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Britton W. Brewer, Joanne M. Daly, Judy L. Van Raalte, Albert J. Petitpas and Joseph H. Sklar

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Joanne M. Daly, Britton W. Brewer, Judy L. Van Raalte, Albert J. Petitpas and Joseph H. Sklar

Cognitive appraisal models of adjustment to sport injury hold that cognitive appraisals of the injury determine emotional responses to the injury, which in turn influence behavioral responses (e.g., adherence to rehabilitation). To test this model, recreational and competitive athletes undergoing rehabilitation following knee surgery (N = 31) appraised their ability to cope with their injury and completed a measure of mood disturbance. Adherence to rehabilitation was measured in terms of attendance at rehabilitation sessions and physical therapist/athletic trainer ratings of patient behavior during rehabilitation sessions. As predicted, cognitive appraisal was associated with emotional disturbance. Emotional disturbance was inversely related to one measure of adherence (attendance) but was unrelated to the other measure of adherence (physical therapist/athletic trainer ratings). The results of this study provide support for cognitive appraisal models and suggest that emotional disturbance may be a marker for poor adherence to sport injury rehabilitation regimens.

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Britton W. Brewer, Allen E. Cornelius, Judy L. Van Raalte, Albert J. Petitpas, Joseph H. Sklar, Mark H. Pohlman, Robert J. Krushell and Terry D. Ditmar

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Carrie B. Scherzer, Britton W. Brewer, Allen E. Cornelius, Judy L. Van Raalte, Albert J. Petitpas, Joseph H. Sklar, Mark H. Pohlman, Robert J. Krushell and Terry D. Ditmar

Objective:

To examine the relationship between self-reported use of psychological skills and rehabilitation adherence.

Design:

Prospective correlational design.

Setting:

Outpatient physical-therapy clinic specializing in sports medicine.

Patients:

Fifty-four patients (17 women and 37 men) undergoing rehabilitation after anterior-cruciate-ligament reconstruction.

Main Outcome Measures:

An abbreviated version of the Sports Injury Survey (Ievleva & Orlick, 1991) was administered approximately 5 weeks after surgery to assess use of goal setting, imagery, and positive self-talk. Four adherence measures were obtained during the remainder of rehabilitation: attendance at rehabilitation sessions, practitioner ratings of patient adherence at rehabilitation sessions, patient self-reports of home exercise completion, and patient self-reports of home cryotherapy completion.

Results:

Goal setting was positively associated with home exercise completion and practitioner adherence ratings. Positive self-talk was positively correlated with home exercise completion.

Conclusions:

Use of certain psychological skills might contribute to better adherence to sport-injury rehabilitation protocols.

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Britton W. Brewer, Allen E. Cornelius, Judy Van Raalte, John C. Brickner, Howard Tennen, Joseph H. Sklar, John R. Corsetti and Mark H. Pohlman

The accuracy of retrospective ratings of pain intensity was examined in a sample of 72 men and 36 women undergoing rehabilitation following anterior cruciate ligament (ACL) reconstructive surgery. Participants completed daily ratings of current, worst, and average pain intensity for the first 42 days of rehabilitation. Participants provided retrospective ratings of worst and average pain intensity twice for a 7-day period (on Days 7 and 21) and once for a 30-day period (on Day 30). Correlations between concurrent and retrospective pain ranged from .74 to .88. Retrospective pain ratings consistently overestimated concurrent pain ratings, but were generally not biased by current pain. The results suggest that retrospective pain ratings can substitute for concurrent pain ratings if the tendency toward overestimation is taken into account.