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

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.

Validity and reliability of Greek versions of two scales assessing family and friend support for exercise behaviour.

This study examined the validity and reliability of Greek versions of two scales assessing family and friend support for exercise behaviour. Exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) were performed in a sample of 360 students. Additionally, CFAs were applied in a second sample of 726 physically active adults. Finally, associations were examined among scales and physical activity, exercise self-efficacy, and socio-demographic variables. Results indicated (a) a two-factor model for the Family Support for Exercise Behaviour Scale, (b) a one-factor solution for the Friend Support for Exercise Behaviour Scale, (c) satisfactory reliability coefficients, and (d) associations among the scales and physical activity, self-efficacy and socio-demographic variables. Conclusively, the social support scales were valid and reliable.

A meta-analysis investigating the outcomes and correlation between heart rate variability biofeedback training on depressive symptoms and heart rate variability outcomes versus standard treatment in comorbid adult populations.

BACKGROUND AND AIM: Heart rate variability biofeedback (HRVB) has previously been used to ameliorate depressive symptoms but its uses for tackling depressive symptoms in an array of comorbid adult patients is less established. This meta-analysis aims to evaluate whether HRVB is a useful tool to reduce depressive symptoms and improve HRV relative to standard treatment in adult comorbid populations, while also attempting to establish the association between the two outcomes. METHODS: An extensive literature review was conducted using several databases including PubMed, Cinahl, Medline, Web of science and clinical.gov/UK register. A total of 149 studies were identified with 9 studies, totalling 428 participants were analysed using a random effects model. RESULTS: Depressive outcomes yielded a mean effect size g=0.478 (CI 95% 0.212, 0.743) with HRV outcomes, yielding a mean effect size of g=0.223 (95% CI 0.036 to 0.411). Total heterogeneity was non-significant for depressive outcomes (Q= 13.77, p=0.088 I^=42.86%) and HRV (Q= 1.598, p=0.991, I^=0.000%) which indicates that little variance existed for the included studies. CONCLUSIONS: In summary, the outcomes demonstrate that HRVB can improve both clinically relevant depressive symptoms and physiological HRV outcomes in various comorbid conditions in adult populations, while the correlation between the two was moderately negative, but non-significant.

The Effect of Aerobic Fitness on Psychological, Attentional and Physiological Responses during a Tabata High-Intensity Interval Training Session in Healthy Young Women.

The current study examines the effects of a Tabata high-intensity interval training (HIIT) session on affective, cognitive and physiological indicators in women of different fitness levels. A total of 28 adult women (aged 24.2 ± 1.5 years) completed a 20 m shuttle run test and were then assigned to higher fitness and lower fitness groups (HF and LF, n = 14 each) according to their predicted aerobic power. On a separate occasion, participants completed a 30 min Tabata workout (six 4 min rounds separated by 1 min passive rest). Each round included eight exercises (20 s exercise and 10 s rest). Affective, physiological and cognitive responses were assessed prior to, during and after the protocol. Heart rate and blood lactate concentration increased similarly in both groups over time throughout the workout (p < 0.001). Total Mood Disturbance was higher for LF (111.4 ± 15.7) vs. HF (102.9 ± 11.7) (p = 0.48), vigor showed a level by time interaction of p = 0.006 and Activation−Deactivation Adjective Check List factors deteriorated over time (p < 0.001). The Concentration Grid Test was better overall for HF (10.5 ± 3.6) vs. LF (8.6 ± 3.6) (p = 0.05). The Feeling Scale and Rating of Perceived Exertion worsened similarly in both groups over time (p = 0.002 and p < 0.001, respectively). Positive and negative affect and arousal did not differ between groups or change over time (p > 0.05). These results show that, despite the different levels of aerobic fitness, physiological, metabolic, perceptual and affective responses were similar in the two groups of women during a 30 min Tabata session. This may imply that affective responses during this type of HIIT are independent of aerobic fitness.

Development and validation of the attention questionnaire of rehabilitated athletes returning to competition.

The present study describes the development and validation of an instrument designed to examine athletes' selective attention returning to competition following a musculoskeletal injury--the attention questionnaire of rehabilitated athletes returning to competition (AQ-RARC). Using a sample of 186 rehabilitated athletes, exploratory factor analysis revealed a 10-item model that examines functional attention and distraction attention. Confirmatory factor analysis further supported the factorial validity of the AQ-RARC with another sample of 184 rehabilitated athletes. The two subscales have good internal consistency and test-retest reliability. The concurrent and discriminant validity of the new instrument were confirmed by examining correlations between the AQ-RARC with other constructs. It is concluded that the AQ-RARC is a valid and reliable instrument that can be used for clinical and research purposes.

Children's Involvement in Different Sport Types Differentiates Their Motor Competence but Not Their Executive Functions.

Sports provide a context where important aspects of children's health, such as motor skills and cognitive functions, can be enhanced. However, it is unknown which type of sport may be better for the development of motor competence (MC) and executive functions (EFs). This study investigated potential differences in MC and EFs in boys and girls, being involved in different types of sports (team, individual open skill, individual closed skill). A total of 115 children (49 boys), 8-12 years old (10.30 ± 1.19 years), participated in the study. Their MC was assessed with the Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form, whereas for EFs, the Attention Network Test, the digits backwards test, and the how many-what number test were utilized. Significant MC differences among participants in different types of sports were revealed, favoring those from closed-skill sports; nevertheless, their EFs were at similar levels. Furthermore, no significant gender MC and EFs differences were detected. It seems that children's participation in specific types of sports differentiates their motor skills but not their EFs, whereas boys and girls, when provided with the same opportunities, present similar levels of MC and EFs.

Validity and reliability evidence of the Asthma Control Test--ACT in Greece.

BACKGROUND: The dimensionality of the Asthma Control Test (ACT) was examined in two counterview studies. Up to now, the ACT has not been validated for the Greek asthma patients. OBJECTIVE: The present study was designed to examine the validity and reliability of the ACT responses in Greek asthma outpatients under a specialist's care. STUDY DESIGN: Following evidence for sample-specific validity, the ACT (n = 100) was examined through construct, cross-sectional, convergent, and discriminant validity as well as internal consistency and test-retest reliability [root mean squared error of approximation (RMSEA)]. RESULTS: A one-factor solution fit the data [χ(2) (chi-square) = 3.899, df (degrees of freedom) 5, ns, RMSEA <0.001]. The ACT showed a high internal consistency (Cronbach alpha = 0.72) and a high 2 months test-retest reliability (IR = 0.85) for the total sample. Significant differences were found between the five categories of asthma control patients (not controlled at all, poorly controlled, somewhat controlled, well controlled, and completely controlled), according to the specialists' rating, for the ACT (p < .001). Significant differences were found between patients with and without asthma control (p = .001), patients of different gender (p = .05), educational status (p = .05), mean year income (p = .01), body mass index (p = .05), follow-up visits (p = .01), as well as among patients of different age (p < .001) and severity (p < .001). An ACT score of 19 or less provided optimum balance of sensitivity (98.46) and specificity (88.57) for screening 'not controlled' asthma. Cross-sectional validity testing showed moderate correlation of the ACT score with FEV1% predicted (r = 0.57, p < .001) and disability (r = -0.42, p < .001) and moderately high correlation with dyspnea (r = -0.71, p < .001). Convergent validity testing showed that the ACT score was correlated with the specialists' rating (r = 0.89, p < .001). CONCLUSION: The ACT is valid and reliable in Greek outpatients with asthma under a specialist's care.

The effect of physiotherapy-based breathing retraining on asthma control.

BACKGROUND: The mechanism of the breathing retraining effect on asthma control is not adequately based on evidence. OBJECTIVE: The present study was designed to evaluate the effect of physiotherapy-based breathing retraining on asthma control and on asthma physiological indices across time. STUDY DESIGN: A 6-month controlled study was conducted. Adult patients with stable, mild to moderate asthma (n = 40), under the same specialist's care, were randomized either to be trained as one group receiving 12 individual breathing retraining sessions (n = 20), or to have usual asthma care (n = 20). The main outcome was the Asthma Control Test score, with secondary outcomes the end-tidal carbon dioxide, respiratory rate, spirometry, and the scores of Nijmegen Hyperventilation Questionnaire, Medical Research Council scale, and SF-36v2 quality-of-life questionnaire. RESULTS: The 2 × 4 ANOVA showed significant interaction between intervention and time in asthma control (F = 9.03, p < .001, η(2) = 0.19), end-tidal carbon dioxide (p < .001), respiratory rate (p < .001), symptoms of hypocapnia (p = .001), FEV1% predicted (p = .022), and breathlessness disability (p = .023). The 2 × 4 MANOVA showed significant interaction between intervention and time, with respect to the two components of the SF-36v2 (p < .001). CONCLUSION: Breathing retraining resulted in improvement not only in asthma control but in physiological indices across time as well. Further studies are needed to confirm the benefits of this training in order to help patients with stable asthma achieve the control of their disease.

Development and validation of the Causes of Re-Injury Worry Questionnaire.

Re-injury worry is an important construct in competitive sport that may influence performance and increase the risk of re-injury. However, there are currently no available instruments to measure the causes of re-injury worry. The purpose of this study was to develop the Causes of Re-Injury Worry Questionnaire (CR-IWQ). The study was conducted in three independent research phases to investigate the following: (a) the content relevance, (b) the factor structure and the factorial validity, (c) the concurrent validity, (d) the discriminant validity, and (e) the test-retest reliability (intraclass correlation coefficients; ICC), and the internal consistency of the instrument. Exploratory factor analysis (EFA) was chosen to examine the factor structure of the CR-IWQ. Confirmatory factor analysis (CFA) was used to examine further the factorial validity of the instrument. A number of valid constructs were used to assess the concurrent and discriminant validity of the CR-IWQ. The reliability of the new instrument was examined using Pearson r (ICC) and Cronbach α. Three hundred and seventy athletes with an acute musculoskeletal sport injury in the last year participated in the study. EFA revealed a 12-item model, representing two factors ("Re-injury worry due to rehabilitation" and "Re-injury worry due to opponent's ability"). CFA supported the two-factor model of the CR-IWQ. The concurrent and discriminant validity of the CR-IWQ was confirmed by examining correlations between the CR-IWQ with other constructs. The ICCs and the Cronbach α indices of the CR-IWQ were acceptable. We have demonstrated that the CR-IWQ is a good psychometric instrument that can be used for clinical and research purposes.

Hypoxia Worsens Affective Responses and Feeling of Fatigue During Prolonged Bed Rest.

Previous research, although limited, suggests that both hypoxia and bed rest influence psychological responses by exaggerating negative psychological responses and attenuating positive emotions. The present study investigated the effect of a 21-day prolonged exposure to normobaric hypoxia and bed rest on affective responses and fatigue. Eleven healthy participants underwent three 21-day interventions using a cross-over design: (1) normobaric hypoxic ambulatory confinement (HAMB), (2) normobaric hypoxic bed rest (HBR) and (3) normoxic bed rest (NBR). Affective and fatigue responses were investigated using the Activation Deactivation Adjective Check List, and the Multidimensional Fatigue Inventory, which were completed before (Pre), during (Day 7, Day 14, and Day 21) and after (Post) the interventions. The most negative psychological profile appeared during the HBR intervention. Specifically, tiredness, tension, general and physical fatigue significantly increased on days 7, 14, and 21, as well as at Post. After the HBR intervention, general and physical fatigue remained higher compared to Pre values. Additionally, a deterioration of psychological responses was also noted following HAMB and NBR. In particular, both hypoxia and BR per se induced subjective fatigue and negative affective responses. BR seems to exert a moderate negative effect on the sensation of fatigue, whereas exercise attenuates the negative effects of hypoxia as noted during the HAMB condition. In conclusion, our data suggest that the addition of hypoxia to bed rest-induced inactivity significantly worsens affective responses and feeling of fatigue.

Hypoxia Exacerbates Negative Emotional State during Inactivity: The Effect of 21 Days Hypoxic Bed Rest and Confinement.

Hypoxia and confinement have both been shown to influence emotional state. It is envisaged that the inhabitants of future planetary habitats will be exposed to concomitant confinement, reduced gravity and hypoxia. We examined the independent and combined effects of a 21-day inactivity/unloading and normobaric hypoxia under confined conditions on various psychological factors. Eleven healthy men participated in three 21-day experimental campaigns designed in a cross-over manner: (1) Normobaric hypoxic ambulatory confinement, (2) Normobaric hypoxic bed rest and (3) Normobaric normoxic bed rest. The Profile of Mood States, and the Positive and Negative Affect Schedule were employed to assess the participants' psychological responses before (Pre), during (Day 7, Day 14, and Day 21) and after (Post) the confinements. The most negative psychological profile appeared on days 14 and 21 of the hypoxic bed rest campaign. A significant increase in depression, tension, and confusion was noted on days 14 and 21 of the hypoxic bed rest condition. Concomitantly, a decrease, albeit not statistically significant, in positive psychological responses was observed. The psychological profile returned to the initial level at Post following all confinements. These data suggest that the combined effect of hypoxia and bed rest induced the most negative effects on an individual's mood. However, significant intra- and inter-individual differences in psychological responses were noted and should be taken into consideration.

Neighborhood environment, physical activity, and quality of life in adults: Intermediary effects of personal and psychosocial factors.

BACKGROUND: Studies have indicated that there is a positive and indirect relationship between physical activity (PA) and quality of life (QoL). The current study examined this relationship through a social cognitive model with consideration to the intermediary effects of exercise self-efficacy, and physical (PCS, physical component summary) and psychological (MCS, mental component summary) health. Additionally, this model was widened to include concepts from the ecological theory, and any causal associations among neighborhood environment, PA, and QoL. METHODS: Six hundred and eighty-four physically active adults (39.16 ± 13.52 years, mean ± SD), living in Athens, Greece, completed a series of questionnaires measuring PA, QoL, exercise self-efficacy, PCS, MCS, neighborhood environment, and family and friend support for PA. The examined models were analyzed using structural equation modeling. RESULTS: The social cognitive and ecological models proved to be of appropriate fit. Within the social cognitive model, PA positively affected QoL through the mediating effects of exercise self-efficacy, PCS, and MCS. With regards to the ecological model, neighborhood environment positively influenced QoL through the intermediary effects of family support for PA, exercise self-efficacy, PA, PCS, and MCS. CONCLUSION: Results indicated that the most important mediators in the examined models were exercise self-efficacy and health. Further, findings demonstrated the role of neighborhood environment in enhancing PA and QoL. Future studies should be carried out applying longitudinal data for a better understanding of these associations over time.

Absorption in Sport: A Cross-Validation Study.

Absorption has been identified as readiness for experiences of deep involvement in the task. Conceptually, absorption is a key psychological construct, incorporating experiential, cognitive, and motivational components. Although, no operationalization of the construct has been provided to facilitate research in this area, the purpose of this research was the development and examination of the psychometric properties of a sport-specific measure of absorption that evolved from the use of the modified Tellegen Absorption Scale (MODTAS; Jamieson, 2005) in mainstream psychology. The study aimed to provide evidence of the psychometric properties, reliability, and validity of the Measure of Absorption in Sport Contexts (MASCs). The psychometric examination included a calibration sample from Scotland and a cross-validation sample from Australia using a cross-sectional design. The item pool was developed based on existing items from the modified Tellegen Absorption Scale (Jamieson, 2005). The MODTAS items were reworded and translated into a sport context. The Scottish sample consisted of 292 participants and the Australian sample of 314 participants. Congeneric model testing and confirmatory factor analysis for both samples and multi-group invariance testing across samples was used. In the cross-validation sample the MASC subscales showed acceptable internal consistency and construct reliability (≥0.70). Excellent fit indices were found for the final 18-item, six-factor measure in the cross-validation sample, [Formula: see text] = 197.486, p < 0.001; CFI = 0.957; TLI = 0.945; RMSEA = 0.045; SRMR = 0.044. Multi-group invariance testing revealed no differences in item meaning, except for two items. The MASC and the Dispositional Flow Scale-2 showed moderate-to-strong positive correlations in both samples, r = 0.38, p < 0.001 and r = 0.42, p < 0.001, supporting the external validity of the MASC. This article provides initial evidence in support of the psychometric properties, reliability, and validity of the sport-specific measure of absorption. The MASC provides rich research opportunities in sport psychology that can enhance the theoretical understanding between absorption and related constructs and facilitate future intervention studies.

Intensity and direction dimensions of competitive state anxiety: a time-to-event approach.

The purpose of the present study was to examine the temporally patterned changes in intensity and direction of competitive state anxiety prior to and during competition as well as correlations among intensity and direction on the Competitive State Anxiety Inventory-2D subscale scores. 99 athletes completed the inventory one day before and an hour before the competition, based on how they felt during that time, and 30 min. after the competition with reference to how they felt during the competition. Analysis indicated different temporal patterning in subscale scores prior to competition. Correlations were medium (.40) for Intensity and Direction dimensions. Significant differences were noted between scores of those classified as Facilitators and Debilitators on the Intensity dimension. The results support the multidimensional nature of competitive anxiety. Moreover, additional information lies in directional interpretation of competitive anxiety and self-confidence.

The Examination of the Effects of Writing Strategy-Based Procedural Facilitative Environments on Students' English Foreign Language Writing Anxiety Levels.

Empirical studies have shown that anxiety and negative emotion can hinder language acquisition. The present study implemented a writing instructional model so as to investigate its effects on the writing anxiety levels of English Foreign Language learners. The study was conducted with 177 participants, who were administered the Second Language Writing Anxiety Inventory (SLWAI; Cheng, 2004) that assesses somatic, cognitive and behavioral anxiety, both at baseline and following the implementation of a writing instructional model. The hypothesis stated that the participant's writing anxiety levels would lessen following the provision of a writing strategy-based procedural facilitative environment that fosters cognitive apprenticeship. The initial hypothesis was supported by the findings. Specifically, in the final measurement statistical significant differences appeared where participants in the experimental group showed notable lower mean values of the three factors of anxiety, a factor that largely can be attributed to the content of the intervention program applied to this specific group. The findings validate that Foreign Language writing anxiety negatively effects Foreign Language learning and performance. The findings also support the effectiveness of strategy-based procedural facilitative writing environments that foster cognitive apprenticeship, so as to enhance language skill development and reduce feelings of Foreign Language writing anxiety.

Severe hypoxia during incremental exercise to exhaustion provokes negative post-exercise affects.

The post-exercise emotional response is mainly dependent on the intensity of the exercise performed; moderate exercise causes positive feelings, whereas maximal exercise may prompt negative affects. Acute hypoxia impairs peak O2 uptake (V̇O2peak), resulting in a shift to a lower absolute intensity at the point of exhaustion. Hence, the purpose of the study was to examine whether a severe hypoxic stimulus would influence the post-exercise affective state in healthy lowlanders performing an incremental exercise to exhaustion. Thirty-six male lowlanders performed, in a counter-balanced order and separated by a 48-h interval, two incremental exercise trials to exhaustion to determine their V̇O2peak, while they were breathing either room air (AIR; FiO2: 0.21), or a hypoxic gas mixture (HYPO; FiO2: 0.12). Before and immediately after each trial, subjects were requested to complete two questionnaires, based on how they felt at that particular moment: (i) the Profile of Mood States-Short Form, and (ii) the Activation Deactivation Adjective Check List. During the post-exercise phase, they also completed the Multidimensional Fatigue Inventory. V̇O2peak was significantly lower in the HYPO than the AIR trial (~15%; p<0.001). Still, after the HYPO trial, energy, calmness and motivation were markedly impaired, whereas tension, confusion, and perception of physical and general fatigue were exaggerated (p≤0.05). Accordingly, present findings suggest that an incremental exercise to exhaustion performed in severe hypoxia provokes negative post-exercise emotions, induces higher levels of perceived fatigue and decreases motivation; the affective responses coincide with the comparatively lower V̇O2peak than that achieved in normoxic conditions.

Flow theory - goal orientation theory: positive experience is related to athlete's goal orientation.

The main purpose of this study was to examine the relationship between flow experience and goal orientation theory, as well as, the differences in flow experience based on the orthogonal model of goal orientation theory. Two hundred and seventy eight athletes completed the Task and Ego Orientation Sport Questionnaire based on how they usually feel. The challenge and skills ratings were completed 1 h before the competition, based on how they felt at the exact time of answering. In the following, the Flow State Scale-2 was completed up to 30 min after the competition they just participated, along with the challenge-skill ratings, based on how athletes felt during the competition. The results indicated that the athletes' task orientation may be an important factor for attaining flow in competitive sport, feeling more skillful and estimating the upcoming competition as challenging, while low ego and low task oriented athletes lack these elements, which are important for them to get into flow. Additionally, not the level of task and ego orientation per se, but the balance between athletes' goal orientation preferences seems important for the formation of flow experience, indicating that high task - high ego and high task - low ego athletes are experiencing the most positive mental state.

Psychological strain: examining the effect of hypoxic bedrest and confinement.

The aim was to assess the effect of a 10-day exposure to the environmental stressors anticipated in future lunar habitats on indices of psychological strain. In addition to the reduced gravity of the Moon, future habitats on the Moon will likely maintain a hypobaric hypoxic environment. The hypobaric environment will eliminate the need for long decompression profiles prior to each extra-vehicular activity. We investigated the indices of psychological strain during three 10-day conditions, designed to assess the separate and combined effects of inactivity/unloading and normobaric hypoxia on several physiological systems. Eleven male participants underwent three 10-day campaigns in a randomised manner: 1) normobaric normoxic bed rest (NBR), 2) normobaric hypoxic bed rest (HBR) and 3) normobaric hypoxic ambulatory confinement (HAMB). The most negative psychological profile appeared on day 10 of the HBR and HAMB (hypoxic) conditions. Concomitantly, a decrease in positive emotions was observed from baseline to day 10 of the HBR and NBR conditions. Thus, confinement in a hypoxic environment seems to exert a negative effect on an individual's psychological mood.

The effect of treadmill training on gross motor function and walking speed in ambulatory adolescents with cerebral palsy: a randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate the effect of a treadmill program on gross motor function, walking speed, and spasticity of ambulatory adolescents with spastic cerebral palsy (diplegia and tetraplegia). DESIGN: In this randomized controlled trial, 22 adolescents (13-19 yrs old) from a special school for children with physical disabilities were randomly allocated to the experimental and control training groups. The experimental training group underwent a treadmill program without body weight support at a comfortable speed. The control group received treatment with conventional physiotherapy, which consisted of three sets of exercises with mat activities, balance, gait training, and functional gross motor activities. The program lasted 12 wks with a frequency of three times per week for both groups. Pretest and posttest measurements of self-selected walking speed, gross motor function, and spasticity were conducted. RESULTS: The analysis of covariance findings examining posttest differences between groups were significant with respect to self-selected walking speed (F = 8.545, P = 0.000) and gross motor function (F = 9.088, P = 0.007), whereas no significance was found for spasticity. CONCLUSIONS: Treadmill training may improve the walking speed and gross motor function of adolescents with spastic cerebral palsy, without adverse effects on spasticity.