Translation and Adaptation of the Reinjury Anxiety Inventory, the Sport Injury Rehabilitation Adherence Scale, and the Athletic Injury Self-Efficacy Questionnaire Into Turkish.

CONTEXT: Psychological difficulties can adversely affect rehabilitation outcomes and make return to sport more difficult. Identifying psychological difficulties is possible with valid and reliable measurement tools. The purpose of this study is to translate and culturally adapt the Reinjury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), and the Athletic Injury Self-Efficacy Questionnaire (AISEQ) into Turkish and evaluate the psychometric properties of the Turkish versions. DESIGN: Cross-sectional study. METHODS: The instruments were forward- and back-translated, culturally adapted, and validated on 248 athletes and 34 physical therapists. The physical therapists of the athletes completed the SIRAS to evaluate the athletes. Statistical analysis included reliability tests (Cronbach alpha and test-retest), exploratory factor analysis, confirmatory factor analysis, and correlational analysis. Floor and ceiling effects (<15%) were also assessed. RESULTS: Confirmatory factor analyses revealed a satisfactory model fit for the RIAI and the AISEQ, and exploratory factor analysis revealed the 1-factor structure for the SIRAS as in the original. All 3 instruments displayed adequate internal consistency (Cronbach alpha coefficients ranged from .84 to .88) and test-retest reliability (coefficients ranged from .81 to .93). Convergent validity of the instruments was supported by significant correlations between the AISEQ and both the RIAI and the SIRAS. CONCLUSIONS: Our results suggest that the Turkish versions of the instruments were valid, consistent, and reliable in athletes who have serious injuries. Scores on these instruments could be useful for evaluating the contributions of psychological factors to return to sport following serious injuries. Clinicians are encouraged to use RIAI-Turkish (RIAI-TR), SIRAS-Turkish (SIRAS-TR), and AISEQ-Turkish (AISEQ-TR) together to make decisions about the treatment and rehabilitation plans of injured athletes.

Pandemic-specific coping, anxiety, and depression across multiple waves of COVID-19 in elite athletes with disabilities.

Objectives: Competitive athletes have faced many of the same mental health challenges experienced by the general population during the COVID-19 pandemic. The purpose of the current study was to examine the extent to which pandemic-specific coping predicted anxiety and depression over and above general coping styles in elite athletes with disabilities across multiple waves of the COVID-19 pandemic. Methods: Participants were 91 athletes (60 men and 31 women) in the Polish Paralympic Preparation Program before the 2020 Tokyo Summer Paralympic Games and 2022 Beijing Winter Paralympic Games. The Coping Inventory for Stressful Situations and an open-ended item asking participants to describe coping resources they had used to overcome stressful situations caused by the pandemic were administered in April 2021, and the Hospital Anxiety and Depression Scale was administered in April, July, and November of 2021. Results: General coping styles were not significantly associated with pandemic-specific coping, anxiety, or depression in the July and November 2021 assessments. Pandemic-specific coping was related prospectively to both anxiety and depression across the July and November 2021 assessments when controlling for age, gender, general coping styles, and April 2021 anxiety and depression, respectively. Conclusion: The findings suggest that elite athletes with disabilities may cope with pandemic-related stress differently from how they cope with stress in general and that pandemic-specific coping may be relevant to mental health outcomes during the COVID-19 pandemic. This information may be useful in the development of interventions to assist elite athletes with disabilities cope with pandemics and other atypical stressors.

Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial.

BACKGROUND: This study aimed to compare the effects of cognitive functional therapy (CFT) and movement system impairment (MSI)-based treatment on pain intensity, disability, Kinesiophobia, and gait kinetics in patients with chronic non-specific low back pain (CNSLBP). METHODS: In a single-blind randomized clinical trial, we randomly assigned 91 patients with CNSLBP into CFT (n = 45) and MSI-based treatment (n = 46) groups. An 8-week training intervention was given to both groups. The researchers measured the primary outcome, which was pain intensity (Numeric rating scale), and the secondary outcomes, including disability (Oswestry disability index), Kinesiophobia (Tampa Kinesiophobia Scale), and vertical ground reaction force (VGRF) parameters at self-selected and faster speed (Force distributor treadmill). We evaluated patients at baseline, at the end of the 8-week intervention (post-treatment), and six months after the first treatment. We used mixed-model ANOVA to evaluate the effects of the interaction between time (baseline vs. post-treatment vs. six-month follow-up) and group (CFT vs. MSI-based treatment) on each measure. RESULTS: CFT showed superiority over MSI-based treatment in reducing pain intensity (P < 0.001, Effect size (ES) = 2.41), ODI (P < 0.001, ES = 2.15), and Kinesiophobia (P < 0.001, ES = 2.47) at eight weeks. The CFT also produced greater improvement in VGRF parameters, at both self-selected (FPF[P < 0.001, ES = 3], SPF[P < 0.001, ES = 0.5], MSF[P < 0.001, ES = 0.67], WAR[P < 0.001, ES = 1.53], POR[P < 0.001, ES = 0.8]), and faster speed, FPF(P < 0.001, ES = 1.33, MSF(P < 0.001, ES = 0.57), WAR(P < 0.001, ES = 0.67), POR(P < 0.001, ES = 2.91)] than the MSI, except SPF(P < 0.001, ES = 0.0) at eight weeks. CONCLUSION: This study suggests that the CFT is associated with better results in clinical and cognitive characteristics than the MSI-based treatment for CNSLBP, and the researchers maintained the treatment effects at six-month follow-up. Also, This study achieved better improvements in gait kinetics in CFT. CTF seems to be an appropriate and applicable treatment in clinical setting. TRIAL REGISTRATION: The researchers retrospectively registered the trial 10/11/2022, at https://www.umin.ac.jp/ with identifier number (UMIN000047455).

Associations of Pain Vigilance and Past and Current Pain with Kinesiophobia after Sport Injury in Current and Former Athletes from Iran and the United States.

High levels of kinesiophobia (fear of movement/reinjury) have been related to reinjury and adverse injury rehabilitation outcomes in athletes. To examine the extent to which pain vigilance, memory of injury-related pain, and current injury-related pain were associated with kinesiophobia, a cross-sectional study was conducted with 172 current and former athletes from Iran (n = 113) and the United States (n = 59) who reported having experienced a serious injury that affected their participation or performance in sport. Questionnaires were administered to participants via an online survey platform. Hierarchical multiple regression analysis revealed that pain vigilance and memory of pain were positively associated with kinesiophobia, with the full model accounting for 31% of the variance in kinesiophobia scores. The findings suggest that excessive attention to pain-related stimuli and memory of pain for an injury that occurred an average of four years earlier may contribute to the experience of fear of movement and reinjury in current and former athletes.

Intention for Warm-Up among Children and Adolescents Scale: Development and Initial Validation.

The purpose of this study was to develop and validate the Intention for Warm-up among Children and Adolescents Scale (IWCAS). There were four phases and four sets of participants in the development of the IWCAS. In the first phase, the domains of intention were defined, and related components were developed, organized, and validated. In the second phase, 446 elementary and middle school students participated in a pilot study for the first version of the scale, which was revised based on the information obtained. In the third phase, 12 graduates in sports pedagogy served on an expert panel and organized the items into domain areas and developed a second version of the IWCAS. In the final phase, 1322 elementary and middle school students from three k-12 schools completed the revised version of the IWCAS, and exploratory and confirmatory factor analyses were conducted. Based on the results, the IWCAS was shortened by deleting some items in two domains; this resulted in 11 items of the final version with 3 domains: (1) attitude toward warm-up, (2) subjective norm, and (3) perceived behavioral control that, according to the indices, generate reliable and structurally valid scores. The composite internal consistency for the three domains ranged from 0.74 to 0.85. The researchers hypothesized the IWCAS is a valid and reliable scale, which can be used by P.E. teachers or coaches to evaluate the intention of primary and secondary school students to perform warm-ups.

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.

Factors Associated with School Sports Injury among Elementary and Middle School Students in Shanghai, China.

School sports activity (SSA) is beneficial to gaining and maintaining optimal health among elementary and middle school students but might increase risks for school sports injury (SSI). This cross-sectional study aimed to investigate the incidence and identify risk factors of SSI among Chinese elementary and middle school students in Shanghai. Students in grades 4-5 (elementary) and 7-9 (middle) from three k-12 schools (aged from 9 to 16 years old) in Shanghai selected via the method of cluster random sampling were invited to participate in the study. Information on socio-demography, sleep duration, individual internal and external risk factors, and SSI experiences in the past 12 months was collected. A multivariate logistic regression model was performed to estimate the risk factors of SSI. A total of 1303 participants completed the questionnaires, with an overall SSI incidence rate of 29.5%. Along with boys, elementary school students, and sports team members, students scoring high on internal and external risk factors were at higher risk for SSA. In summary, SSI was prevalent among elementary and middle school students in Shanghai, China, and was associated with several modifiable risk factors. The findings provide insights regarding actions that could be taken to reduce the occurrence of SSI and maximize the benefits of SSA, including improvements in safety education, maintenance of facilities and equipment, and completion of warm-up exercises.

Correspondence and Concordance of Retrospective and Concurrent Responses to Physiotherapists and Sport Psychology Questionnaire Items.

Orthopedic and sport-related injuries are a major public health concern and a common reason for referral to physical therapy. The use of psychological techniques by physical therapists has been assessed in research studies primarily with retrospective self-report questionnaires that have not been validated against concurrent assessments of the same behaviors. The primary purpose of this study was to examine the extent to which the results obtained from physical therapists' retrospective self-reports of their use of psychological techniques reflect their use of the techniques assessed concurrently. Physical therapists (N = 14) completed the Physiotherapists and Sport Psychology Questionnaire (PSPQ) at the beginning of this study and a checklist based on the PSPQ at the end of the sessions with patients (N = 306). Patients also completed the checklist at the end of the sessions. Across 12 psychological techniques, the physical therapists' retrospective (PSPQ) responses showed relatively weak correspondence (mean r = 0.31) and poor concordance with their concurrent (checklist) responses. Compared to the physical therapists' checklist responses, the patients' checklist responses showed weaker correspondence (mean r = 0.03) and better concordance with the physical therapists' PSPQ responses. The findings suggest that retrospective self-reports may not accurately reflect the use of psychological techniques by physical therapists and, consequently, that physical therapists should consider documenting their use of psychological techniques as close to their implementation as possible. Suggestions for improved assessment are provided.

Association between Kinesiophobia and Gait Asymmetry after ACL Reconstruction: Implications for Prevention of Reinjury.

Gait asymmetries have been documented in individuals after anterior cruciate ligament (ACL) reconstruction (ACLR). The relationship between gait asymmetry and associated psychological factors, however, is not yet known. This study aimed to examine the relationship between kinesiophobia (fear of reinjury) and asymmetry of vertical ground reaction force (vGRF) and lower-extremity muscular activity in individuals after ACLR during gait. Twenty-eight males with a history of ACLR participated in the study. Force plate and surface electromyography was used to record peak vGRF and muscular activity. The Tampa Scale of Kinesiophobia (TSK-11) was used to measure kinesiophobia. Spearman's rank correlations analysis was used to examine the relationship between TSK-11 scores and both gait asymmetry variables. There was a significant positive relationship between TSK-11 and asymmetry of the second peak of vGRF (rs = 0.531, p = 0.002). In addition, there was a significant positive association between asymmetry of rectus femoris activity (rs = 0.460, p = 0.007) and biceps femoris activity (rs = 0.429, p = 0.011) in the contact phase. Results revealed a significant relationship between kinesiophobia and asymmetry in muscle activity and vGRF in different phases of the gait cycle. Interventions addressing kinesiophobia early in the rehabilitation after ACLR may support the restoration of gait symmetry, facilitate a more rapid return to sport, and reduce the risk of ACL reinjury.

How Many Concussions Would It Take for Athletes to Choose to Discontinue Participation in Their Primary Sport?

The process by which athletes decide to continue or discontinue sport participation after concussion has not been explicated. Intercollegiate and club sport athletes (N = 394) completed an online survey that included assessments of demographic factors, the total number of concussions (and anterior cruciate ligament (ACL) tears) that would prompt sport retirement, concussion history, and athletic identity. On average, participants reported that they would retire from their primary sport after sustaining 3 to 4 concussions (and approximately 2 ACL tears). The total number of concussions reported was negatively correlated with the number of additional concussions it would take to precipitate sport retirement. Athletic identity was positively associated with the number of concussions that participants with a history of one or more concussions reported would prompt them to retire from their primary sport. The results provide information of potential utility to professionals implementing concussion education programs and working with athletes at risk of experiencing concussion.

Adding Mindfulness Practice to Exercise Therapy for Female Recreational Runners With Patellofemoral Pain: A Randomized Controlled Trial.

CONTEXT: Considering current models that highlight the role of psychological components in pain management, mindfulness practice may be an effective strategy in the management of pain. OBJECTIVE: To examine the effects of adding an 8-week mindfulness program to exercise therapy on the perceptions of pain severity, knee function, fear of movement, and pain catastrophizing of female recreational runners with patellofemoral pain (PFP). DESIGN: Randomized controlled clinical trial. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: Thirty female runners (age = 28.3 ± 7.08 years) with PFP were randomly assigned to the exercise or mindfulness-exercise group. INTERVENTION(S): The exercise-only group followed a protocol (18 weeks, 3 sessions/wk) that featured training modifications to help control injury-related symptoms. The mindfulness-exercise group received an 8-week mindfulness intervention in addition to the exercise protocol. The mindfulness component started 4 weeks before the exercise component; therefore, the 2 components overlapped during the first 4 weeks of the intervention. MAIN OUTCOME MEASURE(S): Usual pain, pain during stepping, and pain during running were assessed using visual analog scales. Functional limitations of the knee were assessed using the Knee Outcome Survey. Fear of movement, pain catastrophizing, and coping strategies were measured via the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Coping Strategies Questionnaire, respectively. These outcomes were assessed at baseline, at week 9, and after 18 weeks. RESULTS: Pain during running, pain during stepping, and functional limitations of the knee were less for the mindfulness-exercise group than for the exercise-only group (P values < .05). The mindfulness-exercise group reported greater perceived treatment effects than the exercise-only group (P < .05). Pain catastrophizing was less and coping strategies were more favorable for mindfulness-exercise participants than for exercise-only participants (P values < .05). CONCLUSIONS: Mindfulness practice can be an effective adjunct to exercise therapy in the rehabilitation of PFP in recreational female runners.

The Effects of a Mindfulness-Based Program on the Incidence of Injuries in Young Male Soccer Players.

The authors tested the effectiveness of a mindfulness-based program in reducing sport-injury incidence. A total of 168 young male elite soccer players were randomly assigned to mindfulness and control groups. The mindfulness group consisted of seven sessions based on the mindfulness-acceptance-commitment approach, while the control group consisted of seven presentations on sport-injury psychology. Athlete exposure and injury data were recorded during one season. State and trait mindfulness, sport anxiety, stress, and attention control of participants were assessed. Number of injuries, average of injuries per team, and days lost to injury in the mindfulness group were significantly lower than those in the control group. Mindfulness and attention control were lower and sport anxiety and stress were higher in injured players than in noninjured players. Psychological variables were associated with injury. Mindfulness training may reduce the injury risk of young soccer players due to improved mindfulness and attention control and reduced sport anxiety.

A Visualization Template for the Graphical Representation of Sport Injury Antecedents and Consequences Models and Data.

A template for visually representing factors affecting and affected by the occurrence of sport injury is presented. The visualization template is designed to facilitate comparison among graphic depictions of models and data pertaining to the antecedents and consequences of sport injury. Innovative aspects and limitations of the visualization template are highlighted, and future applications of the visualization template are discussed.

Why wasn't sport included? Comment on the special issue on the science of teamwork (2018).

The special issue of the American Psychologist (May-June 2018) is devoted to the science of teamwork, with 20 articles addressing the history and foundation of teamwork research and highlighting the importance of teamwork in aviation, military, business, space exploration, academic, and health care settings. Articles that address factors influencing team performance and evaluation of interventions with teams are also included. The editors of the special issue direct attention to key areas in teamwork research that would benefit from further inquiry. That is, a call is made for research that focuses on teamwork measurement and assessment tools, explores multi-team systems, and bridges the gap between theory and practice. The special issue is a gem, likely to advance teamwork research in the years to come. Missing, however, is discussion of research related to sport teams and the sport psychology literature, although a sport team is featured on the cover of the science of teamwork special issue. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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.

Relations Among Reinvestment, Self-Regulation, and Perception of Choking Under Pressure.

The purpose of this study was to examine relations among reinvestment, self-regulation, and perception of choking under pressure in skilled tennis players. Participants were 160 collegiate players from the NCAA Division I in the U.S. and the 1st League in Japan. Participants completed questionnaires assessing reinvestment (conscious motor processing and movement self-consciousness), self-regulation, and perception of choking under pressure. Results of correlation analysis indicated self-regulatory factors were positively related to reinvestment conscious motor processing, but not with reinvestment movement self-consciousness. Self-efficacy and movement self-consciousness of reinvestment were found to predict one's perception of choking under pressure. Results of simultaneous entry multiple regression revealed that tennis players who had low self-efficacy and were concerned about making a good impression with their movements were more likely to perceive that they choked during tennis matches. Additionally, Japanese players reported less self-regulation skills and a higher perception of choking under pressure than American players, suggesting the need for additional research on cross-cultural differences. Overall, these results suggest that self-efficacy may protect athletes from choking, but movement self-consciousness may lead athletes to choke during tennis games.

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.

Athletic identity foreclosure.

Athletic identity foreclosure refers to commitment to the athlete role in the absence of exploration of occupational or ideological alternatives. This article traces the theoretical underpinnings of the construct, examines the role of sport participation in identity development, and provides an overview of the course, correlates, and consequences of athletic identity foreclosure. Implications for future research are discussed.