L16 - Injury Reactions And Rehabilitation

Question 1

Why is it important to understand the psychological Impact of injury??

Answer 1

• raise awareness of psychological factors affecting injury experience
• prevent adverse reactions that may disrupt/delay rehab
• assist in rehab of injured athletes via more effective coping

Question 2

Discuss some potential reactions to injury (Walker et al, 2007)

Answer 2

• 10-20% experience extreme reactions to injury, including depressive symptoms at clinical levels
• suicidal tendencies can be an issue

Question 3

What is some of the psychological trauma of being injured? (Brewer et al, 1995; Taylor and Taylor, 1997)

Answer 3

19% of injured athletes experience a perceived inability to cope with their injury which may progress into feelings of guilt, inadequacy, fear and loss of autonomy

-> can lead to barriers to rehab (e.g. Lack of motivation, variability to manage pain)

Question 4

Discuss the implications of being physically but not psychologically ready?

Answer 4

• fears (thoughts and images of reinjury)
• problems with sleeping

-> can lead to [new injury, decreased self confidence/performance, depression ]

Question 5

What did Hemings and Povey (2002) suggest the key component of whether an athletes copes is?

Answer 5

Rehabilitation / treatment programme to their injury

Question 6

Describe Kubler - Ross (1969) grief loss stage model?

Answer 6

Denial -> anger -> bargaining -> depression -> acceptance

Support - athletes report a sense of loss and feeling of alienation
Experience some or all of emotions described
With limited support - no common sequences of emotions, little or no evidence of denial or bargaining

Question 7

What did Walker et al(2007) state about responses to injury ?

Answer 7

Would in fact appear to be more global and varied across individuals than stage models would suggest

Question 8

What did Weiss-Bjornstal et al (1998) suggest with their integrated model of psychological response to sport injury-rehab process??

Answer 8

• a sport injury is a significant source of stress
• personal and situational factors are associated with psychological responses to sport injury
• psychological responses to sport injury are related to sport injury rehabilitation outcomes

Question 9

What is a diagram of cognitive appraisal ?

Answer 9

Attributions for injury -> behavioural factors or mechanical / technical factors

Question 10

Cognitive appraisal involves altered self-perception, what does this refer to and what is it influenced by??

Answer 10

• a loss of athletic identity, loss of self-esteem and self-worth, loss of self-efficacy and self-confidence

Influenced by:- degree of psychological investment, success of previous injury rehab programs

Question 11

Cognitive appraisal also includes coping strategies, what are the two types of coping strategy?

Answer 11

Emotion focused

Process focused

Question 12

Involved with cognitive appraisal, what are perceived benefits of injury concerned with??

Answer 12

• personal growth, challenge, sport performance enhancement

Question 13

Discuss the temporal patterning of emotional response?

Answer 13

Early stage of rehab - depression, frustration, confusion, anger, fear

Middle stage of rehab - depression, frustration, shift towards more rehab concerns

Late stage of rehab - depression, frustration, fear of reinjury

Question 14

Emotional disturbances are influenced by what?

Answer 14

• personal factors (age, investment in sport)

- situational factors (sport,social (coach, physio), environmental (rehab access), injury (prognosis, recovery))

Question 15

What are some signs of poor injury adjustment (Weinberg and Gould, 2003)?

Answer 15

• feelings of anger and confusion
• repeatedly coming back too soon
• dwelling on minor physical complaints
• guilt about letting the team down
• statements indicating that no matter what is done, recovery will not occur

Question 16

Discuss adherence to injury rehabilitation (behavioural responses)??

Answer 16

• attending clinical sessions
• taking medications
• modifying activity levels
• complying with home based activities

adherence ranges from 40-90% (Brewer, 1998)

Question 17

Discuss the 4 factors involved with predicting and enhancing adherence to sport injury rehab (Brewer, 2003)?

Answer 17

• personal attributes - pain tolerance, tough-mindedness, self motivation and athletic identity
• environmental characteristics - social support, convenient scheduling of appointments, clinic settings
• effective adherence interventions- reinforcement, goal setting, education
• predictors of adherence - rehab self efficacy, perceptions of injury severity, emotional distress

Question 18

What are some strategies to ease return to sport concerns? (Podlog and Eklund, 2006,2009,2010)

Answer 18

Promote autonomy - reduce return to sport pressures, foster feelings of personal autonomy

Enhance competence - address re-injury anxieties, build confidence in performance capabilities, mimimize self-presentational concerns

Support relatedness - provide various forms of social support, ensure athletes stay involved in the sport