’ psychology. As I sit here trying to make sense of how I came to Edit this book, I recall various stories as I reflect on my academic career, which provide me with insights into key turning points that led me to this field of research and ultimately the aim and scope of this book ....

A Cognitive Behavioral Intervention for College Athletes With Injuries

Article

Full-text available

Jun 2020

The authors used a quasi-experimental design to examine the efficacy of a cognitive-behavioral-therapy (CBT) intervention for enhancing psychological well-being (positive and negative affect, vitality, self-esteem), rehabilitation adherence, and clinical rehabilitation outcomes (pain, physical function) in 16 NCAA (National Collegiate Athletics Association) Division I athletes experiencing a range of severe injuries. ANCOVAs, with adjusted baseline scores, revealed significant differences between the experimental and control groups for positive affect at rehabilitation midpoint (T2; adjusted mean difference ( AMD ) = 0.41, p = .04, η ² = .34) and return to play (T3; AMD = 0.67, p < .001, η ² = .70), negative affect at T3 ( AMD = −0.81, p = .01, η ² = .47), and vitality at T2 ( AMD = 0.99, p = .01, η ² = .48) and T3 ( AMD = 1.08, p = .02, η ² = .33). Given decrements in emotional functioning after injury, the data support the use of CBT-based interventions for facilitating the emotional well-being of athletes with severe injuries.

A cross-cultural validation of the Attention Questionnaire of Rehabilitated Athletes Returning to competition

Article

May 2020
PHYS THER SPORT

Objectives To culturally adapt the Attention Questionnaire of Rehabilitated Athletes Returning to Competition (AQ-RARC) in the Italian language. Design Cross-sectional study. Setting Italian athletes. Participants We recruited 324 athletes (215 men, 109 women) divided in two samples: 101 injured athletes returning to their first competition following injury, 223 non-injured athletes making their first competition of the regular season. Main outcome measures The AQ-RARC-IT, the Psychobiosocial States Scale (PBS-ST), and a Concentration/Disruption scale. Athletes completed the questionnaires at the end of their first competition. We investigated the construct validity, the internal consistency, and the concurrent validity of all measures. Results A confirmatory analysis (CFA) supported the two-factor structure of the AQ-RARC-IT yielding acceptable fit indices, CFI = 0.930, TLI = 0.912, RMSEA (90% CI) = 0.100 (.076–.123), and SRMR = 0.082. Concurrent validity was evaluated through Pearson's correlation coefficients between measures. Correlations ranged in magnitude from weak to moderately high. Conclusions Study findings showed satisfactory psychometric properties of the AQ-RARC-IT. The questionnaire can be used for clinical and research purposes.

Responsiveness of the anterior cruciate ligament – Return to Sports after Injury (ACL-RSI) and Injury – Psychological Readiness to Return to Sport (I-PRRS) scales

Article

Full-text available

Jul 2019

The ACL-Return to Sport after Injury (ACL-RSI) and Injury-Psychological Readiness to Return to Sport (I-PRRS) scales were developed to assess psychological factors associated with return to sports. Validity and reliability have been determined. The aim of this study was to investigate the responsiveness of the Dutch ACL-RSI and I-PRRS. Seventy patients with ACL reconstruction completed both scales twice 2 months apart, plus a Global Rating of Change (GRC) questionnaire. Distribution and logistic regression-based methods were used to study responsiveness. The Standardized Response Mean (SRM) for the ACL-RSI was 0.3 and for the I-PRRS 0.1, indicating low responsiveness. The minimally important change (MIC) for ACL-RSI was 2.6 and for the I-PRRS 0.9. Since the standard error of measurement (SEM) and smallest detectable change (SDC) were larger than MIC in individual patients, it does not seem possible to distinguish minimally important changes from measurement error in individual patients with either scale. At the group level responsiveness seemed sufficient; hence, both scales can be used to investigate the effectiveness of an intervention at the group level. Both scales can also be used in cross-sectional research and in clinical practice as screening instruments to identify patients at risk of not returning to sports.

Physiotherapists’ views, perceived knowledge, and reported use of psychosocial strategies in practice

Article

Full-text available

Mar 2019

Background: Research has addressed the usefulness of psychosocial strategies within physiotherapy, as part of a biopsychosocial model. A lack of current research in Australia concerning the views of physiotherapists, from a range of practice areas, regarding a variety of strategies, suggests the need for broader exploration. Methods: This research employed a cross-sectional survey asking Australian physiotherapists (n = 251) to rate their perceived importance and perceived benefits of psychosocial strategies; perceived positive effects on rehabilitation outcomes and adherence; confidence in applying strategies, and perceived benefits of further training. Data were analyzed using descriptive statistics, Crosstabs with Chi-Squared Tests of Contingencies and Spearman's Rank-Order Correlations. Results: Physiotherapists reported that having knowledge of such strategies was important and considered them beneficial for practice. Respondents rated highly their perceived knowledge about goal setting and positive reinforcement, both of which were reported as most used in practice. Approximately one quarter of physiotherapists reported using cognitive behavioral therapy and motivational interviewing. Physiotherapists communicated a lack of confidence to apply psychosocial strategies in their practice, and desired further training. Conclusion: Physiotherapists could benefit from tailored instruction regarding psychosocial strategies at a level appropriate to, and within their scope of practice. This could enhance their practice from a biopsychosocial perspective, subsequently improving outcomes for their patients.

A Review of the Sport Injury and Rehabilitation Literature: From Abstraction to Application

Article

Dec 2018

Despite advancements in sport-injury rehabilitation theory and intervention design, return-to-play outcomes remain suboptimal. To explore the current knowledge base in sport-injury rehabilitation, the authors use an existing framework to review and outline gaps in the sport-injury evidence base. Through the lens of this framework they highlight the dearth of literature exploring how professionals approach rehabilitation, which may be one of several factors contributing to persistently poor rehabilitation outcomes. To begin addressing the identified gap in practice, the authors hypothetically apply 3 established team-based approaches from other rehabilitation domains to a single sport-injury case study to provide concrete examples of how team-based practice approaches can be effectively used in the sport domain. Professional-practice implications are discussed alongside areas for future research.

Stress and Injuries in Elite Sport

Chapter

Full-text available

Jan 2018

NCAA DI Athletic Trainers� Perception and Use of Psychological Techniques During Sport Injury Rehabilitation

Article

Nov 2024

Could Motor Imagery Training Provide a Novel Load Management Solution for Athletes? Recommendations for Sport Medicine and Performance Practitioners

Article

Full-text available

Nov 2024

Context Athletes often face the dual challenge of high training loads with insufficient time to recover. Equally, in any team, sports medicine and performance staff are required to progress training loads in healthy athletes and avoid prolonged reductions in training load in injured athletes. In both cases, the implementation of a well-established psychological technique known as motor imagery (MI) can be used to counteract adverse training adaptations such as excessive fatigue, reduced capacity, diminished performance, and heightened injury susceptibility. Study Design Narrative overview. Level of Evidence Level 5. Results MI has been shown to enhance performance outcomes in a range of contexts including rehabilitation, skill acquisition, return-to-sport protocols, and strength and conditioning. Specific performance outcomes include reduction of strength loss and muscular atrophy, improved training engagement of injured and/or rehabilitating athletes, promotion of recovery, and development of sport-specific skills/game tactics. To achieve improvements in such outcomes, it is recommended that practitioners consider the following factors when implementing MI: individual skill level (ie, more time may be required for novices to obtain benefits), MI ability (ie, athletes with greater capacity to create vivid and controllable mental images of their performance will likely benefit more from MI training), and the perspective employed (ie, an internal perspective may be more beneficial for increasing neurophysiological activity whereas an external perspective may be better for practicing technique-focused movements). Conclusion We provide practical recommendations grounded in established frameworks on how MI can be used to reduce strength loss and fear of reinjury in athletes with acute injury, improve physical qualities in rehabilitating athletes, reduce physical loads in overtrained athletes, and to develop tactical and technical skills in healthy athletes.

Optimising the Early-Stage Rehabilitation Process Post-ACL Reconstruction

Article

Full-text available

Oct 2023
SPORTS MED

Outcomes following anterior cruciate ligament reconstruction (ACLR) need improving, with poor return-to-sport rates and a high risk of secondary re-injury. There is a need to improve rehabilitation strategies post-ACLR, if we can support enhanced patient outcomes. This paper discusses how to optimise the early-stage rehabilitation process post-ACLR. Early-stage rehabilitation is the vital foundation on which successful rehabilitation post-ACLR can occur. Without high-quality early-stage (and pre-operative) rehabilitation, patients often do not overcome major aspects of dysfunction, which limits knee function and the ability to transition through subsequent stages of rehabilitation optimally. We highlight six main dimensions during the early stage: (1) pain and swelling; (2) knee joint range of motion; (3) arthrogenic muscle inhibition and muscle strength; (4) movement quality/neuromuscular control during activities of daily living (5) psycho-social-cultural and environmental factors and (6) physical fitness preservation. The six do not share equal importance and the extent of time commitment devoted to each will depend on the individual patient. The paper provides recommendations on how to implement these into practice, discussing training planning and programming, and suggests specific screening to monitor work and when the athlete can progress to the next stage (e.g. mid-stage rehabilitation entry criteria).

Educational level and injury treatment response: An observational study with football players

Article

Oct 2023
Gazz Med Ital

BACKGROUND: Education level is an item that is not usually considered when talking about injury prevention and treatment in football. Different education levels can influence the perception of the players about their careers and in consequence the risks they take in the field, and no studies are found about this influence. Injuries are considered important problems in football, with individual and team consequences. This study examined whether primary or university studies could condition this rehabilitation process METHODS: An observational study was carried with football players of professional clubs of second division. 52 injured players of these clubs were recruited. A questionnaire created ad-hoc was passed to the players measuring the number of injuries, number of games played and type of treatment. RESULTS: Meaningful interactions were found between the treatment and education on number of games (F=5.99; p=0.018) and injuries and educational levels of players (F=3.96; p=0.052). CONCLUSIONS: We can conclude that higher education levels may contribute to improve rehabilitation processes after soccer injuries.

Psychologie appliquée à la blessure en sport

Chapter

Jan 2023

Alexis Ruffault

The Association of Physical Competence With Psychological Response Among Young Athletes at Time of Return to Sport After ACL Reconstruction

Article

Aug 2023

Background: The traditional index of return-to-sport (RTS) readiness after anterior cruciate ligament reconstruction (ACLR) is the achievement of physical competence criteria. Emerging research indicates that psychological response and self-perceptions of physical competence may be critical mechanisms for successful RTS among young athletes. Hypothesis: Young athletes with higher actual physical competence (APC) and perceived physical competence (PPC) will demonstrate a more positive psychological response at the time of RTS after ACLR. Study design: Cross-sectional study; Level of evidence, 3. Methods: A total of 41 young athletes after primary ACLR completed testing within 8 weeks of medical clearance to RTS. APC was measured with isokinetic knee extension strength, single-limb crossover hop for distance, and the Knee injury and Osteoarthritis Outcome Score. PPC was measured with the Athletic Competence subscale of the Self-Perception Profile. Criteria for APC and PPC were based on established age- and activity-relevant cutoff scores. Different constructs of psychological response were assessed with the adapted Sport Motivation Scale, Brief Resilience Scale, and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) total and subscale scores (Emotions, Confidence, and Risk Appraisal). Multiple linear regression analyses were used to determine differences in measures of psychological response based on achievement of APC and PPC, while adjusting for age and sex. Results: Of the 41 participants, 10 (24.4%) met all criteria for APC and 22 (53.7%) met the PPC criteria. The regression models estimating the ACL-RSI score (P < .001; adjusted R2 = 0.331), ACL-RSI Emotions score (P < .001; adjusted R2 = 0.427), and ACL-RSI Risk Appraisal score (P = .013; adjusted R2 = 0.212) were statistically significant. Although APC was not associated with any measure of psychological response, meeting PPC criteria, younger age, and male sex were found to be associated with a more positive psychological readiness to RTS, but not with motivation or resilience. Conclusion: Meeting PPC criteria was associated with higher psychological readiness to RTS among young athletes after ACLR, while meeting APC criteria was not associated with any construct of psychological response.

Sports, Stress, and Health

Chapter

Feb 2023

The topic of stress regulation and sports can be viewed from two differing perspectives. From the point of view of sports as a health-promoting activity, the focus is on sports as a means to stress regulation. The central question is the degree to which sports, exercise, and physical activity can help us to cope with daily challenges, so that the negative health effects of these stressors can be avoided or reduced. From the point of view of performance sports, on the other hand, the central focus is stress regulation during sporting activity. In other words, how can athletes cope with high levels of training and psychological pressure, without suffering a drop in physical performance or psychological complaints? From this perspective, important factors are those which allow high-performance and elite athletes to perform at the highest level under pressure. The first section of this chapter presents the theoretical foundations of stress regulation and sports; in the second section, the two perspectives presented here will be discussed in detail.

Proposal for Physical Fitness Enhancement Methods Based on Survey of Musculoskeletal Injuries and Treatment Experience in Active Duty Soldiers

Article

Dec 2020

JinHak Do

Etude des déterminants de l'anxiété de re-blessure chez le sportif : Identification de profils psychologiques et étude de l'efficacité d'une intervention d'imagerie mentale auprès de sportifs blessés au ligament croisé antérieur

Thesis

Full-text available

Jul 2020

Benjamin Caumeil

Résumé : Lors du retour au sport, les sportifs blessés sont exposés à des émotions et cognitions négatives spécifiques. Ce vécu psychologique a donné lieu à l’émergence du concept d’anxiété de re-blessure, dont les conséquences portent également sur la performance et la santé physique du sportif au vu du risque accru de re-blessure qui y est associé. Si certains travaux scientifiques récents ont permis d’améliorer la prédiction de l’anxiété de re-blessure ainsi que d’évaluer l’efficacité d’interventions psychologiques visant à la réduire, de nombreux domaines d’étude restent à approfondir en lien avec ce concept. Ce travail doctoral, structuré des articles scientifiques rédigés et soumis pendant la thèse ainsi que de ceux qui pourront en découler de façon prioritaire, proposera donc d’étudier le concept d’anxiété de re-blessure en référence à 5 objectifs complémentaires. Le premier chapitre de ce travail présentera une revue systématique de littérature visant à mieux identifier les déterminants de l’anxiété de re-blessure et des autres concepts proches, tout en précisant leurs définitions. Cette revue souligne l’importance de privilégier le concept d’anxiété de re-blessure pour décrire les réactions psychologiques du sportif reprenant la pratique sportive après blessure. Le second chapitre portera sur l’adaptation et une validation en langue française d’un outil de mesure de l’anxiété de re-blessure. L’étude de la structure factorielle de l’outil permet, au-delà du score global issu du questionnaire, l’identification de trois sous-dimensions : la peur de se re-blesser, l’anxiété de contre-performance et les manifestations anxieuses. Le troisième chapitre proposera d’étudier les déterminants de l’anxiété de re-blessure à l’aide d’analyses de régression et de modèles de médiation et de modération. Les résultats montrent que le stress, la symptomatologie anxieuse et le genre prédisent l’anxiété de re-blessure de façon directe, mais également indirecte au vu des effets médiateurs et modérateurs traduisant leurs interactions avec d’autres caractéristiques psychologiques. L’utilisation d’un modèle croisé décalé permet également de montrer le rôle du stress dans la prédiction de l’anxiété de re-blessure dans une perspective longitudinale. Le quatrième chapitre proposera de tester l’existence de profils psychologiques liés à l’anxiété de re-blessure. Les analyses en clusters réalisées mettent en évidence quatre profils différents, au sein desquels apparaissent deux profils caractérisé par la présence de l’anxiété de re-blessure et d’autres émotions négatives (l’un à un niveau modéré, l’autre à un niveau élevé), un profil caractérisé par un faible niveau d’anxiété de re-blessure, et un dernier profil caractérisé par un niveau d’anxiété de re-blessure « intermédiaire » et surtout par le manque de confiance que le sportif accorde à la partie du corps blessé. Enfin, le cinquième chapitre présentera le travail d’élaboration et de mise en place ainsi que l’évaluation de l’efficacité d’une intervention d’imagerie mentale de type Visuo-Motor Behavior Rehearsal (VMBR) proposée à des sportifs ayant subi une intervention chirurgicale du ligament croisé antérieur dans le cadre d’un protocole randomisé contrôlé. L’intervention s’avère efficace sur la réduction de l’anxiété de re-blessure, du stress et de la douleur. Par ailleurs, elle permet de renforcer d’autres facteurs protecteurs tels que l’optimisme et la recherche de soutien social. L’intervention permet également aux athlètes de revenir plus rapidement au sport que ceux ne l’ayant pas reçue. La synthèse générale de ce travail proposera de déterminer les conditions de généralisation des principaux résultats obtenus tout en identifiant les perspectives d’applications rendues possibles dans le champ sportif dans la prise en charge d’autres problématiques sportives mais également auprès d’autres populations confrontés à des enjeux de performance ou exposés à des risques de blessure.

The Structural Validity of the IKDC and its Relationship with Quality of Life Following ACL Reconstruction

Article

Full-text available

Jun 2020
SCAND J MED SCI SPOR

Objective The purpose of this study was to (1) examine the structural validity of the International Knee Documentation Committee Subjective Knee Form (IKDC) in light of previously reported dimensionality issues, and (2) examine the relationships between the IKDC and patients’ knee‐related quality of life 2‐9 years after anterior cruciate ligament (ACL) reconstruction. Methods A prospective research design was employed, wherein 319 patients (mean age = 29.07, SD = 9.03) completed the IKDC before surgery, 191 patients (mean age = 29.71, SD = 9.36) completed the IKDC at 6 months post‐surgery, and 132 patients (mean age = 34.34, SD = 7.89) completed the IKDC and the Anterior Cruciate Ligament Quality of Life Survey (ACL‐QOL) at 2‐9 years post‐surgery. Results Bayesian structural equation modeling analysis confirmed the two‐factor structure (symptom & knee articulation and activity level ) represented the most accurate conceptualisation of perceived knee function across the three time points. Moreover, findings revealed that of the two IKDC subscales preoperatively, ‘activity level’ was most strongly associated with long‐term quality of life at 2‐9 years following surgery, whereas 2‐9 years postoperatively, ‘symptoms and knee articulation’ was most strongly associated with long‐term quality of life. Conclusions The IKDC provides clinicians with a convenient total score to assess patients’ perceived knee function, but its unidimensional factor structure is a poor representation of its items and fails to detect discrepancies in patients’ post‐operative quality of life, such as the relative importance of perceived knee activity level before reconstructive surgery.

Sport, Stress und Gesundheit

Chapter

Nov 2019

Markus Gerber

Das Thema Stressregulation und Sport kann aus zwei unterschiedlichen Perspektiven betrachtet werden. Aus Sicht des Gesundheitssports geht es primär um Stressregulation durch Sport. Es stellt sich die Frage, inwieweit sich durch körperliche und sportliche Aktivität die Belastungen des Alltags besser bewältigen lassen, so dass Gesundheitsbeeinträchtigungen vermieden oder reduziert werden können. Aus Sicht des Leistungssports geht es um Stressregulation im Sport. Mit anderen Worten: Wie können Athleten und Athletinnen mit hohen Trainingsbelastungen und psychischem Druck umgehen, ohne dass dabei die Leistungsfähigkeit beeinträchtigt wird oder psychische Beschwerden entstehen? Hier geht es also um Faktoren, die dazu beitragen, dass Personen im Leistungs- und Spitzensport auch unter Druck ihre besten Leistungen abrufen können. Nachdem im ersten Teil dieses Kapitels die theoretischen Grundlagen erarbeitet werden, wird im zweiten Teil auf diese beiden Perspektiven eingegangen.

Positive Client Mind-Set and Rehabilitative Success During Hippotherapy and Therapeutic Riding

Article

Aug 2019

A review of the psychological support mechanisms available for long-term injured footballers in the UK throughout their rehabilitation

Article

Jun 2019

Objectives: Athletes regularly suffer psychologically as a consequence of long-term injury. However, to date, there has been no investigation into the psychological protocols implemented to support long-term injured professional footballers. Methods: An online questionnaire was developed to identify the current rehabilitation practices in English football. Seventy-five heads of medical departments responded to the survey from first teams and academies across the English Leagues. Results: Medical staff recognised that there were clinical mental health problems, namely anxiety and depression affecting long-term injured players. It was acknowledged that there was a need for psychological support for long-term injured players. However, findings revealed most clubs had limited access to psychological practitioners and physiotherapy staff were almost entirely responsible for providing psychological support throughout rehabilitation. Conclusion: Clubs responded overwhelmingly that they wanted to be able to access psychological support for long-term injured players.

Well-Come Back! Professional Basketball Players Perceptions of Psychosocial and Behavioral Factors Influencing a Return to Pre-injury Levels

Article

Full-text available

Feb 2019

The psychological factors influencing a return to sport has gained increased research attention. In the current investigation, we explored professional basketball players’ perceptions of the psychosocial and behavioral factors facilitating a return to performance equal to or exceeding previous performance standards. We also sought to describe athletes’ experiences – both positive and negative – of returning to sport following injury recovery. Ten Italian professional male basketball players (age range 22–36 years), were retrospectively interviewed in relation to three time-periods: (1) from the commencement of rehabilitation to their first official competition, (2) the first official competition, and (3) the 6-months following the initial competition. Qualitative content analysis of the data revealed numerous themes across the three time periods. In regards to Period 1, participants indicated that social support, investment in rehabilitation and training programs, coping skills and motivation were fundamental in reaching pre-injury performance levels. During their first official game (i.e., Period 2), athletes reported that realistic performance expectations, focusing on the performance, positive emotions, motivation, arousal and social support facilitated their return to sport. Athletes, however, also described a predominance of factors that hindered their return to pre- injury levels (i.e., low confidence in personal abilities, decrements in skill execution and dysfunctional physical sensations). Moreover, participants typically described a substandard level of performance during their first competition back following injury. In recounting experiences during the 6 months following their first official game, basketballers reported improvements in skill execution and highlighted the importance of coping skills, motivation and social support. The process of restoring self-confidence in one’s ability to successfully perform was perceived as crucial in enabling participants to move beyond a mere return to sport to a return to high performance – that is, to reach a level of proficiency equal to or exceeding previous performance standards. Findings support the relevance of cognitive, emotional and behavioral responses highlighted in the Integrated Model and suggest the importance of addressing psychological factors throughout the return-to-sport process. Finally, results from the present study hold a number of practical implications for athletes’ aiming to achieve a return to pre-injury levels.

Achtsamkeit in der Rehabilitation im Leistungssport: Theorie und Praxis zu achtsamkeitsbasierten Verfahren in Freizeit, Training, Wettkampf und Rehabilitation

Chapter

Jan 2019

Verletzungen können als ein bio-psycho-soziales Phänomen angesehen werden, dementsprechend erfordert eine Rehabilitation sowohl biologische als auch psychologische und soziale Interventionen. Brewer nennt als psychologisch beeinflussenden Variablen die Persönlichkeit, die Emotion und das Verhalten. Bislang gibt es noch sehr wenige achtsamkeitsbasierte Verfahren in der Rehabilitationsphase. Hier fehlt es an qualitativ hochwertigen Studien. Wenn es Studien gibt, ist die Stichprobengröße sehr gering und langfristige Untersuchungen wurden kaum durchgeführt. Die angewandten sportpsychologischen Verfahren umfassen eher bestimmte Imaginationstechniken und das mentale Training. Zusammenfassend lässt sich sagen, dass achtsamkeitsbasierte Verfahren im Leistungssport noch nicht in der Rehabilitation nach Verletzungen etabliert sind. Daraus folgt, dass der Forschungsbedarf im Feld achtsamer Methoden in der Behandlung sportspezifischer Verletzungen im Leistungssport noch sehr groß ist.

Meaning and Spirituality in Sport and Exercise: Psychological Perspectives

Book

Full-text available

Nov 2018

Despite the growing literature on spirituality and its positive impact on wellbeing in health psychology, education, occupational psychology and leisure studies, it has been less examined in sport studies. Meaning and Spirituality in Sport and Exercise: Psychological Perspectives examines the many forms of spirituality in sport from a psychological perspective, from moments of transcendence and finding deeper meaning and value to prayer before an important competition or adversity such as career-threatening injury

Modeling and Quantification of Impact of Psychological Factors on Rehabilitation of Stroke Patients

Article

Apr 2018

The brain damage could lead to the loss of the central nervous system, so a stroke patient may lose the function of dominating his/her body. The rehabilitation aims to maximize the potential to restore a patient who has an impairment. Traditional rehabilitation is to train a patient's muscles and joints under the guide of doctors to improve the strength of muscles and restore the motor function of joints. However, stroke patients are usually depressed, lonely and irritable, and they might easily generate negative emotions during a rehabilitation process. With a sole goal of helping patients restore their body functions from the physiology perspective, the traditional rehabilitation took little consideration on the impact of rehabilitation, which is reflected and measured from the perspective of emotions. Therefore, we suggest adding affective regulation to the stroke rehabilitation; in such a way, the patients' exercise could be completed with high intrinsic motivation, and the performance of the rehabilitation process can be enhanced. Two main contributions in the presented works are (1) the expanded emotional model to represent the status of stroke patients where the impact of psychological factors can be taken into consideration, (2) the quantifiable measurement of rehabilitation performance as well as the corresponding design of experiments (DoE) to verify the positive impact of psychological adjustment on human subjects. Note that due to the limited conditions, the experimental verification was performed on healthy college students. Since our work focused on modeling and quantification of psychological factors, it is reasonable to expend our work to other human subjects including stoke patients.

Psychological Factors Influencing Return to Sport After Anterior Cruciate Ligament Reconstruction

Chapter

Mar 2018

Despite having good knee function, many athletes do not return to their previous level of preinjury sport following anterior cruciate ligament (ACL) reconstruction. This suggests that there are other factors which influence return to sport after this surgery. Recent reviews and meta-analyses have demonstrated that a range of contextual factors affect the return-to-sport rate after ACL reconstruction including age, sex, sport participation level and psychological factors. In terms of psychological factors, there is convincing evidence that a lower fear of reinjury and greater psychological readiness are associated with higher return-to-sport rates. A number of measurement tools are now available which aim to measure such constructs, one of which is specific to ACL injury, the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scale. This scale has shown clear associations between psychological readiness and return to sport, even when used before athletes undergo surgery. Clinical cut-off scores have been proposed, which may guide both the athlete and clinician in the return-to-sport process. This chapter provides a summary of the evidence of the psychological aspects related to injury recovery and returning to sport following ACL reconstruction injury and surgery.

Effects of Stress Inoculation Training on Athletes' Postsurgical Pain and Rehabilitation After Orthopedic Injury

Article

Full-text available

Apr 1996

The efficacy of a cognitive–behavioral intervention (stress inoculation training; SIT) for postsurgical anxiety, pain, and physical rehabilitation in injured athletes was tested. Sixty male athletes who underwent arthroscopic surgery for miniscus injury in 1 knee were randomly assigned to either treatment (SIT and physical therapy) or control (physical therapy only) conditions. Results showed that participants in the treatment group demonstrated significantly less postsurgical pain and anxiety during the rehabilitation process, compared with controls. Additionally, treated participants required fewer days to return to criterion physical functioning, compared with nontreated participants.

Stages and processes of self-change of smoking: Toward an integrative model of change

Article

Full-text available

Jun 1983

An integrative model of change was applied to the study of 872 Ss (mean age 40 yrs) who were changing their smoking habits on their own. Ss represented the following 5 stages of change: precontemplation, contemplation, action, maintenance, and relapse. 10 processes of change were expected to receive differential emphases during particular stages of change. Results indicate that Ss (a) used the fewest processes of change during precontemplation; (b) emphasized consciousness raising during the contemplation stage; (c) emphasized self-reevaluation in both contemplation and action stages; (d) emphasized self-liberation, a helping relationship, and reinforcement management during the action stage; and (e) used counterconditioning and stimulus control the most in both action and maintenance stages. Relapsers responded as a combination of contemplaters and people in action would. Results are discussed in terms of developing a model of self-change of smoking and enhancing a more integrative general model of change. (14 ref)

A model of psychologic response to athletic injury and rehabilitation

Article

Full-text available

Jan 1995

Examining Psychological Factors during Injury Rehabilitation

Article

Full-text available

Nov 1997

The aim of this study was to examine the effectiveness of goal setting on performance and on a number of psychological variables such as self-efficacy, pretesting anxiety, and self-satisfaction during an injury rehabilitation program. An experimental group (n = 20) and a control group (n = 17) of injured physical education students were studied. Both groups underwent a 4-week quadriceps strengthening program on an isokinetic dynamometer, with the experimental group setting specific personal goals in each training session. The experimental group improved in performance significantly more than the control group. Although both groups exhibited an increase in self-efficacy and a decrease in pretesting anxiety, only the experimental group had an increase in self-satisfaction with performance. Results confirm that incorporating goal setting in the rehabilitation process enhances rehabilitation results.

A Psychological Approach to the Prediction and Prevention of Athletic Injury

Article

Full-text available

Sep 2005

Two interrelated studies examined the role psychological factors play in the prediction and prevention of sport related injury. Study 1 involved 470 rugby players who completed measures corresponding to variables in the revised Williams and Andersen (1998) stress and injury model at the beginning of the 2001 playing season. Prospective and objective data were obtained for both the number of injuries and the time missed. Results showed that social support, the type of coping, and previous injury interacted in a conjunctive fashion to maximize the relationship between life stress and injury. Study 2 examined the effectiveness of a cognitive behavioral stress management (CBSM) intervention in reducing injury among athletes from Study 1 who were identified as having an at-risk psychological profile for injury. Forty-eight players were randomly assigned to either a CBSM intervention or a no-contact control condition. Participants completed psychological measures of coping and competitive anxiety at the beginning and end of the 2002 rugby season. The assessment of injury was identical to that used in Study 1. Results showed that those in the intervention condition reported missing less time due to injury compared to their nonintervention counterparts. The intervention group also had an increase in coping resources and a decrease in worry following the program. Taken together, both studies underscore the importance of (a) psychosocial factors in identifying those athletes most vulnerable to injury and (b) cognitive behavioral stress management programs in reducing the vulnerability to injury.

The Theory of Planned Behavior

Article

Full-text available

Dec 1991

Icek Ajzen

Research dealing with various aspects of* the theory of planned behavior (Ajzen, 1985, 1987) is reviewed, and some unresolved issues are discussed. In broad terms, the theory is found to be well supported by empirical evidence. Intentions to perform behaviors of different kinds can be predicted with high accuracy from attitudes toward the behavior, subjective norms, and perceived behavioral control; and these intentions, together with perceptions of behavioral control, account for considerable variance in actual behavior. Attitudes, subjective norms, and perceived behavioral control are shown to be related to appropriate sets of salient behavioral, normative, and control beliefs about the behavior, but the exact nature of these relations is still uncertain. Expectancy value formulations are found to be only partly successful in dealing with these relations. Optimal rescaling of expectancy and value measures is offered as a means of dealing with measurement limitations. Finally, inclusion of past behavior in the prediction equation is shown to provide a means of testing the theory*s sufficiency, another issue that remains unresolved. The limited available evidence concerning this question shows that the theory is predicting behavior quite well in comparison to the ceiling imposed by behavioral reliability.

Return to Sport After Serious Injury: A Retrospective Examination of Motivation and Psychological Outcomes

Article

Full-text available

Aug 2005

Context It is argued in self-determination theory that the motivation underlying behavior has implications for health and well-being independent of the behavior itself. Objective To examine associations between athlete motivations for returning to sport after injury and perceived psychological return-to-sport outcomes. Design A correlational survey design was employed to obtain data in Canada, Australia, and England. Participants Elite and subelite athletes (N = 180) with injuries requiring a minimum 2-month absence from sport participation. Main Outcome Measures Participants completed an inventory measuring perceptions of motivation to return to sport from a serious injury and psychological return-to-sport outcomes. Results Correlational analyses revealed that intrinsic motivations for returning to competition were associated with a positive renewed perspective on sport participation. Conversely, extrinsic motivations for returning to sport were associated with increased worry and concern. Conclusions The motivation underlying return to sport might play an important role in return-to-sport perceptions among elite and subelite athletes.

Adherence to Rehabilitation after Anterior Cruciate Ligament Reconstructive Surgery: Implications for Outcome

Article

Full-text available

Aug 2005

Objective To investigate the relationship between adherence to rehabilitation and outcome after reconstructive surgery of the anterior cruciate ligament (ACL). Design A prospective cohort study with adherence to rehabilitation evaluated over 8 weeks correlated with outcomes at 9 and 12 months postsurgery. Participants 68 patients who had undergone ACL-reconstructive surgery. Main Outcome Measures Adherence was measured to and during appointments and by a self-report diary of home exercise. Outcomes were measured by 6 knee-function scales and 2 hop tests. Results There was a significant relationship between home-exercise adherence and many outcomes for participants under 30 years of age ( r s = .33-.44). For participants age 30 and over there was a negative relationship between home-exercise adherence and outcome. There were no significant relationships between adherence to and during physical therapy appointments and outcome after ACL-reconstructive surgery. Conclusion Participants under 30 years of age who adhered to their home-exercise regimen had better functional outcome, whereas adherent participants age 30 and over experienced worse outcome with better home-exercise adherence.

The Effect of Personal Goals, Self-Efficacy, and Self-Satisfaction on Injury Rehabilitation

Article

Full-text available

Aug 1996

This study examined the effect of god setting on injury rehabilitation, specifically, differences in personal goal setting, self-efficacy, self-satisfaction, and performance between injured and noninjured subjects. Two experimental groups (32 women with knee injuries and 29 noninjured women) and one control group (n = 30) were used. Subjects performed four trials of a knee extension task on an isokinetic dynamometer. Prior to the third and fourth trials, subjects in the experimental groups set personal goals and completed self-efficacy and self-satisfaction scales. There were significant performance improvements for the two experimental groups; correlation coefficients between self-efficacy, self-satisfaction, goal setting, and performance were significant at the .001 level. Personal goal setting was affected by level of ability and in turn had a direct effect on performance. Self-efficacy and self-satisfaction were affected by ability or performance but had no significant effect on personal goals or performance. The findings indicate that personal goal setting might be an important determinant for performance improvement in injury rehabilitation programs.

A Longitudinal Investigation of Competitive Athletes' Return to Sport Following Serious Injury

Article

Full-text available

Mar 2006

Returning to sport following a serious injury can be a difficult process for competitive athletes (Bianco, 2001; Bianco, Malo, & Orlick, 1999; Gould, Udry, Bridges, & Beck, 1997). Unfortunately, no qualitative longitudinal studies were found that examine athlete return-to-sport experiences following injury recovery. The purpose of this study was to examine the experiences of competitive athletes' returning to sport following a serious injury over a period of up to 8-months. Salient themes relating to motives to return to sport, return-to-sport appraisals and emotions and decision-making processes were identified in participant interviews. Athletes also described their experiences in overcoming return-to-sport fears and concerns, and how they dealt with adversity. Finally, the enjoyable aspects of the return to competition and the positive consequences of injury were articulated. Findings from this research indicate that self-determination theory (Ryan & Deci, 2000) may offer a valuable framework for coaches and practitioners hoping to better understand and assist athletes with the return-to-sport process.

The effectiveness of imagery on pain, edema, and range of motion in athletes with a grade II ankle sprain

Article

Full-text available

Aug 2007
PHYS THER SPORT

Objectives: To examine the effectiveness of imagery on pain, edema, and range of motion in athletes who have sustained a grade II ankle sprain. Participants: The sample consisted of 18 active male athletes, aged from 18 to 30 years, with a grade II ankle sprain, confirmed by ultrasound testing. The participants were randomly divided into two conditions: a relaxation and imagery condition (n=9) and a control condition (n=9). The participants in the relaxation and imagery condition received 12 individual sessions of imagery rehearsal in addition to a normal course of physiotherapy, while the participants in the control condition followed only the physiotherapy treatment. Main outcome measures: Participants were administered a Visual Analogue Scale (VAS) in order to measure acute pain intensity. Edema was evaluated with the water volumetric displacement method. Ankle range of motion (ROM) was assessed using a goniometer. Results: The study did not show demonstrable effects on pain, edema, and ROM after the application of imagery treatment. Conclusions: Further research could examine the relationship between different types of imagery and rehabilitation from sport injury using standardized imagery instruments.

Fear of Reinjury, Negative Affect, and Catastrophizing Predicting Return to Sport in Recreational Athletes With Anterior Cruciate Ligament Injuries at 1 Year Postsurgery

Article

Full-text available

Feb 2007

Objective: To examine fear of reinjury, negative affect, and pain catastrophizing as determinants of athletes' confidence in their ability to take part in sport activity and their reported return to sport 1 year after undergoing anterior cruciate ligament (ACL) reconstruction. Participants: 49 recreational-level athletes (27 men and 22 women; M age=29.15 years, SD=11.57). Results: Negative affect was inversely associated with sport confidence, and fear of reinjury was inversely associated with reported return to sport. Regression models showed that negative affect was the lone significant predictor (β=-.32, p

Effects of Relaxation and Guided Imagery on Knee Strength, Reinjury Anxiety, and Pain Following Anterior Cruciate Ligament Reconstruction

Article

Full-text available

Feb 2001

Objective: To examine the effects of relaxation and guided imagery on knee strength, reinjury anxiety, and pain for knee surgery patients. Study Design: A randomized controlled clinical trial. Setting: A sports medicine clinic. Participants: Thirty individuals in rehabilitation for anterior cruciate ligament (ACL) reconstruction. Interventions: Ten relaxation and guided imagery sessions for each treatment group participant; attention, encouragement, and support for placebo group participants; no intervention for control group participants. Main Outcome Measures: Knee strength, reinjury anxiety, and pain. Results: Significantly greater knee strength and significantly less reinjury anxiety and pain for treatment group participants at 24 weeks postsurgery than for placebo and control group participants. Conclusions: Relaxation and imagery may be beneficial to ACL rehabilitation, thus warranting further research on mechanisms of obtained effects. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Psychological Factors, Rehabilitation Adherence, and Rehabilitation Outcome After Anterior Cruciate Ligament Reconstruction

Article

Full-text available

Feb 2000

Objective: To examine prospectively the relationships among psychological factors, rehabilitation adherence, and short-term rehabilitation outcome after knee surgery. Study Design and Participants: Individuals with acute anterior cruciate ligament (ACL) tears ( N = 95) completed measures of self-motivation, social support, athletic identity, and psychological distress before reconstructive surgery. After surgery, 93 participants reported on their completion of home rehabilitation exercises and cryotherapy, and their rehabilitation practitioners indicated the patients' attendance at, and adherence during, rehabilitation sessions. Rehabilitation outcome measures were taken from 69 participants approximately 6 months postsurgery. Main Outcome Measures: Knee laxity, functional ability, and subjective symptoms were the primary outcomes assessed. Results: Self-motivation was significant predictor of home exercise completion; athletic identity and psychological distress were significant predictors of knee laxity; and attendance at rehabilitation sessions and home cryotherapy completion were significant predictors of functional ability. Rehabilitation adherence did not mediate the relationship between psychological factors and rehabilitation outcome. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Imagery use, perceived pain, limb functioning and satisfaction in athletic injury rehabilitation

Article

Full-text available

Jan 2006

Purpose: This study examined the relationship between athletes' imagery use, perceived pain, overall lower limb functioning, and satisfaction in the context of injury rehabilitation. Methods: In this cross-sectional study, eighty-three injured athletes receiving physiotherapy for a lower limb injury completed a questionnaire package containing the Athletic Injury Imagery Questionnaire-2 (AIIQ-2), the Visual Analogue Scale (VAS) for pain, the Lower Extremity Functional Scale (LEFS), and questions concerning their use of imagery for pain management and satisfaction with rehabilitation. Main Findings: Based on their self-reported use of imagery to manage pain, athletes were divided into two groups: athletes who used imagery to manage pain (Pain Imagery Group; n = 35) and athletes who did not use imagery to manage pain (No Pain Imagery Group; n = 48). Athletes in the Pain Imagery Group did not differ in perceptions of pain or level of lower limb functioning compared to those in the No Pain Imagery Group (p > .05). However, athletes in the Pain Imagery Group employed signi cantly more cognitive, motivational and healing imagery and expressed signi cantly greater satisfaction with their rehabilitation (p < .05). Principal Conclusions: Athletes employ imagery for multiple purposes, such as pain management, outside training and competition settings. When athletes employ imagery for pain management they report increased satisfaction with their rehabilitation.

Injury Representations, Coping, Emotions, and Functional Outcomes in Athletes With Sports‐Related Injuries: A Test of Self‐Regulation Theory1

Article

Full-text available

Jul 2006
J APPL SOC PSYCHOL

This study examined the influence of injury representations on emotions and outcomes of athletes with sports-related musculoskeletal injuries using self-regulation theory. Participants were athletes (N= 220; M age = 23.44 years, SD= 8.42) with a current sports-related musculoskeletal injury. Participants self-reported their cognitive and emotional injury representations, emotions coping procedures, physical and sports functioning, attendance at treatment centers, and 3-week follow-up attendance. Participants’ negative and positive affect were influenced by emotional representations. Identity, causal attributions, and emotional representations influenced physical functioning; and identity, serious consequences, causal attributions, and emotional representations predicted sports functioning. Injury severity, identity, and personal control predicted attendance at treatment centers, but the effect of personal control was mediated by problem-focused coping. Problem-focused coping predicted 3-week follow-up attendance. Results support self-regulation theory for examining injury representations in athletes.

Confidence Restoration Following Athletic Injury

Article

Full-text available

Dec 2000

The impact of goal orientations, perceptions of social support, and sources of rehabilitation confidence on the process of confidence restoration from athletic injury was examined among 40 injured intercollegiate athletes (ages 18 to 22 years). Athletes completed the Task and Ego Orientation in Sport Questionnaire (TEOSQ; Duda & Nicholls, 1992), the Social Support Questionnaire (SSQ; Dude, Smart, & Tappe, 1989), and modified versions of the Sources of Sport Confidence Questionnaire (M-SSCQ; Vealey, Hayashi, Garner-Holman, gr Giacobbi, 1998) and the Stale Sport Confidence Inventory (M-SSCI: Vealey, 1986) within the first two days of their rehabilitation program. The SSQ, M-SSCQ, and M-SSCI were completed during the midpoint of the rehabilitation and the day before returning to practice/competition. Results indicated that the tendency to emphasize task-involved goals in sport significantly predicted the selection of mastery and more self-referenced sources of confidence in rehabilitation. Athletes who perceived more social support specific to injury rehabilitation at the beginning of the rehabilitation program were more likely to rely on performance sources to build confidence.

Use of Mental Imagery to Limit Strength Loss after Immobilization

Article

Full-text available

Aug 2003

Objective To assess whether mental imagery of gripping prevents the loss of grip strength associated with forearm immobilization. Design Pretest–posttest randomized-group design. Setting Laboratory. Participants 13 female and 5 male university students, age between 17 and 30 years, randomly assigned into 2 groups—1 control and 1 experimental. Interventions Both groups had their nondominant forearms immobilized for 10 days. The experimental group undertook three 5-min mental-imagery sessions daily, during which they imagined they were squeezing a rubber ball. Main Outcome Measures Wrist-flexion and -extension and grip strength before and after immobilization. Results There was no significant change in wrist-flexion or -extension strength in the mental-imagery group. The control group experienced a significant decrease in wrist-flexion and -extension strength during the period of immobilization ( P < .05). Conclusions Despite study limitations, the results suggest that mental imagery might be useful in preventing the strength loss associated with short-term muscle immobilization

Two alternative models of health behaviour and recovery from activity limitations due to acute injury: A prospective study

Article

Full-text available

Mar 2009
PSYCHOL HEALTH

Cognitions influence recovery from activity limitations. In this study we aimed to independently test, compare and combine the common sense self-regulation model (CS-SRM) and social cognitive theory (SCT) in predicting recovery from activity limitations due to acute injury. Measures were gathered at two time points 5-6 weeks apart. The sample consisted of 146 university students (Mean age: 21.86, SD: 4.83, 62% female) with a heterogeneous range of injuries that limited their participation in physical activity. The dependent variable was recovery from activity limitations (Physical Functioning - Short Form-36). The predictor variables were measured using the Brief Illness Perception Questionnaire and SCT items designed according to theoretical recommendations. Time-line (TL) and self-efficacy (SE) were significant predictors of recovery in a multivariate analysis, controlling for reported pain at Time 1. A combined model including the best predictors from both models, TL (beta = -0.25, p < 0.05, R(2) change = 0.17, p < 0.01) and SE (beta =0.31, p < 0.05, R(2) change = 0.05, p < 0.05), accounted for a significant amount of the variance in recovery from activity limitations. A combination of key variables from both models may be particularly useful for understanding the cognitive factors that influence recovery from activity limitations.

Injury Prevention in Sweden: Helping Soccer Players at Risk

Article

Full-text available

Mar 2005

In contrast to the rich body of empirical studies investigating psychological factors in sport injury occurrence, there are few controlled intervention studies examining relationships among psychological risk variables, prevention treatments, and injury outcomes (Cupal, 1998). Moreover, little attention has been given to those brief interventions that occur frequently when working with athletes in the field, often referred as brief contact interventions (see Giges & Petitipas, 2000). In the field of clinical psychology, there has been interest and research in brief or focused interventions, especially in the cognitive-behavioral therapies, and particularly for clients diagnosed with anxiety and somatic disorders (Bergin & Garfield, 1994). Most brief therapies typically range from 5 to 15 sessions (Pinkerton & Rockwell, 1994) and are commonly organized with close spacing of initial sessions and gradually increasing inter-session intervals with a planned follow-up or booster session (Budman & Gurman, 1983). Such brief therapy models seem well-suited for sport interventions, and have been used, in various forms, in the past.

Stages and Processes of Self-Change of Smoking - Toward An Integrative Model of Change

Article

Full-text available

Jul 1983

EMG feedback-assisted postoperative rehabilitation of minor arthroscopic knee surgeries

Article

Full-text available

Oct 1995

This study assessed the effectiveness of surface integrated electromyographic (EMG) biofeedback in the rehabilitation of 51 patients undergoing minor arthroscopic knee surgery. Prior to surgery, both control (n = 23) and treatment (n = 28) groups received verbal and written explanations of postoperative isometric exercises; the treatment group received additional instruction in the use of ambulatory biofeedback equipment during exercise. Isokinetic tests of strength at approximately two weeks post-surgery revealed that patients given EMG biofeedback during postoperative exercise demonstrated significantly greater extensor torque and quadriceps muscle fiber recruitment than controls. Implications for the use of EMG biofeedback in long-term postoperative rehabilitation are discussed.

Psychology of the injured athlete

Article

Jan 1986

Coping with Season-Ending Injuries

Article

Dec 1997
SPORT PSYCHOL

This study was designed to identify coping strategies and factors thought to facilitate recovery in elite skiers who suffered season-ending injuries. Differences in the frequency that these variables were cited between unsuccessful and successful postinjury performers and between male and female participants were examined. Retrospective qualitative interviews were conducted with 21 U.S. alpine and freestyle ski team members who suffered season-ending injuries. Content analysis of the interviews revealed that 140 coping strategy raw-data themes coalesced into seven higher order dimensions: driving through; distracted self; managed emotions and thoughts; sought and used social resources; avoidance and isolation; took note and drew upon lessons learned; and other. Six higher-order facilitating factors were identified from 78 raw-data themes and included: interpersonal resources, accessible quality medical resources, fortunate circumstances, environmental resources, past experience with injury, and financial backing. The successful versus unsuccessful skier and male versus female comparisons revealed several differences between groups, especially in the use of coping strategies.

A Three-Year Follow-Up of Long-Term Injured Competitive Athletes: Influence of Psychological Risk Factors on Rehabilitation

Article

Aug 1997

Urban Johnson

The rehabilitation of 77 competitive athletes with long-term injuries was followed for 2-3 years from the time of the injury with the aim of identifying potential risk factors in rehabilitation. Seven athletes not returning to competitive sport despite favorable physical records were compared with 5 athletes who returned despite unfavorable records and with 65 athletes whose rehabilitation met expectations. Twelve tests were employed on four different occasions. The results suggested that being younger, being female, and having had no previous experience with injury characterized the nonreturning athlete. An insufficient mental plan for rehabilitation and a predominantly negative attitude toward it, as well as restricted social contacts with fellow athletes and a low mood level, appeared to accompany a problematic and prolonged rehabilitation. It was concluded that the nonreturning, long-term injured athlete can be identified as early as the beginning of the rehabilitation process.

Predictors of Recovery Time

Article

Feb 2000

Objective To explore predictors of recovery time. Design Repeated measures on 4 occasions throughout recovery included injury appraisal, demographics, emotional responses, and psychological variables. Participants Elite injured athletes ( N = 136). Main Outcome Measure Recovery time. Results At all phases, being a team athlete was a significant predictor of faster recovery. At partial recovery (approximately one-third of the recovery time), significant predictors were active coping, confidence of reaching full recovery in the estimated time, not completing rehabilitation, and having less social support. By semirecovery (approximately two-thirds of the recovery time), vigor and using denial significantly predicted quicker recovery. At recovery, having previously suffered a serious nonsporting injury or illness, vigor, more confidence, and intensity of effort significantly predicted faster recovery. Conclusions This study has expanded on and refined the work in this area and will help increase understanding of the role that psychological variables play in decreasing recovery time, which has important implications for those implementing rehabilitation programs.

The Effect of Psychological Response on Recovery of Sport Injury

Article

Jan 2004

The aim of this study was to analyze how psychological responses influence the physical and sporting recovery of an injured person. The sample comprised 20 amateur football players aged between 18 and 35, with moderately serious or serious injuries. The psychological variables evaluated were mood states, subjective estimation of the injury and adherence, and the psychological response was assessed continuously, from the beginning of the treatment until its completion. The results indicate that as the subjects recovered from their injuries, they gradually adopted the ICEBERG profile, which is characteristic of good performance. Subjective estimation of the injury was inversely related to the time required for physical and sporting recovery (Physical R: Sig:=0.60, p

Protection Motivation Theory and Preventive Health: Beyond the Health Belief Model

Article

Sep 1986

As the importance of social psychological factors in health has been increasingly recognized, a premium has been increasing recognized, a premium has been placed on the elucidation of theoretical models of preventive health behavior. Two of the more comprehensive and extensively investigated models advanced are the Health Belief oodel and Protection Motivation Theory. In the present article, the organization and research of the two frameworks are compared. In addition, several interesting features of Protection Motivation Theory that have been highlighted by recent research are discussed.

Toward a psychoeducational curriculum for training sport-injury rehabilitation personnel

Article

Mar 1998

This paper addresses significant gaps in the wining programs of sport-injury rehabilitation personnel (SIRPs) in the psychology ma. The main aim of the article is to offer for consideration a psychoeducational curriculum that is specifically designed for the training of professionals who work with injured athletes. In addition to describing the applied implications of research on the psychological aspects of sport injuries for professional practitioners. reviews of what SIRPs consider is missing-but-desirable in their professional wining. and the effectiveness of certain psychological strategies, are presented. Finally. an overview of a prototypical three-year curriculum for professional training programs is outlined.

The Changes in Psychological Characteristics and Reactions of Elite Athletes from Injury Onset until Full Recovery

Article

Sep 1999

The purpose of this investigation was to describe the psychological characteristics and reactions of injured athletes and to examine the changes in these reactions throughout their rehabilitation. This study examined 136 elite injured athletes from 25 sports at four phases: upon injury, partial recovery, semi-recovery, and full recovery. Injury appraisal, athlete's demographics, and emotional and psychological variables were measured. Duration of injuries ranged from 4 to 99 weeks (M = 19 weeks). Changes were examined through a series of repeated measure MAN-OVAs with polynomial contrasts. Findings were typically as expected: increased confidence and vigor and decreased negative emotional responses over the recovery period. The changes over the recovery period were not always at a constant rate. Confidence of adhering to rehabilitation, passive, and emotion-focused coping, remained stable over time. The initial injury appraisal, regarding anticipated loss of time and the psychological impact of this, needs to be examined further. The psychological state of the athlete at the various stages of recovery has important implications for those diagnosing injuries and implementing rehabilitation programs.

An integrated model of response to sport injury: Psychological and sociological dynamics

Article

Mar 1998

This paper reviews literature on the psychological and sociological dynamics of response to sport injury. An integrated model is illustrated which provides a synthesis of existing conceptual models depicting the dynamic process of psychological response to sport injury. This integrated model encompasses personal and situational moderating factors. as well as cognitive, emotional. and behavioral responses of athletes to sport injury. Empirical research on the cognitive appraisals and emotional responses associated with sport injury is reviewed and general themes are summarized. As the cultural context of sport has a major influence on these cognitive appraisals and emotional responses, sociological literature on sport injury is also highlighted. Concluding recommendations are made for future research on the psychological and sociological dimensions of sport injury.

Rehabilitation adherence and anterior cruciate ligament reconstruction outcome

Article

May 2004

This study examined the relationship between adherence to postoperative physical therapy and outcome after surgical reconstruction of the anterior cruciate ligament (ACL) of the knee in a sample of 72 men and 36 women. Indices of adherence were obtained during the first 6 weeks of postsurgical rehabilitation. Outcome measures were administered before surgery and approximately 6 months after surgery. Results of a canonical correlation analysis indicated a statistically significant association between the adherence variables and the outcome variables (r = 0.56, p

Short-Term Psychological Intervention: A Study of Long-Term-Injured Competitive Athletes

Article

Aug 2000

Urban Johnson

Objective To explore the effectiveness of psychological interventions for a sample of competitive athletes with long-term injuries. Design Modified 2-group, pretreatment and posttreatment (repeated measure). Patients 58 patients, 14 in the experimental group and 44 in the control group. Interventions Three intervention strategies: stress management and cognitive control, goal-setting skills, and relaxation/guided imagery. Main Outcome Measure Mood level was used as the outcome variable. Results The experimental group had a higher overall mood level at the midpoint and end of rehabilitation and were also feeling more ready for competition than the control group was, both as rated by themselves and by the treating physiotherapist The only strategy to show statistical differences was relaxation/guided imagery. Conclusions The results of this study support the idea that a short-term intervention has the potential to elevate mood levels in competitive athletes with long-term injuries.

Attributions for recovery and adherence to rehabilitation following anterior cruciate ligament reconstruction: A prospective analysis

Article

Mar 2000

The relationship between causal attributions for recovery and adherence was examined in a sample of 80 individuals (25 females and 55 males) undergoing rehabilitation following anterior cruciate ligament reconstruction. Participants estimated their speed of recovery and then rated their open-ended attributions for recovery on the Revised Causal Dimension Scale (McAuley, Duncan and Russell, 1992). Adherence was assessed in terms of attendance at rehabilitation sessions and practitioner ratings for the remainder of the rehabilitation period. Participants who perceived themselves as recovering rapidly attributed their recovery to more stable and personally controllable factors than participants who perceived themselves as recovering slowly. Causal dimension ratings predicted attendance at rehabilitation sessions, but not practitioner ratings of adherence. The results, which further demonstrate the relevance of causal attributions to health behavior, are compared with previous cross-sectional findings.

Psychological Rehabilitation and Physical Injury: Implications for the Sportsmedicine Team

Article

Dec 1987

Describes information available on the nature of injuries and offers suggestions concerning the application of sport psychology principles when working with injured athletes. Four concerns are addressed with regard to current knowledge and practical implications: (1) how injuries happen, (2) how athletes respond to injuries, (3) how psychological rehabilitation and physical recovery from injuries can be facilitated, and (4) determining when injured athletes are psychologically ready to return to competition. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Mental Links to Enhanced Healing: An Exploratory Study

Article

Mar 1991

Examined whether rapid healing athletes (aged 14–48 yrs) who had recovered from knee/ankle injuries demonstrated greater evidence than did slower healing Ss of psychosocial factors thought to be related to enhanced healing. 32 Ss completed surveys designed to measure positive attitude, outlook, stress and stress control, social support, goal setting, positive self-talk, mental imagery, and items about beliefs and recommendations for enhanced healing. 19% of the Ss had exceptionally fast recoveries. These Ss evidenced high scores on all variables tested, while Ss in the slowest healing group evidenced low scores. The most significant results were found in the more action related factors of goal setting, positive self-talk, and the use of healing imagery. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

The role of psychological factors in sport injury rehabilitation outcomes

Abstract

No full-text available