Adam Gledhill

Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review

Background The prime focus of research on sports injury has been on physical factors. This is despite our understanding that when an athlete sustains an injury it has psychosocial as well as physical impacts. Psychosocial factors have been suggested as prognostic influences on the outcomes of rehabilitation. The aim of this work was to address the question: are psychosocial factors associated with sports injury rehabilitation outcomes in competitive athletes? Study design Mixed studies systematic review (PROSPERO reg.CRD42014008667). Method Electronic database and bibliographic searching was undertaken from the earliest entry until 1 June 2015. Studies that included injured competitive athletes, psychosocial factors and a sports injury rehabilitation outcome were reviewed by the authors. A quality appraisal of the studies was undertaken to establish the risk of reporting bias. Results 25 studies were evaluated that included 942 injured competitive athletes were appraised and synthesised. Twenty studies had not been included in previous reviews. The mean methodological quality of the studies was 59% (moderate risk of reporting bias). Convergent thematic analysis uncovered three core themes across the studies: (1) emotion associated with rehabilitation outcomes; (2) cognitions associated with rehabilitation outcomes; and (3) behaviours associated with rehabilitation outcomes. Injury and performance-related fears, anxiety and confidence were associated with rehabilitation outcomes. There is gender-related, age-related and injury-related bias in the reviewed literature. Conclusions Psychosocial factors were associated with a range of sports injury rehabilitation outcomes. Practitioners need to recognise that an injured athletes thoughts, feelings and actions may influence the outcome of rehabilitation.

Psychosocial factors associated with talent development in football: A systematic review

Objectives To provide a critical systematic review of recent research into psychosocial factors associated with talent development in football. Design Systematic review informed by the PRISMA guidelines. Method Literature was sourced from Science Direct, Sport Discus, Psycharticles and Psychinfo. This was followed by a detailed screening and sifting process to identify literature. Identified literature was independently appraised by multiple reviewers using the mixed‐methods Appraisal Tool (MMAT). Data was represented using concept mapping. Results Forty‐three studies met the inclusion criteria. They investigated a cumulative 14,977 participants and gleaned 48 psychosocial factors associated with talent development in football. Findings suggest that social and psychological factors are interrelated and influence adaptive developmental behaviours (e.g., adaptive lifestyle choices, practice and play behaviours). These can influence coach perceptions of players and whether they may recommend players for career progression. Independent MMAT appraisal demonstrated a moderate risk of bias. Female football players and female coaches are significantly under‐represented in the literature; with white, adolescent, able‐bodied, male European football players dominating the literature. Descriptive, cross‐sectional, correlational and retrospective designs are most commonly adopted in the literature. Conclusions Psychosocial factors can differentiate between performance levels of football or are positively associated with career progression to a senior elite level in football, however findings should be viewed with caution due to a moderate risk of bias in reporting. The research area would be advanced by diversification of participant groups, longitudinal, prospective designs, and by testing the predictive validity of existing grounded theories. HighlightsWe reviewed psychosocial factors associated with talent development in football.We created a concept map of hypothesized relationships between these factors.We noted five behavioural indicators of talent development in football.Independent study appraisals using MMAT show a moderate risk of reporting bias.Female players and female coaches are underrepresented in the literature.

Psychological readiness to return to sport: three key elements to help the practitioner decide whether the athlete is REALLY ready?

Return to sport (RTS) outcomes after severe injury are consistently poor.1 ,2 Psychological factors are important influences on returning to sport3 yet what it means to be psychologically ready to RTS is unclear.4 Rarely will an athlete be held back from RTS because he/she is not psychologically ready to return. Psychological factors correlate with injury occurrence,5 therefore these factors should be offered greater weighting in RTS decision-making. Characteristics of an athlete who is psychologically ready to RTS are multifaceted and include, among others: realistic expectations, high levels of self-efficacy and low levels of anxiety.1 ,4 ,6 Psychological readiness to RTS is likely influenced by multiple social agents, personal and contextual factors (eg, coaches, sports medicine practitioners, personality traits, performance level).4 Consequently, RTS decisions should be made from an interdisciplinary perspective, with multidimensional monitoring of psychological factors (eg, concurrently monitoring self-efficacy and re-injury anxiety levels).6 Psychological readiness to RTS is not commonly monitored in practice, despite specific instruments being available.7 Many practitioners feel underprepared to work within this area8 or might view evaluating psychological readiness to RTS as being outside their scope of their practice. On the …

Motivational orientation and risk taking in elite winter climbers: A qualitative study

Objectives: High-risk sports participants have typically been viewed as a homogeneous group despite variability in performance characteristics and the level of risk undertaken. Prolonged engagement high-risk sports such as winter climbing are relatively underserved within current literature. Elite winter climbers attempt climbs that are outside the scope of the current “known”, i.e. unclimbed routes. The majority of the current understanding of motivation in high-risk sports is based on quantitative research and the methodologies and instruments used. The purpose of this study was to explore the experiences of elite winter climbers and gain a richer understanding of their motivational orientation and risk-taking behaviour. Design: Qualitative–inductive. Method: Four elite male winter climbers (aged 42–49 years old) took part in semi-structured interviews and explore their motivational orientation and risk-taking behaviour. A thematic analysis was used. Results: Two superordinate themes of enactive mastery and engendered disinhibition emerged from the data. Enactive mastery was interpreted as a composite of two higher-order themes: Task mastery and self-mastery. Engendered disinhibition was interpreted as a composite of two higher-order themes: Social cognitive appraisal and self-perception. Conclusion: Enactive mastery and engendered disinhibition emerged as key behavioural and psychological determinants that influenced individuals to attempt more difficult and riskier forms of winter climbing. Goal achievement was their primary motive which was set within a confidence frame encapsulated within these superordinate themes.

Psychological interventions used to reduce sports injuries: A systematic review of real-world effectiveness.

Objective To systematically review studies examining the role of psychological interventions in injury prevention. The primary research question was: What is the real-world effectiveness of psychological intervention in preventing sports injuries? Design Mixed methods systematic review with best evidence synthesis. Data sources CINAHL, MEDLINE, PsycARTICLES, PsycINFO, SPORTDiscus, Science Direct and PubMed. Eligibility criteria for selecting studies Randomised controlled trials (RCT), non-RCTs that included a comparison group, before and after study designs and qualitative methods. Studies were required to outline specific unimodal or multimodal psychological interventions used in relation to injury prevention in the real-world setting. Outcome measure Studies were independently appraised with the Mixed Methods Appraisal Tool. Results Thirteen papers (incorporating 14 studies) met the eligibility criteria, of which 93% (13/14) reported a decrease in injury rates (effect size range=0.2–1.21). There was an overall moderate risk of bias in reporting (52%). There is a dominance of stress management-based interventions in literature due to the prominence of the model of stress and athletic injury within the area. Summary/conclusions Psychological interventions demonstrate small (0.2) to large (1.21) effects on sports injury rates. The research area demonstrates a cumulative moderate risk in reporting bias (52%). PROSPERO registration number CRD42016035879.

Perfectionism and Coping with Injury in Marathon Runners: A Test of the 2×2 Model of Perfectionism

&NA; Previous research has found perfectionism dimensions to predict coping strategies in sport when dealing with various stressors. We aimed to extend previous research by examining the interactive effects of perfectionism dimensions on strategies employed by marathon runners to cope with injury. This involved testing the hypotheses of the 2 × 2 model of perfectionism in marathon runners. Marathon runners (n = 224, female n = 81, M age = 39.77 years, SD = 9.50 years) completed measures capturing four subtypes of perfectionism (pure self‐oriented perfectionism, pure socially prescribed perfectionism, mixed perfectionism, and non‐perfectionism) and strategies for coping with injury (problem‐focused coping, emotion‐focused coping, and avoidance coping). Moderated regression analyses provided support for all four hypotheses of the 2 × 2 model for problem‐focused coping, one hypothesis for emotion‐focused coping, and none for avoidance‐coping. Problem‐focused coping was highest for pure self‐oriented perfectionism and lowest for pure socially prescribed perfectionism. Emotion‐focused coping was higher for pure self‐oriented perfectionism compared to non‐perfectionism. Finally, avoidance coping was similar across all subtypes. The results provide initial evidence that the 2 × 2 model of perfectionism explains differences in the use of coping strategies in context of marathon running injury. HighlightsPerfectionism subtypes differentially associate with broad coping dimensions.Pure SOP associated with higher levels of problem‐focused coping.Pure SPP associated with lower levels of problem‐focused coping.Pure SOP associated with higher levels of emotion‐focused coping.

Infographic: Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes

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PSYCHOLOGICAL INTERVENTIONS ASSOCIATED WITH INJURY PREVENTION: A SYSTEMATIC REVIEW

Background Sports injuries can have broad reaching health, performance, and financially-related problems for individual athletes and teams. There are widely recognized psychological injury risk factors therefore it follows that psychological skills training may be able to reduce the levels of injury risk. Objective To examine the relationship between psychological injury prevention interventions and injury risk reduction. Design Systematic review adopting PRISMA guidelines (PROSPERO reg. CRD42016035879). Setting Databases searched were CINAHL, MEDLINE, PsycARTICLES, PsycINFO, SPORTDiscus, PubMed and Science Direct. RCTs, non-RCTs that incorporated a comparison group, pre- and post- designs, and qualitative studies were eligible. Patients (or Participants) Twelve studies met the inclusion criteria. Studies included 1306 athletes (female n=520; male n=786) with an age range of 10–33 years and drawn from regional to international level sports. Interventions (or Assessment of Risk Factors) Varying psychological intervention strategies of varying modalities, intensities and volumes were adopted in the final studies. Main Outcome Measurements Mixed-methods Appraisal Tool (MMAT) was used to appraise study quality. Results Studies were appraised as having a moderate risk of bias in reporting. Eleven of the 12 included studies demonstrated a reduced injury risk as a result of the intervention. Five of the 12 included studies demonstrated a statistically significant difference. There is a bias towards the Stress Injury Model as the theoretical underpinning, contributing to a bias towards stress management studies. There is a dearth of literature which considers the role of psychological skills training in reducing non-stress related risk factors (e.g. imagery training to manage neuromuscular deficiency). Conclusions Evidence suggests psychological skills training can reduce the risk of sports injury occurrence, however this claim is drawn on research with a moderate risk of reporting bias.