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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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Andrew R. Levy, Remco C.J. Polman, Peter J. Clough, David C. Marchant and Keith Earle

Objective:

To investigate the relationship between mental toughness, sport injury beliefs, pain, and adherence toward a sport injury rehabilitation program.

Design:

A prospective design was employed that evaluated adherence over the entire rehabilitation period.

Participants:

70 patients undertaking a sport injury rehabilitation program for a tendonitis related injury.

Main Outcome Measures:

Adherence was measured using self report measures of clinic and home based rehabilitation alongside attendance.

Results:

No association was found between mental toughness and coping appraisals, although high mentally tough individuals displayed more positive threat appraisals and were better able to cope with pain than their less mentally tough counterparts. Greater attendance at rehabilitation sessions was displayed by more mentally tough individuals; however, more positive behavior during clinic rehabilitation was characterized by low mental toughness.

Conclusions:

Despite the 0benefits of being mentally tough, sports medicine providers need to be aware that a high degree of mental toughness may have negative consequences upon rehabilitation behavior and subsequently recovery outcomes.

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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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Tania Pizzari, Helen McBurney, Nicholas F. Taylor and Julian A. Feller

Objective:

To investigate the subjective experience of anterior cruciate ligament (ACL) rehabilitation and identify variables that influence adherence as perceived by ACL-reconstructed patients.

Design:

A qualitative study using in-depth interviews to gather data and thematic coding to analyze findings.

Setting:

Participants were interviewed at home or in their workplace.

Participants:

Eleven patients were interviewed at an average of 4.8 months (SD = 0.8) after ACL reconstruction.

Results:

Using thematic coding of the interview data, 3 categories of variables influencing adherence emerged: environmental factors, physical factors, and psychological factors. Variables specifically affecting adherence to home exercise were perceived lack of time and a lack of self-motivation. Fear of reinjury emerged as a significant consideration for those who were nonadherent. Factors such as therapist support, the rehabilitation clinic, and the progression of exercises were identified as being important for attendance at physiotherapy appointments and adherence during appointments.

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Damien Clement

Context:

The transtheoretical model has been widely used in the investigation of how people adapt to new behaviors; however, the literature appears to be lacking documentation of any assessment/s administered to injured athletes to determine their readiness for rehabilitation, which depending on the severity of the injury, could possibly represent a behavior change for that individual.

Objective:

To validate the application of the transtheoretical model to injury rehabilitation and assess the impact of stages of change on athletes’ adherence and compliance rates.

Design:

Descriptive correlational.

Setting:

Large Mid Atlantic Division I institution.

Participants:

Seventy injured athletes.

Main Outcome Measures:

Readiness was assessed using the Transtheoretical Model. Adherence was assessed using the percentage of rehabilitation attendance and compliance was assessed using the Sport Injury Rehabilitation Scale.

Results:

Participants who were advanced in their stages of change generally reported an increase in self efficacy, utilization of pros versus cons, and the use of behavioral processes instead of experiential processes of change. No significant relationships were found between stages of change and athletes’ adherence and compliance.

Conclusion:

Although no statistical significance was found between stages of change and adherence and compliance the results did validate the application of the transtheoretical model to injury rehabilitation.

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Landon Lempke, Abbis Jaffri and Nicholas Erdman

school attendance, that may aggravate the symptoms. 1 Physical rest recommendations consist of refraining from physical activity until the postconcussive symptoms have subsided, followed by progressive restoration of physical activity as long as the athlete is asymptomatic. 1 , 2 Despite the widespread

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Wei Sun, Xiujie Ma, Lin Wang, Cui Zhang, Qipeng Song, Houxin Gu and Dewei Mao

entire 16-week study. Furthermore, 64 attendance sessions out of 80 (80%) were required for each participant in the three groups. Twelve individuals dropped out because of health reasons ( n  = 2), low attendance rate ( n  = 6), lack of time ( n  = 3), and no reason ( n  = 1). No statistical difference

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Marissa J. Basar, Justin M. Stanek, Daniel D. Dodd and Rebecca L. Begalle

. Over the course of the study, 6 total participants were lost due to attendance (n = 2), musculoskeletal injury (n = 1), or absent of dependent measurements (n = 3). Of the eligible 44 participants, 14 were military science (MS) Is, 5 were MS IIs, 15 were MS IIIs, and 10 were MS IVs. Each MS year

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Megan Elizabeth Evelyn Mormile, Jody L. Langdon and Tamerah Nicole Hunt

cognitive tests, along with both cognitive and physical rest as a mainstay of recovery. 9 Cognitive rest has been utilized to decrease brain activities during the recovery process, typically through decreased or no attendance at school or physical activity. 10 Additionally, the use of video games

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Neil Maguire, Paul Chesterton and Cormac Ryan

participants prior to the sessions so as not to influence outcomes and/or attendance. For ethical purposes, the intervention group received red flag content the following academic week and the control group received the PNE content. The lead author carried out the allocation of the participants to each group