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Kinesiology 1070A > Rehabilitation Psychology > Flashcards

Rehabilitation Psychology Flashcards

1
Q

What are the moderator variables of the Williams and Anderson model and what are some examples?

A

moderator variables affects the intensity of the stress response

  • history of stressors: experience with previous injury, fear of another injury
  • coping resources: amount of social support received ability to cope with stressors
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2
Q

(Williams and Anderson model) what happens when an athlete encounters a potentially stressful situation?

A

the athlete gives a stress response when demands of a situation exceed the coping resources leading to a stress response
(ex, physiological affects like increase blood pressure, more sweat or muscle tension)
(ex 2, attention is narrowed or unfocused)

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3
Q

how do the affects from the stress response affect athletes?

A

these physiological affects and attentional demands increase vulnerability of injury

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4
Q

do all individuals demonstrate a stress response?

A

no, some individuals might not show any stress response even in a stressful situation depending on moderating factors

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5
Q

moderator variable

A

is a quantitative variable that affects the nature, direction or the strength of a relation between an independent or predictor variable (life stress) and dependent variable (this case injury)

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6
Q

life stress, coping skills, social support vs time loss (smith)

A
  • measured the life stress, social support and coping skills at the start of the high school sport season.
  • then recorded injury data collected over the season and time loss due to injury.
  • research assistants were trained to record injury and the amount of exposure the athletes had in the season
  • athletes with low-low (social support and coping skills) had a 22% more risk of being injured
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7
Q

how can we reduce the stress response?

A

1) alteration of cognitive appraisal of potentially stressful situations
2) modifying the physiological and attentional aspects of the stress response
- > interventions can also be used to directly influence the moderator variables (coping resources and personality factors)

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8
Q

design of stress intervention vs injury occurrence? (Gerr and Koss)

A
  • 2 arm randomized trial (randomly get selected for no treatment arm or treatment arm)

time period of the study:
- time 1 - pre-season and pre-intervention measures (athletic stress)

  • time 2 - four months after time 1 (mid-season)
  • time 3 - four months after time 2 (peak season, national championships)

dependent variable: injury occurrence

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9
Q

what was stress intervention vs injury occurrence study? (Gerr and Koss)

A
  • > the experimental group (stress management program) decreased in negative stress as the season progressed
  • > the control group (no treatment) increased in stress as the season progressed
  • > the incidence of injury can be reduced in athletes (gymnasts) when negative athletic stress is reduced
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10
Q

what information did Tranaeus reveal from the meta-analysis?

A
  • looked at injury vs intervention relationships in 7 studies
  • most of the articles favored the intervention
  • the total Hedges’ g effect was 0.82
  • the result indicates that psychological injury prevention interventions have a large effect on reducing injury
  • diamond = the average of all the studies
  • 0.8 or higher Hedges’ g effect is a large effect
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11
Q

findings of intervention and knee strength, pain, re-injury anxiety?

A

by cupal and brewer

knee strength - treatment group greater strength than control and treatment

re-injury anxiety - treatment group less anxiety in re-injury

pain - treatment group lesser pain

  • > knee strength was correlated with both re-injury anxiety (r = -.53, p > .003) and pain reduction (r = -.46, p < .01)
  • psychological-based interventions can enhance functional and related cognitive outcomes during rehabilitation
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12
Q

why does guided imagery work? (cupal and brewer)

A
  • our bodies do not discern whether an image is real or imagined

psychological mechanisms - personal control, motivation

physiological - reduced stress -> better immume-inflammatory response

-> promotes tissue regeneration and repair

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13
Q

Bandura’s model

A

modeled act -> attention -> retention -> production -> motivation -> response

  • emphasizes the importance of observing, modelling, and imitating the behaviors, attitudes, and emotional reactions of others
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14
Q

what are some examples of outcome measures in modeling rehab psychology?

A

performance - adherence, errors, outcome, form

cognitive and affective psychological responses - anxiety, mood, self-efficacy, RPE

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15
Q

Research and applications of modeling in rehab psychology

A
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16
Q

types of modeling interventions

A
  • mastery vs coping model
  • imagery vs modeling as a vicarious experience (experienced in the imagination through the feelings or actions of another person)
  • self-modeling
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17
Q

mastery models

A
  • demonstrate errorless performance
  • verbalize confidence
  • demonstrate positive attitude
  • verbalize low task difficulty
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18
Q

coping models

A
  • display decreasing distress as they struggle with difficulties or threats
  • demonstrate strategies for dealing with different situations
  • voice progressively self-efficacious beliefs
  • approach or achieve mastery
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19
Q

how modeling is used in medical settings

A
  • preparing patients for non-surgical procedures
  • preparing patients for surgical procedures
  • using video for patient education and skill development
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20
Q

what is a problem with individuals in “medical” settings

A

many individuals are prone to exhibit high anxiety

“white coat phenomenon”

ex) increase in b

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21
Q

what did Kulik and Mahler find in their study?

A
  • pre-operative patients had less anxiety with a post-operative patient
  • the exposure to postoperative sensations and events through a coping model better prepares the observer by providing accurate information on which cognitivie appraisal of the situation can be made

(the patients knew how the results of other patient’s surgery went)

22
Q

what did flint examine and study?

A

examined the role of coping models compared to no models on psychological factors and functional outcomes following a rehabilitation program for anterior cruciate ligament reconstruction (ACL) among ten female basketball players.

23
Q

what was the procedure for flint’s study?

A

Players were assigned to watch a coping model video of peers participating in rehabilitation from ACL surgery

The coping model video showed female athletes similar in age, basketball position, and type of injury progressing through the rehabilitation process to full recovery

24
Q

what did flint find from his study?

A

At 3-weeks post-surgery, athletes who watched the modelling video had greater self-efficacy (belief that they can achieve their goals) than the control group.

At 2-months post-surgery the intervention group had higher perceived athletic competence (ability to do something successfully)

25
Q

what were the limitations of flint’s study?

A
  • the sample size was very small and hence underpowering
  • the modeling intervention was only introduced post-operatively and pre-operative benefits weren’t studied
26
Q

what were the psychological measure of prapvessis’ study?

A

Perceptions of expected pain

Perceptions of actual pain

Anxiety - Participants rated levels of state anxiety

Self-efficacy - Participants rated their confidence to perform specific tasks over increasing duration and frequency:

Walk with crutches (post-op)

Walk without crutches (post-op, 2-weeks)

Perform rehabilitation exercises (post-op, 2- and 6-weeks)

27
Q

what were the functional measures of prapavessis’ study?

A
  • International Knee Documentation Committee Form (IKDC)
  • Objective component (surgeon): Knee laxity, swelling, ROM
  • Subjective component (patient): Symptoms, difficulty performing tasks

(baseline and 6-weeks)

  • Range of Motion (Baseline, 2- and 6-weeks using a goniometer)
  • Time walking without crutches (in days)
28
Q

what was the procedure of prapavessis’ research?

A
29
Q

psychological intervention for ACL reconstruction (prapavessis)

A
  • psychological intervention was a DVD the patients watched a succesful ACL reconstruction
  • made them think it would be successful for them too
30
Q

how did the intervention affect patient’s expected pain? (prapavessis)

A
  • intervention group had a lower expectation of pain
31
Q

how did the intervention affect patient’s clutch self-efficacy? (prapavessis)

A
  • intervention group had more self-efficacy (confidence to walk in crutches)
32
Q

how did the intervention affect patient’s walking self-efficacy? (prapavessis)

A
  • only differences at pre-discharge where intervention group had more confidence
33
Q

how did the intervention affect the amount of days patients walked with crutches? (prapavessis)

A
  • intervention group got off the crutches at average of 5 and a half days
  • where control got off 9 and a half days
34
Q

how did the intervention affect patient’s excersize self-efficacy? (prapavessis)

A
  • intervention group had more confidence only at pre-discharge
35
Q

how were the IKDC objective scores? (prapavessis)

A
  • done by the surgeon, they didn’t know which patient was in the intervention group
  • intervention group was in better condition (closer to 0 means better function)
36
Q

how were the IKDC subjective scores? (prapavessis)

A
  • intervention group rated themselves higher in condition than the control group

(higher means better condition)

37
Q

what conclusions are made in prapavessis’ study?

A

(psychological)

  • Preoperative anxiety, no effect
  • Perceptions of expected pain, positive effect
  • Perceptions of actual pain, no effect
  • Self-efficacy measures, early effect

(functional)

  • Crutch walking, positive effect
  • IKDC, positive effect
  • ROM (range of motion), no effect
38
Q

how can prapavessis’ research be used in the future?

A
  • The use of interactive modeling techniques in specific rehabilitation exercises
  • Non-pharmacological pain-management techniques used during pain focusing and pain reduction might be presented using a modeling format
  • Use of modeling techniques could be employed to alter psychological variables previously shown to affect adherence behavior (i.e., motivation, intention and perceived behavioral control)
39
Q

Placebo

A

Improvement in health not attributable to treatment. (Sham surgery)

Subjects believe that they are getting better without knowing there was no treatment

Attenuated: Effects are reduced.

Placebos cause brain to release endorphins that reduce pain.

Attention, care and affection triggers physical reactions in human body to hea

40
Q

nocebo

A

if an individual does not expect the drug to work, or expects there to be side effects, the placebo can generate negative outcomes, the placebo is instead refered to as a nocebo

41
Q

the process of treatment theory

A
  • placebos cause the brain to release endogenous opioids, or endorphins that reduce pain
  • showing attention, care, affection, etc. to the patient/subject triggers physical reactions in the body which reduce stress and promote healing (ex, better immune system response)
42
Q

A controlled trial of Arthroscopic surgery for Osteoarthritis of the knee

A

By Moseley.

Lavage (Flush damaged cartilage out), Debridement (Scrapping) or Placebo.

Patients with placebo got similar results to the patients with real surgery (even after 2 years).

Ethical issues: Deceit of sham surgery vs false benefits of actual surgery.

Will insurance stop covering the surgery

43
Q

knee surgery vs sham surgery (moseley)

A
  • osteoarthritis
  • Arthroscopic surgery-damaged cartilage is scraped (debridement) or flushed out (lavage) with the aid of a viewing scope is a common option
  • sham surgery is faked, where incision is made and movements are made to make the surgery feel as believable as possible
44
Q

psychological reaction to injury

A

injury-relevant processing: information about pain, extent of injury, how it happened, negative consquences

emotional upheaval and reactive behaviour: agitation, emotional depletion, isolation, shock, disbelief, denial, self-pity

positive outlook and coping: acceptance, coping efforts, optimism, relief with progress

identity loss: especially if no longer able to participate

fear and anxiety: recovery? reinjury? be replaced?

lack of confidence: decreased physical status

performance decrements: less confidence, lack of practice, deconditioning expectations

45
Q

stress

A
  • substantial imbalance between demand and response capability
  • underconditions where failure to meet demands has important consequences
46
Q

prehabilitation

A

training/treatment in preparation for an anticipated stressor

can be physical (for physical stressors), psychological (for psych. stressors) or both

question: can we deal with the stressors in the prehab time to optimize the recovery

47
Q

theory of prehabilitation affects

A

by topp et al.

prehab. and non-prehab patients start at the same level of function

prehab patients increase function during prehab phase while non-prehab. patients maintain or decrease in function

similar decrease in response to the stressor for prehab and non-prehab patients

prehab. patients spent ashorter time below the minimum function level than non-prehab patients

similar recovery, but prehab. patients are quicker (higher in function levels) to pre-operation levels

48
Q

why might prehabilitation work?

A

traing specific systems that will be affected by the stressor (specifically)

ex) build muscle strength if the stressor will cause strength loss

build up a functional reserve to compensate for depletion by the stressor

49
Q

sport injury vs chronic condition

A

sport injury

  • acute injury
  • shorter surgical wait time
  • performance goals
  • return-to-play timeline

chronic condition

  • gradual onset
  • longer wait time
  • daily living / health goals
  • no defined recovery timeline
50
Q

crochane review

A

systematic reviews of primary research in human health care and health policy, and are internationally recognised as the highest standard in evidence-based health care

51
Q

total joint replacement and rehabilitation, systematic review and meta-analysis

A

by Wang et al.

prehab interventions - physiotherapy supervised exercise vs. usual care

main measures: pain & function

conclusion: evidence suggests prehab may slightly improve early post-operative pain and function, however effects remain too small and short-term to be considered clinically-imporant, and did not affect key outcomes of interest (length of stay, quality of life, cost)

strength: converted outcomes to a standardized measurement of WOMAC

limitation: compliance was not reported in a number of studies

no physical measure of function

Kinesiology 1070A (11 decks)

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