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Donald R. Marks

Despite valuable research regarding multicultural encounters in sport psychology settings, the mechanisms by which culture operates, including the ways that it is transmitted and learned, and the specific processes though which it exerts influence upon behavior, remain poorly understood. Research also has not addressed how a dimension of experience that is so fundamental could remain so transparent and reside so consistently outside the awareness of researchers, clinicians, and clients. Recent contributions to cultural psychology using an interactivist model provide a theoretical perspective through which clinical sport psychologists could conceptualize these challenging issues and address the complex behaviors observed in cross-cultural contexts. Interactivism offers a framework for investigating the internally inconsistent “polyphonic,” or multivoiced, nature of the self. In doing so, it highlights the need for investigative methods that can account for frequent discrepancies between implicit attitudes and observed behaviors, on one hand, and explicit attitudes and behaviors as endorsed on self-report measures, on the other.

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Donald R. Marks

Recent studies using neuroimaging technologies offer evidence that ancient beliefs about the benefits (e.g., enhanced attention, increased distress tolerance) associated with mindfulness practice and other forms of meditation may be supported by identifiable neuroanatomical changes in the brain. Although it is too early to make probative statements regarding exactly how and why contemplative practices affect the structure and activity of the brain, sport psychologists may want to consider the potential implications of the findings that have begun to emerge from this neural correlates research. The goal of this article is to (a) review the findings from the principal studies of contemplative practice that have employed measures of neuronal activity (e.g., fMRI, EEG) and (b) examine the potential relevance of these studies to the treatment of psychological disorders among athletes and the enhancement of athletic performance.

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Kendahl M. Shortway, Andrew Wolanin, Jennifer Block-Lerner and Donald Marks

Few studies have examined the development or implementation of protocols based on acceptance and commitment therapy (ACT) to enhance sport injury rehabilitation, despite findings that suggest ACT may be an effective intervention for this purpose. The current article details the rationale for and design of Return to ACTion, an ACT-based protocol intended to target psychological flexibility and mindfulness to increase rehabilitation adherence and overall well-being for injured athletes. The initial feasibility of delivering the intervention at a Division III public university in the northeastern United States was also explored. Return to ACTion was offered in the athletic training facility to injured student-athletes during a 12-week period with recruitment assistance from the athletic trainers. Qualitative data pertaining to feasibility was collected with a log of observations maintained by the principal investigator and with verbal and electronic interactions with the athletic trainers. Although there were no participants in the intervention, there were important findings relevant to further application and research.

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Mark De Carlo, Thomas E. Klootwyk and K. Donald Shelbourne

Rehabilitation following intraarticular anterior cruciate ligament (ACL) reconstruction has undergone a dramatic evolution during the last decade. This paper describes our accelerated rehabilitation program, which is divided into four phases. The preoperative phase begins immediately after injury and emphasizes control of swelling and restoration of full range of motion (ROM) and strength before surgery. Phase II, which includes the first 2 weeks after surgery, emphasizes helping the patient obtain full terminal knee extension and weight bearing. The final two phases focus on improving lower extremity strength and full return to daily and athletic activities. This accelerated program has resulted in an earlier return of ROM and strength as well as a decrease in postoperative procedures, without compromising ligamentous stability.

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Kelly R. Holcomb, Cheryl A. Skaggs, Teddy W. Worrell, Mark DeCarlo and K. Donald Shelbourne

A paucity of information exists concerning reliability of the KT-1000 knee arthrometer (MEDmetric Corp., San Diego, CA) when used by different clinicians to assess the same anterior cruciate ligament-deficient patient. The purpose of this study was to determine the reliability and standard error of measurement of four clinicians who routinely report KT-1000 arthrometer values to referring orthopedic surgeons. Two physical therapists and two athletic trainers performed anterior laxity tests using the KT-1000 on 19 subjects. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were used to determine reliability. Intratester ICC ranged from .98 to 1.0 and intratester SEM ranged from 0.0 to .28 mm. Intertester ICC and SEM for all four testers were .53 and 1.2 mm, respectively. A 95% confidence interval (M ± 1.96 × SEM) of the intertester variability ranged from −0.18 to 4.52 mm. Therefore, large intertester variation existed in KT-1000 values. Each facility should standardize testing procedures and establish intratester and intertester reliability for all clinicians reporting KT-1000 values.

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Mark S. De Carlo, Kecia E. Sell, K. Donald Shelbourne and Thomas E. Klootwyk

It is well established that intra-articular anterior cruciate ligament reconstruction with autogenous bone-patellar tendon-bone graft provides satisfactory long-term stability. However, the rehabilitation programs employed following this surgical procedure have been a topic of considerable debate. This paper describes an accelerated rehabilitation protocol that is divided into four phases. The first phase encompasses the preoperative period, during which the patient will work to decrease swelling and restore range of motion and strength. The second phase involves Weeks 1 and 2 following surgery, with the patient emphasizing immediate terminal knee extension and weight bearing. The final two phases involve improving lower extremity strength and full return to daily and athletic activities. This accelerated rehabilitation protocol has resulted in an earlier return of range of motion and strength without compromising ligamentous stability.

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Jessica J. DeGaetano, Andrew T. Wolanin, Donald R. Marks and Shiloh M. Eastin

The purpose of this study was to explore the influence of psychosocial factors and psychological flexibility on rehabilitation protocol adherence in a sample of injured collegiate athletes. Self-report measures were given to injured athletes before the start of a physical rehabilitation protocol. Upon completion of rehabilitation, each athlete was assessed by the chief athletic trainer using a measure of rehabilitation adherence. Correlational analyses and bootstrapped logistic regression analyses were conducted to determine whether broad psychosocial factors and level of psychological flexibility predicted engagement and adherence to a rehabilitation protocol. Psychological flexibility, as measured on the Acceptance and Action Questionnaire (2nd ed.; Bond et al., 2011), contributed significantly to the overall logistic regression model. Study findings suggested that assessment of psychological flexibility could give medical providers a way to evaluate both quickly and quantitatively potentially problematic behavioral responding among injured athletes, allowing for more effective adherence monitoring.