| 1. |
- Dunlop, Gordon, et al.
(författare)
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Examination of the validity of the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale in male professional football players : A worldwide study of 29 professional teams
- 2023
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Ingår i: Journal of Sports Sciences. - Abingdon, Oxon : Routledge. - 0264-0414 .- 1466-447X. ; 41:21, s. 1906-1914
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Tidskriftsartikel (refereegranskat)abstract
- Perceived confidence is an important dimension of an athlete’s psychological readiness to return-to-play. However, there is no established and validated tool to evaluate confidence in professional football. This study aimed to provide preliminary evaluation of the internal structure of the Injury-Psychological Readiness to Return-to-Sport scale (I-PRRS) in a cohort of injured male professional footballers. Over an 18-month period, 29 teams from 17 leagues participated. Players sustaining injuries eliciting (Formula presented.) 3 weeks’ time-loss were recruited. Cross culturally adapted to 4 further languages, the I-PRRS was administered on two occasions: 1) day before returning-to-training and 2) day before returning-to-match-play. In total, 113 injuries were recorded with 96 completed I-PRRS data sets collected. Confirmatory factor analysis indicated the I-PRRS was a unidimensional scale, with all items measuring the same construct. The scale demonstrated good internal consistency (ω =.88). When examining longitudinal invariance of the I-PRRS across administration time-points, indices of model fit supported scalar invariance. There was preliminary evidence of good internal structure for the I-PRRS in professional male footballers. However, before further research involving the I-PRRS can be endorsed, efforts to confirm or refute empirical developments pertaining to psychological readiness are necessary. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 2. |
- Grinberg, Adam, 1980-
(författare)
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Sensorimotor function following anterior cruciate ligament injury : movement control, proprioception and neuropsychological perspectives
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The high incidence of anterior cruciate ligament (ACL) injuries in sports suggests an involvement of both biomechanical and neurocognitive risk factors. Athletes are constantly exposed to challenging sports scenarios, which are often characterised by high-intensity movements combined with a multi-stimuli environment and continuous psychological pressure. Post-injury loss of knee proprioception and long-term injury-associated neuroplasticity arguably place an athlete in a disadvantage when coping with such situations when returning to sports (RTS). This is postulated to contribute to a high rate of re-injuries, seen despite achieving RTS eligibility. Psychological factors such as re-injury fears and anxieties are also suggested to influence central sensorimotor processing and to therefore play a role in the generation and control of functional movements. Their assessment is however based on suboptimal tools, particularly when administered to the athletic population. In general, current clinical assessments focus primarily on coarse outcome measures while disregarding aspects such as multi-joint control and the influence of psychological aspects on motor performance. This thesis focuses on the role of proprioception and re-injury anxiety on functional movement control following ACL injury and reconstruction (ACLR), with implications for risks of re-injury.Methods: This thesis is comprised of four cross-sectional studies (Papers I-IV), that stem from two data collections performed in a motion analysis laboratory. Paper I introduces a novel obstacle clearance test aimed to functionally assess proprioception and sensorimotor control. The goal of the test was to cross an obstacle, downward vision occluded, aiming for minimal foot clearance. Individuals following ACLR and rehabilitation were compared to both mildly active uninjured persons (CTRL) and elite athletes (ATH). A kinematic analysis, using 3D motion capture, included estimates of lower limb movement accuracy, variability and symmetry. Paper II evaluates knee proprioception among the same individuals using a weight-bearing knee joint position sense (JPS) test, and outcomes were compared with associated outcomes from the obstacle clearance test. Paper III explores whether self-reported fear of re-injury is manifested in the biomechanics (kinematics and electromyography) of a standardised rebound side-hop test (SRSH). An ACLR group was stratified into high-fear and low-fear subgroups based on one discriminating question, and compared also to uninjured controls. In Paper IV, a threat-conditioning test paradigm is introduced, aiming to invoke and measure a neurophysiological arousal response to movement-related fear, among uninjured individuals. Conditioned auditory stimuli were occasionally followed by unexpected perturbations of the base of support, and compared with neutral stimuli. Electroencephalography was continuously registered and event-related potentials were explored as potential anxiety biomarkers.Results: Kinematic asymmetry was observed for the ACLR group during obstacle crossing, both for individual joints and for multi-joint movement and velocity curves. In addition, trailing leg trajectory variability during higher obstacle crossings was lower for ACLR compared to both control groups. The less physically-active CTRL group demonstrated less crossing accuracy (larger obstacle distances and JPS errors) compared to both ACLR and ATH. Moderate positive correlations were observed between knee JPS absolute errors and obstacle distances, for the injured leg of the ACLR group only. Individuals with ACLR, classified as having high fear, demonstrated higher biceps femoris amplitudes and anterior-posterior co-contraction index during landing. Side-hop performance was also distinguishable for ACLR (regardless of fear allocation) with greater hip and knee flexion, while high-fear individuals also had more trunk flexion. Perturbation-related fearful response was reflected as a high-amplitude contingent negative variation (CNV) wave in response to conditioned compared to neutral stimuli. The CNV wave was observed over all electrode cites but most significantly over frontal and central cortical areas.Conclusions: Even following rehabilitation, individuals with ACLR showed unique sensorimotor function, characterised by less trajectory variability and greater multi-joint asymmetry when proprioception was challenged (i.e., downward vision occluded). However, knee JPS did not seem to be deficient among these individuals, but instead more related to physical activity, than to the ACLR history. Correlations to JPS errors, seen exclusively for the ACLR leg might suggest a tendency to focus attention more internally when crossing an obstacle (generally an external focus task), though this should be investigated further. Higher levels of self-reported fear of re-injury were manifested in the biomechanics of side hops, with seemingly stiffer landings and protective neuromuscular strategy. This has potential implications for joint degeneration hastening as well as reduced motor adaptability, implying a risk for re-injury. Finally, the balance-perturbation test paradigm seemed to provoke threat-associated arousal in the form of a CNV wave among uninjured individuals. The CNV wave should further be explored as a potential biomarker for re-injury anxiety. Future research should implement this paradigm on individuals with different levels of self-reported movement-related fears and anxieties, striving for a more holistic approach in rehabilitation following ACLR.
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| 3. |
- Pluim, Babette M, et al.
(författare)
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Physical Demands of Tennis Across the Different Court Surfaces, Performance Levels and Sexes: A Systematic Review with Meta-analysis
- 2023
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Ingår i: Sports Medicine. - : Springer Science and Business Media LLC. - 0112-1642 .- 1179-2035. ; 53:4, s. 807-836
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Forskningsöversikt (refereegranskat)abstract
- BackgroundTennis is a multidirectional high-intensity intermittent sport for male and female individuals played across multiple surfaces. Although several studies have attempted to characterise the physical demands of tennis, a meta-analysis is still lacking.ObjectiveWe aimed to describe and synthesise the physical demands of tennis across the different court surfaces, performance levels and sexes.MethodsPubMed, Embase, CINAHL and SPORTDiscus were searched from inception to 19 April, 2022. A backward citation search was conducted for included articles using Scopus. The PECOS framework was used to formulate eligibility criteria. Population: tennis players of regional, national or international playing levels (juniors and adults). Exposure: singles match play. Comparison: sex (male/female), court surface (hard, clay, grass). Outcome: duration of play, on-court movement and stroke performance. Study design: cross-sectional, longitudinal. Pooled means or mean differences with 95% confidence intervals were calculated. A random-effects meta-analysis with robust variance estimation was performed. The measures of heterogeneity were Cochrane Q and 95% prediction intervals. Subgroup analysis was used for different court surfaces.ResultsThe literature search generated 7736 references; 64 articles were included for qualitative and 42 for quantitative review. Mean [95% confidence interval] rally duration, strokes per rally and effective playing time on all surfaces were 5.5 s [4.9, 6.3], 4.1 [3.4, 5.0] and 18.6% [15.8, 21.7] for international male players and 6.4 s [5.4, 7.6], 3.9 [2.4, 6.2] and 20% [17.3, 23.3] for international female players. Mean running distances per point, set and match were 9.6 m [7.6, 12.2], 607 m [443, 832] and 2292 m [1767, 2973] (best-of-5) for international male players and 8.2 m [4.4, 15.2], 574 m [373, 883] and 1249 m [767, 2035] for international female players. Mean first- and second-serve speeds were 182 km·h−1 [178, 187] and 149 km·h−1 [135, 164] for international male players and 156 km·h−1 95% confidence interval [151, 161] and 134 km·h−1 [107, 168] for international female players.ConclusionsThe findings from this study provide a comprehensive summary of the physical demands of tennis. These results may guide tennis-specific training programmes. We recommend more consistent measuring and reporting of data to enable future meta-analysts to pool meaningful data.
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| 4. |
- Ringberg, Magnus, et al.
(författare)
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Athletes' experiences of using a self-directed psychological support, the BAck iN the Game (BANG) smartphone application, during rehabilitation for return to sports following anterior cruciate ligament reconstruction
- 2023
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Ingår i: BMC SPORTS SCIENCE MEDICINE AND REHABILITATION. - : BioMed Central (BMC). - 2052-1847. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Following anterior cruciate ligament reconstruction (ACLR), many athletes do not return to their sport, often driven by concerns about re-injury. Psychological support strategies might help, but are not routinely included in rehabilitation after ACLR. The BAck iN the Game (BANG) intervention is a 24-week eHealth program delivered via smartphone application (app), beginning directly after ACLR, with a self-directed approach that aims to target the specific challenges athletes encounter in rehabilitation.Aim: To describe athletes' experiences of using the BANG app during rehabilitation, to support returning to sport following ACLR.Method: Participants were athletes, in contact and/or non-contact pivoting sports, who had ACLR with the goal to return to sports. Semi-structured, individual interviews were conducted 6-10 months after their ACLR; all had access to the BANG intervention. Verbatim transcripts were analysed with a qualitative content analysis.Results: The 19 participants were 17-30 years, mean 21.6 years (SD 3.5); 7 men and 12 women. The analysis generated three main categories. (A) Interacting with the app illustrated how, when, or why the participants engaged with the app. The app was helpful because of its varying content, the notifications served as reminders and participants stopped using the app when no longer needing it. (B) Challenging experiences with the app illustrated that the app itself came with some difficulties e.g., content not appearing with the right timing and material not tailored to their sport. (C) Supportive experiences with the app reflected how the app facilitated the participants' rehabilitation progress; it included positive aspects of the app content and navigation, boosting their confidence to return to sport, and motivated them to continue with rehabilitation.Conclusion: The analysis of the interviews illustrates athletes' awareness in interacting with, and the challenging and supportive experiences of using the app. The BANG app might provide support for returning to sport, primarily psychological support, as an adjunct to regular physiotherapy-guided rehabilitation. Athletes' experiences of the BANG app could be improved by healthcare professionals providing additional advice about when to use which content and why.
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| 5. |
- Slater, Diane, et al.
(författare)
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Biopsychosocial Factors Associated With Return to Preinjury Sport After ACL Injury Treated Without Reconstruction: NACOX Cohort Study 12-Month Follow-up
- 2023
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Ingår i: SPORTS HEALTH-A MULTIDISCIPLINARY APPROACH. - : SAGE PUBLICATIONS INC. - 1941-7381 .- 1941-0921. ; 15:2, s. 176-184
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Tidskriftsartikel (refereegranskat)abstract
- Background: The limited research on prognosis after nonsurgical management of anterior cruciate ligament (ACL) injury has focused on physical factors. We aimed to assess relationships between key patient-reported outcomes, in line with a biopsychosocial approach, and returning to preinjury sport at 12 months after ACL injury treated without reconstruction. Hypothesis: We hypothesized that biopsychosocial factors would be associated with returning to preinjury sport at 12 months after ACL injury. Study Design: Prospective single cohort study. Level of Evidence: Level 2. Methods: Patients who had an ACL injury and did not have reconstruction during the first year after injury were recruited from healthcare clinics in Sweden, and followed up at 3, 6, and 12 months after injury. Return to preinjury sport at 12 months was the primary outcome. Explanatory variables were psychological readiness to return to sport, knee-related quality of life, and self-reported knee function. Using generalized estimating equations, we evaluated the relationships between the explanatory variables and the primary outcome at each timepoint. Results: Data were analyzed for 88 participants with a median age of 27 years (15-40 years). Soccer was the most frequently reported preinjury sport (n = 22). Forty participants (46%) had returned to their preinjury sport at 12 months after ACL injury. The odds of returning to preinjury sport at 12 months increased with higher self-reported knee function at 6 months (odds ratio [OR], 1.1; 95% CI, 1.0-1.1), and the odds of being returned to the preinjury sport at 12 months doubled for every 1-point increase (1-10 scale) in psychological readiness to return to sport measured at 12 months (OR, 1.9; 95% CI, 1.2-3.2). Conclusion: Superior self-reported knee function at 6 months and greater psychological readiness to return to sport at 12 months were associated with returning to the preinjury sport 1 year after ACL injury treated without reconstruction.
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