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Kathryn Longshore and Michael Sachs

Mindfulness-based research in sport has focused on athletes, while coaches remain unexplored. Research consistently shows that coaches experience high stress, which can lead to burnout, reduced performance, and emotional mismanagement. The present study developed and explored Mindfulness Training for Coaches (MTC), which is aimed at increasing mindfulness and emotional stability while reducing anxiety. Participants were 20 Division I coaches. The mixed-method design included trait and state measures of anxiety, mindfulness, and emotion, along with qualitative semistructured interviews. Trained coaches reported significantly less anxiety and greater emotional stability from pre- to posttraining. The state measures showed trained coaches were lower in anxiety and adverse emotions at each time point. Interviews showed six distinct positive impacts on coaches: anxiety and stress; emotions; mindfulness; coaching; athletes; and personal life. MTC is a promising intervention for coaches to reduce stress, improve well-being, and enhance coach-athlete interactions.

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Emily Bremer and Meghann Lloyd

The purpose of this pilot study was to demonstrate the impact of a fundamentalmotor-skill (FMS) intervention on the motor skills of 3- to 7-year-old children with autism-like characteristics in an early intervention classroom. A secondary purpose was to qualitatively assess the impact of the program as described by the classroom’s special education teacher. All children in the classroom (N = 5) took part in an FMS intervention for two 6-wk blocks (fall 2013 and winter 2014). Motor-skill proficiency and social skills were assessed at 3 times: baseline, after Block 1 of the intervention, and after Block 2 of the intervention. In addition, an interview was conducted with the classroom teacher after Assessment 3 to draw further insights into the relative success and impact of the program. Results were analyzed through a visual analysis and presented individually. They indicated improvements in the participants’ individual FMS and social-skill scores, possible improvements in declarative knowledge, and an increase in the special education teacher’s readiness to teach FMS; further research with larger, controlled samples is warranted.

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Jessica Ross and Peter D. MacIntyre

mixed methods approach—specifically a sequential explanatory design ( Creswell, Plano Clark, Gutmann, & Hanson, 2003 ). Using this strategy, research takes place in two phases. First, quantitative data is collected and analyzed. Based on the results of the data analysis, a qualitative phase is

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Diane M. Wiese-Bjornstal, Kristin N. Wood, Andrew C. White, Amanda J. Wambach and Victor J. Rubio

injuries? Given the lack of previous studies about the relationships between R/S and coping with sport injuries, and the desire to examine connections to the integrated model of psychological response to the sport injury and rehabilitation process, a mixed methods approach was used which allowed for

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Richard J. Boergers, Thomas G. Bowman, Nicole Sgherza, Marguerite Montjoy, Melanie Lu and Christopher W. O’Brien

In 2015, new practice recommendations to remove equipment prior to transport when cervical spine injury is suspected were released. The purpose of this study was to determine current emergency management practices and perceptions of the new practice recommendation. We received completed mixed-method surveys from 143 athletic trainers practicing in the Mid-Atlantic region (response rate = 10.11%). The majority of respondents stated that the number of personnel required, along with the training and time to practice equipment removal, were barriers to implementation. Requiring assistance from emergency medical services (EMS) was common, but many failed to practice with local EMS. Emergency management procedures should be appropriate given the resources (personnel and training) available. Collaboration between athletic trainers and EMS is needed.

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Megan D. Granquist, Diane L. Gill and Renee N. Appaneal

Context:

Rehabilitation adherence is accepted as a critical component for attaining optimal outcomes. Poor adherence is recognized as a problem in the athletic training setting. Measurement has been inconsistent, and no measure has been developed for athletic training settings.

Objective:

To identify indicators of sportinjury rehabilitation adherence relevant to athletic training and develop a Rehabilitation Adherence Measure for Athletic Training (RAdMAT) based on these indicators.

Design:

Mixed methods, 3 steps.

Setting:

College athletic training facility.

Participants:

Practicing certified athletic trainers (ATCs; n = 7) generated items, experts (n = 12) reviewed them, and practicing ATCs (n = 164) completed the RAdMAT for their most, average, and least adherent athlete.

Main Outcome Measure:

RAdMAT.

Results:

The RAdMAT is 16 items with 3 subscales. Subscales and total have good internal consistency and clearly discriminate among adherence levels.

Conclusions:

The RAdMAT is based on scholarly literature and clinical practice, making it particularly appropriate for use in athletic training clinical practice or for research purposes.

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Monna Arvinen-Barrow, Nathan Maresh and Jennifer Earl-Boehm

Context: The use of active video games (AVG) as a treatment modality in the rehabilitation context is increasing. However, little is known about the functional outcomes and psychological benefits of such rehabilitation in college athletes with lateral ankle sprains (LASs). Objective: To examine functional outcomes and psychological benefits of AVG-aided rehabilitation program for LAS. Design: A mixed-methods, single-subject case series design. Setting: College athletic training clinic. Patients: Two female college soccer players who sustained LAS (grades I and II) during sport participation. Intervention: A 4-week balance training program. One patient completed balance exercises using AVG, whereas the other patient completed traditional balance exercises. Main Outcome Measures: Several validated instruments were used to evaluate different functional outcomes and psychological factors: balance (Balance Error Scoring System, Star Excursion Balance Test), rehabilitation adherence (Rehabilitation Adherence Measure for Athletic Training), foot and ankle function (Foot and Ankle Ability Measure), perceptions of pain (Visual Analog Scale for pain), perceived readiness to return to sport (Injury-Psychological Readiness to Return to Sport Scale), and mood (Brunel Mood Scale). Results: It appears that the balance training protocols (AVG and traditional balance exercises) were equally effective in restoring patient’s balance to functional levels. Despite very individualistic processes of rehabilitation, the participants’ perceived pain, perceived readiness to return to sport, and mood states were closely linked with objective and subjective functional measures of progress. Conclusions: Based on the results, AVG has the potential to provide more versatility into the static and dynamic postural control exercises typically used following acute LAS. Moreover, the current results support the existing psychological and biopsychosocial theoretical conceptualizations of athletes’ responses to injuries and rehabilitation process.

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Robert C. Hilliard, Lindsey Blom, Dorice Hankemeier and Jocelyn Bolin

Context:

Athletic identity has been associated with rehabilitation overadherence in college athletes.

Objectives:

To explore which constructs of athletic identity predict rehabilitation overadherence, gauge athletes’ views of the most salient aspect of their athletic participation, and understand their perceptions of the reasons they adhere to their rehabilitation program.

Design:

Cross-sectional, mixed methods.

Setting:

University athletic training clinics and online.

Participants:

Currently injured college athletes (N = 80; 51 male, 29 female).

Main Outcome Measures:

Athletic Identity Measurement Scale (AIMS), Rehabilitation Overadherence Questionnaire (ROAQ), and 2 open-ended questions about athletic participation and rehabilitation adherence.

Results:

Higher levels of athletic identity were associated with higher levels of rehabilitation overadherence (r = .29, P = .009). Hierarchical multiple regression used on AIMS subscales to predict ROAQ subscales did not reveal a significant model for the subscale “ignore practitioner recommendations.” However, a significant model was revealed for the subscale “attempt an expedited rehabilitation,” F 5,73 = 2.56, P = .04, R 2 = .15. Negative affectivity was the only significant contribution to the equation (β = 0.33, t = 2.64, P = .01). Content analysis revealed that bodily benefits, sport participation, personal achievement, social relationships, and athlete status were perceived to be the most important aspects of being an athlete. The themes of returning to competition, general health, and relationship beliefs were identified as the major factors for adhering to a rehabilitation program.

Conclusions:

Negative affectivity accounted for a significant but low amount of variance for rehabilitation overadherence, suggesting that athletic trainers should pay attention to personal variables such as athletic identity that might influence the rehabilitation process. Using the knowledge of why athletes adhere to their rehabilitation and what is most important to them about being an athlete, athletic trainers can use appropriate interventions to facilitate proper rehabilitation adherence.

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Megan D. Granquist, Leslie Podlog, Joanna R. Engel and Aubrey Newland

Context:

Adherence to sport-injury rehabilitation protocols may be pivotal in ensuring successful rehabilitation and return-to-play outcomes.

Objectives:

To investigate athletic trainers' perspectives related to the degree to which rehabilitation adherence is an issue in collegiate athletic training settings, gain insight from certified athletic trainers regarding the factors contributing to rehabilitation nonadherence (underadherence and overadherence), and ascertain views on the most effective means for promoting adherence.

Design:

Crosssectional, mixed methods.

Setting:

Collegiate athletic training in the United States.

Participants:

Certified athletic trainers (n = 479; 234 male, 245 female).

Main Outcome Measures:

Online survey consisting of 3 questions regarding rehabilitation adherence, each followed by an open-ended comments section. Descriptive statistics were calculated for quantitative items; hierarchical content analyses were conducted for qualitative items.

Results:

Most (98.3%) participants reported poor rehabilitation adherence to be a problem (1.7% = no problem, 29.2% = minor problem, 49.7% = problem, 19.4% = major problem), while most (98.96%) participants reported that they had athletes who exhibited poor rehabilitation adherence (1% = never, 71.4% = occasionally, 22.5% = often, 5% = always). In addition, the majority (97.91%) of participants reported that overadherence (eg, doing too much, failing to comply with activity restrictions, etc) was at least an occasional occurrence (2.1% = never, 69.3% = occasionally, 26.3% = often, 1.9% = always). Hierarchical content analyses regarding the constructs of poor adherence and overadherence revealed 4 major themes: the motivation to adhere, the development of good athletic trainer–athlete rapport and effective communication, athletic trainers' perception of the coaches' role in fostering adherence, and the influence of injury- or individual- (eg, injury severity, sport type, gender) specific characteristics on rehabilitation adherence.

Conclusions:

These results suggest that participants believe that underadherence (and to a lesser extent overadherence) is a frequent occurrence in collegiate athletic training settings. Strategies for enhancing rehabilitation adherence rates and preventing overadherence may therefore be important for optimizing rehabilitation outcomes.

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Virginie de Bressy de Guast, Jim Golby, Anna Van Wersch and Fabienne d’Arripe-Longueville

This study presents a complete psychological skills training (PST) program with a wheelchair athlete and examines the program effectiveness using a mixed-method approach. After initial testing, the athlete followed a two-month program of self-confidence building, motivational, visualization/relaxation, and injury management techniques. Quantitative and qualitative methods were used to examine the impacts on performance and psychological abilities. The triangulated results suggest that the PST program was perceived as effective by the athlete in terms of his sporting performances and mental skills. The characteristics and implications of a PST program with this wheelchair athlete are discussed, as well as the study limitations and the perspectives for future research.