Natalie Walker

Psychological responses to injury in competitive sport: a critical review.

Research has attempted to examine the psychological impact of athletic injury to assist rehabilitation personnel when treating injured athletes. Sports trainers, sports therapists, physiotherapists, medical staff and sports psychologists should be aware of psychological factors impacting on the injury experience when involved in an athletes rehabilitation. A number of models have been proposed as useful frameworks for investigating and describing the psychological response to athletic injury. Many researchers have relied upon applying or adapting grief and cognitive appraisal models originally derived from the clinical and stress related psychology literature in an attempt to describe the psychological response to athletic injury. This article provides an overview of these models and offers a critical appraisal of this research, specifically focusing on the grief response models and the integrated model of response to sport injury and rehabilitation. Criticisms focus on the lack of research supporting a uniformed sequence of stages as a feature of response to athletic injury. Further grief criticisms centre on the absence of denial in much of the research to date. The article then focuses on the dynamic core of the integrated response to sport injury and rehabilitation model. It is argued that the interrelationships between emotional responses, behavioural responses, cognitive appraisals and recovery outcomes are not as simple as suggested in the model.

A preliminary development of the Re-Injury Anxiety Inventory (RIAI)

OBJECTIVES The present paper outlines the initial development of an instrument to measure re-injury anxiety. METHODS Face, content and factorial validity were examined over three stages of exploratory factor analyses. PARTICIPANTS 248 injured sport participants completed the scale. RESULTS A 28-item measure was produced to measure re-injury anxiety, comprising of two factors: re-injury anxieties regarding rehabilitation (RIA-R: 15 items) and re-injury anxieties regarding returning to training/competition (RIA-RE: 13 items). These two factors accounted for 80.56% of the total variance. The internal consistency for both factors was above the .70 criterion value; rehabilitation re-injury anxiety (alpha=.98); re-entry into competition re-injury anxiety (alpha=.96). CONCLUSIONS Future research needs to test the proposed 2-factor model presented in the current research using confirmatory factor analysis.

A Qualitative and Quantitative Investigation of the Psychology Content of UK Physiotherapy Education Programs

Background and Purpose. A knowledge and understanding of psychology is recognized as being important to physiotherapy practice since psychological factors can impact upon physical recovery. However, little is known about the nature of psychology education within UK physiotherapy training programs. The purpose of the study was, therefore, to examine current psychology provision within physiotherapy programs in UK universities, using both qualitative and quantitative methods. Subjects. The participants were self‐selected representatives from 17 UK universities. These representatives were program directors, program leaders, or lecturers teaching on the physiotherapy program. Methods. The participants were questioned regarding the nature and extent of psychology covered in their program, the delivery and assessment of any psychology content, the perceived importance of psychology in physiotherapy training, and factors influencing psychology provision in their physiotherapy programs. Results. All of the universities claimed to include some degree of psychology content within their physiotherapy programs and largely agreed that psychology is an important component in the education and training of physiotherapists. However, there appears to be great diversity both within and between universities in the provision of psychology education, and an underlying inconsistency between the reported importance of psychology and the demonstrated importance of psychology through its visibility within physiotherapy programs. Discussion and Conclusion. More needs to be done to standardize the psychology content of physiotherapy programs in order to ensure that students at all institutions receive a similar level of training in psychology, which can have a positive impact on their professional practice.

Sport psychology education for sport injury rehabilitation professionals: a systematic review

Sport psychology education has been shown to have a positive impact on the practice of sport injury rehabilitation professionals (SIRPs). The purpose of this paper is to review recommendations relating to such education. The paper presents a review of existing literature relating to the content and mode of delivery for a sport psychology education programme for SIRPs. The review seeks to address four questions: (1) What topic areas do researchers suggest should be integrated into the sport psychology education of SIRPs? (2) What topic areas are currently being recommended by professional bodies? (3) What are the findings of research examining the impact of sport psychology education on SIRPs? and (4) What do researchers recommend to be the most appropriate mode of delivery for sport psychology education for SIRPs? The findings of the review suggest that in order to maximise adherence amongst already qualified SIRPs sport psychology education should be delivered in a flexible short duration package. Additionally three broad areas that sport psychology education should cover emerged: (1) understanding of the psychological impact of injury, (2) interventions and psychological skills/techniques, and (3) referral and professional boundaries. This has important implications for the future training of SIRPs.

'We've just learnt to put up with it': an exploration of attitudes and decision-making surrounding playing with injury in English professional football

A number of psychological and sociocultural factors have been suggested to influence athletes’ willingness to play despite being injured. Investigation of this phenomenon is undertaken optimally at the time when athletes are injured; however, many studies have relied upon retrospective recall of feelings in individuals following recovery. This study aimed, through semi-structured existential-phenomenological interviews, to explore decision-making and attitudes surrounding playing with injury in professional footballers that were currently injured but continuing to play in matches in the English football leagues. Using deductive qualitative content analysis, cultural, situational and personal moderators that have been theorised to influence playing with injury in professional football were tested. The sample comprised nine professional footballers from three different playing leagues that were identified as playing whilst injured by team physiotherapists. There was a high level of agreement in the findings of this study with previous research. Personal and cultural moderators were stable across participants, and included conforming to the athlete role and operating in a culture where pain has been normalised. Situational factors, however, were unstable and were influenced by playing league, with constraints in squad size being an important influence for lower league players. These professional footballers sought windows of opportunity for treatment and recovery both within the season and at the end of the season. It appeared that a decline in performance, rather than the presence of pain, is used as a critical marker for injury. More research is needed to explore differences in presenteeism practices at different playing levels using larger number of participants.

The impact of a sport psychology education intervention on physiotherapists

Abstract The purpose of this study was to measure the impact of an online sport psychology education module on the attitudes and behaviours of qualified sports physiotherapists in the UK. Ninety-five sport physiotherapists studied either a sport psychology module or a control module, and their attitudes and behaviours towards sport psychology were measured prior to studying the module and at three points over a six-month period following its completion. It was found that those who had studied the sport psychology module demonstrated an improvement in their attitudes towards sport psychology immediately following its completion that was significantly higher than those who had studied the control module. Use of sport psychology also increased following the sport psychology module, with significant differences seen between the intervention and control group on the sport psychology subscale, indicating that those who had studied the sport psychology module were integrating more sport psychology techniques into their practice than those who had studied the control module. It was concluded that the online sport psychology module was effective in improving the attitudes and behaviours of UK physiotherapists and that more sport psychology education opportunities should be made available.

A Comparison of Two Anaerobic Test Measurement Systems using an Upper Body Wingate Test

This study aimed to compare performance measures acquired by two different Wingate Anaerobic Test systems; Cranlea and Monark. Twenty participants undertook 58 Wingate tests against a 4% body mass resistive load on a cycle ergometer adapted for arm cranking. Corrected peak power output (PP; W) was recorded using 1 rev min–1, 0.5, 1 and 5 s averages and mean power output (MP; W). The Cranlea system recorded the greatest PP (589 ± 267 W) compared with the Monark (546 ± 267 W; P < 0.001). The PP using all other methods was also greater for the Cranlea compared with the Monark system (P < 0.001) with mean differences of 55 ± 18 W for 1 s averages and 22 ± 18 W for MP. Correlations between all PPs were strong (r = 0.99 – 0.97; P < 0.001). In conclusion, although the Cranlea system provides a consistently greater corrected PP it may not be enough to substantially differentiate between systems.