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

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; M age = 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.

Sleep Disturbance and Its Association With Sluggish Cognitive Tempo and Attention in Pediatric Brain Tumor Survivors.

Background: Pediatric brain tumor (PBT) survivors are at risk for developing sleep disturbances. While in other pediatric populations sleep disturbance has been associated with worse cognitive functioning, it is unclear to what extent this relationship generalizes to PBT survivors. The aim of the current study was to assess the relationship between sleep disturbance and aspects of cognition, including sluggish cognitive tempo (SCT) as well as attention and working memory. Materials and Methods: Eighty-three PBT survivors 6-18 years of age who were at least 3 months post-treatment were included in the present cross-sectional study. Level of sleep disturbance was measured as a composite score reflecting various sleep problems as rated by caregivers. Cognitive measures included caregiver-ratings of sluggish cognitive tempo and attention problems, as well as performance-based cognitive measures assessing attention and executive functioning. Hierarchical regression analysis was used to assess associations between sleep and cognition. Results: Of all caregivers, 32.5% reported one or more sleep disturbances as "very/often true" and over 68% of caregivers rated at least one sleep-related item as "somewhat true." Of all cognitive variables, scores were most frequently impaired for SCT (30%). A higher level of sleep disturbance was associated with worse SCT and parent-rated attention problems. Associations between sleep and performance-based cognitive measures assessing attention and working memory were not statistically significant. Conclusion: Findings of the current study highlight the importance of further investigation into the relationship between sleep and cognition in PBT survivors, which may assist efforts to maximize cognitive outcome and health-related quality of life in PBT survivors. The current study additionally suggests further investigation of SCT in this population is warranted, as it may be more sensitive to detecting possible associations with sleep disturbance relative to discrete measures that assess cognitive performance under ideal circumstances.

It's about Time: Effects of Physical Exertion on Duration Estimates.

BACKGROUND: Task duration is a fundamental aspect of exercise, but little is known about how completed bouts of physical activity are perceived. Consequently, the purpose of the five experiments conducted for this investigation was to examine the effects of engaging in physical tasks on retrospective duration estimates with college student participants. METHODS: Across the five experiments, participants were 113 college students (82 women, 31 men). In Experiments 1 and 2, participants provided duration estimates of a period spent engaging in physical activity or rest. In Experiments 3, 4, and 5, participants provided duration estimates of periods spent engaged in physical tasks of high intensity and low intensity. RESULTS: In Experiments 1, 2, and 3, participants engaged in physical activity tended to perceive durations as shorter than participants at rest. When completing less familiar tasks (Experiments 4 and 5), however, participants recalled a high intensity bout of physical activity as lasting longer than a low intensity bout of physical activity of comparable duration. Cohen's d values for physical activity effects on duration estimates ranged from 0.40 to 1.60. CONCLUSION: The findings, which partially support a contextual-change interpretation, suggest that factors, such as perceived exertion and task familiarity, affect retrospective duration estimates.

Effects of a Mental Warmup on the Workout Readiness and Stress of College Student Exercisers.

The importance of warming up prior to sport competition has been highlighted in the scientific literature, with increasing attention paid to the benefits of mental warmups. The purpose of this research was to explore the possibility that a mental warmup may also benefit exercisers. Two studies were conducted in which the effects of a mental warmup on the psychological readiness and psychological stress of exercisers were examined. Study 1 used a pretest-posttest design and Study 2 used an experimental pretest-posttest design, comparing mental warmup participants to a control group. In both studies, exercisers were assessed before and after they completed a prerecorded mental warmup that consisted of goal setting, imagery, and arousal control. Overall, the results showed that completing a mental warmup increased exercisers' readiness to exercise and to use mental skills to enhance workouts. The mental warmup also reduced stress. These findings suggest that mental warmup strategies that facilitate readiness for sport performance may have utility in exercise settings. Future research exploring the applicability of a mental warmup in diverse settings, as a stress reduction, and as a potential injury reduction intervention is warranted.

Adversarial Growth After Anterior Cruciate Ligament Reconstruction.

Although psychological research on sport injury has long focused on negative responses to injury, investigators have begun to explore positive consequences as well. This study examined adversarial growth longitudinally after anterior cruciate ligament surgery and rehabilitation. Participants (N = 108) completed questionnaires measuring (a) aspects of adversarial growth before anterior cruciate ligament surgery and at 6, 12, and 24 months after surgery and (b) daily pain and negative mood for 42 days postoperatively. Although most participants reported little or no adversarial growth due to their injury and rehabilitation, significant increases over preoperative values were found at 6 months postsurgery for three aspects of adversarial growth. Daily pain and negative mood were positively associated with aspects of adversarial growth at each postoperative assessment. It appears that modest but detectable increases in aspects of perceived adversarial growth can occur after anterior cruciate ligament reconstruction and be related to indices of adversity experienced during rehabilitation.

Big Five Personality Characteristics and Adherence to Clinic-Based Rehabilitation Activities after ACL Surgery: A Prospective Analysis.

PURPOSE: A prospective, longitudinal study was conducted to examine Big Five personality characteristics as predictors of adherence to clinic-based rehabilitation activities following anterior cruciate ligament (ACL) reconstruction surgery. METHOD: Participants (72 men, 36 women) completed a questionnaire assessing Big Five personality dimensions prior to surgery. For the first 7 weeks after surgery, participants' rehabilitation session attendance was recorded and rehabilitation professionals rated participants' adherence during rehabilitation sessions.. RESULTS: Results of multiple regression analyses indicated that the 5 personality factors explained 11 percent of the variance in attendance and 17 percent of the variance in adherence ratings, that agreeableness was a significant positive predictor of attendance, and that conscientiousness and openness to experience were significant positive predictors of adherence ratings. CONCLUSION: As a potential contributor to adherence, personality warrants consideration when implementing rehabilitation programs after ACL surgery.

Predictors of adherence to home rehabilitation exercises following anterior cruciate ligament reconstruction.

OBJECTIVE: Although home exercises are commonly prescribed following anterior cruciate ligament (ACL) reconstruction and are considered important in obtaining successful rehabilitation outcomes, little is known about factors associated with the completion of such exercises. Consequently, this study was designed to identify predictors of adherence to home rehabilitation exercises after ACL surgery. METHOD: Participants (33 women, 58 men) completed indices of athletic identity, neuroticism, optimism, and pessimism before ACL surgery and measures of daily pain, negative mood, stress, and home exercise completion for 42 days postoperatively. RESULTS: Participants reported a high level of adherence to the prescribed regimen. Home exercise completion increased significantly over time as the number of sets of prescribed home exercises declined. Personal factors were not predictive of home exercise completion. Participants completed fewer home exercises on days when they experienced more stress or negative mood. CONCLUSIONS: Day-to-day variations in negative mood and stress may contribute to adherence to prescribed home exercises.

Self-Protective Changes in Athletic Identity Following Anterior Cruciate Ligament Reconstruction.

OBJECTIVES: This study was designed to examine the possibility of self-protective changes in athletic identity (AI) being initiated after the occurrence of a severe injury. METHOD: People (72 men and 36 women) undergoing anterior cruciate ligament (ACL) surgery and rehabilitation were asked to complete a measure of AI prior to surgery and measures of AI and rehabilitation progress at approximately 6, 12, and 24 months after surgery. RESULTS: A repeated-measures ANCOVA controlling for age and gender indicated that AI decreased significantly across the 24-month period following surgery, with the most substantial decline occurring between 6 and 12 months postsurgery. Significantly greater decreases in AI were observed among participants whose rehabilitation progress was slowest from 6 to 12 months postsurgery. CONCLUSIONS: The findings suggest that some participants reduced their identification with the athlete role in response to the threat to a positive self-image posed by their ACL injuries and the difficulties they encountered in postoperative rehabilitation.

Electronic CommunKNEEcations: A Descriptive Analysis of Anterior Cruciate Ligament Message Board Postings.

OBJECTIVE: The purpose of this study was to identify topics of potential concern to anterior cruciate ligament (ACL) surgery patients. DESIGN: An archival design was used. SETTING: Qualitative data were collected from two Internet message boards. METHOD: A thematic content analysis was performed on the initial postings of 900 threads from the archives of two online forums. Postings (N = 797) in which questions were asked of the message board communities were placed in 1 of 22 content themes by two independent raters. RESULTS: More than half of the postings in which questions were asked pertained to rehabilitation and the postoperative period (N = 436, 55%), with approximately one-third of the postings (N = 287, 36%) corresponding to issues associated with surgery and the preoperative period. The content themes observed most frequently (all with more than 51 postings) were those pertaining to rehabilitation progress, pain, complications, physical therapy, diagnosis, returning to sport, and whether to have surgery. CONCLUSIONS: A substantial number of individuals use Internet message boards to learn about ACL surgery and rehabilitation. Information gleaned from this study can be used to help ensure that the primary concerns of patients are addressed in educational materials.

Age-Related Differences in Predictors of Adherence to Rehabilitation After Anterior Cruciate Ligament Reconstruction.

OBJECTIVE: To examine whether the relationships between psychological factors and rehabilitation adherence after knee surgery differ as a function of age. DESIGN AND SETTING: Participants completed inventories of self-motivation, social support, athletic identity, and psychological distress before anterior cruciate ligament (ACL) reconstruction. After surgery, participants recorded their completion of home rehabilitation exercises and cryotherapy, and the sport rehabilitation professionals providing their treatment reported on the patients' attendance at, and adherence during, rehabilitation sessions. SUBJECTS: Sixty-one individuals with acute ACL tears. MEASUREMENTS: The Self-Motivation Inventory, Social Support Inventory, Athletic Identity Measurement Scale, Brief Symptom Inventory, and Sport Injury Rehabilitation Adherence Scale were used to measure self-motivation, social support, athletic identity, psychological distress, and adherence, respectively, during rehabilitation sessions. RESULTS: Hierarchic regression analyses indicated that age moderated the relationships between (1) self-motivation and home exercise completion, (2) social support and home exercise completion, (3) athletic identity and home exercise completion, and (4) athletic identity and home cryotherapy completion. CONCLUSIONS: The prospective moderating relationships for between psychological factors and indices of adherence to home-based rehabilitation activities indicate the need to consider developmental issues when examining psychological aspects of sport-injury rehabilitation.

Muscle dysmorphia in elite-level power lifters and bodybuilders: a test of differences within a conceptual model.

The purpose of this study was to determine if associated characteristics of muscle dysmorphia (MD) were different between elite-level competitive bodybuilders and power lifters. Elite-level competitive bodybuilders (n = 100) and power lifters (n = 68) completed the muscle dysmorphia inventory (MDI) at the time of or immediately before competition. A 2 x 6 (group x MDI subscales) multivariate analysis of variance indicated that bodybuilders were significantly more likely to report body size-symmetry concerns (F(1, 167) = 10.31, p < 0.001), physique protection (F(1, 167) = 10.27, p < 0.001), dietary behavior (F(1, 167) = 28.38, p < 0.001), and pharmacological use (F(1, 167) = 19.64, p < 0.001) than were power lifters. These results suggest that elite-level bodybuilders are significantly more likely to engage in characteristics associated with MD than are elite-level power lifters.