The primary purpose of this study was to determine if life stress had any affect on athletic performance and the occurrence of injury. The athletes in this study ranged in age from 17 to 22, and all had the potential and ability to practice and compete at the Division I level in track and field. The goal of the researcher was to collect as much information as possible on each athlete. Each athlete was required to write in a daily journal. A standard set of questions were asked in interviews prior to competition and following competition. Each athlete completed two types of scales prior to competition as well: Everyday Problem Scale (EPS) and Sport Competition Anxiety Test (SCAT). Through this information five common trends emerged: injury with treatment, external distractions, a higher performance was perceived if their family and friends were present at competition, teammate support, and teammate frustration.The researcher believed there was sufficient evidence to dismiss the comparison between the five common trends and the scores of the SCAT and EPS. The SCAT scores were mainly at the moderate level. The average score among all the athletes was approximately "19" or moderate. The EPS dealt with life stress and not athletic stress.The most frequently cited concern by the athletes were financial problems, difficulties with a girlfriend, wanting a relationship with someone, and so forth, but none were consistently cited.The perception of the stressor was an important factor in this study since the athletes perceived each competition either as distressful or eustressful. Depending on how much the athlete perceived each competition as a stressor may have effected his performance. Few stressors were identified but depending on the competition the athlete may have focused so much on the stressor that it became distressful while at another competition the same stressor was not focused on as much so it was viewed as eustressful. / School of Physical Education

Dissertation (PhD)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: The present study was undertaken with the aim of developing and implementing a model for the rehabilitation of sports injuries. Injury is, without a doubt, one of the most significant obstacles to athletic performance. Very few, if any, athletes escape injury and it seems that regardless of experience and ability, all physically active individuals are prone to injury at some stage of their careers. The ability to resist injury and to rehabilitate well when injury does occur is fundamental to longevity in sport. Previous injury rehabilitation interventions commonly addressed only the physiological dimensions of injury, excluding the psychological dimensions. Only very recently has there been a shift in focus to include psychological principles in the treatment procedures, with Heil (1993) and Pargman (1993a) some of the first authors to publish works on the subject. A comprehensive literature review was done. In the first chapter attention was paid to the role of personality in injury occurrence and rehabilitation outcome, with special emphasis on the model of stress and athletic injury of Andersen and Williams (1993). An extension to this model, taking into account the role of personality, coping resources, cognitions, interventions and other injury and treatment related factors in the rehabilitation process was added by Grove (1993). The next chapter was devoted to the causes and stresses of sports injuries. Topics that were covered include the over-training syndrome, understanding injuries from the athlete's, physician's and psychologist's points of view and a study of what exactly the stresses involved in athletic injury are. Special attention was paid to the concept of pain and all its dimensions, the social well-being of the injured athlete and the impact of injury on the athlete's self-concept and identity. In the following chapter psychological adjustment to athletic injury was discussed. The concepts of loss and grief and applicability of grief response models in particular were discussed. In response to grief response models, cognitive appraisal models (Brewer, 1994) and an integrated model by Wiese-Bjomstal et al. (1998) were also discussed. Attention was given to the factors associated with rehabilitation adherence with particular remarks on malingering athletes. Peer modelling as a coping strategy in injury rehabilitation also came under scrutiny, as did the role and effect of social support. The next chapter focused on the development of the service-provider model for sports injury rehabilitation. From the initial literature review it was clear that of all the treatment providers involved with injured athletes, physiotherapists and biokineticians (athletic trainers) are probably those who spend the most time with them. In the development of the model for injury rehabilitation, special emphasis was therefore placed on the role of the physiotherapist and biokineticians. As a basis for developing the model, the traditional medical model was used, but it was adapted to incorporate psychological principles. A computer program was written to assist physiotherapists and biokineticians in treating injured athletes through the use of psychological principles. This program was constructed using psychological instruments that already exist, but they were adapted to be used as non-pen and paper tests. The tests used were the Emotional Responses of Athletes to Injury Questionnaire (ERAIQ), the Incredibly Short POMS (ISP), a Pain Drawing Instrument, a Visual Analogue Scale and the Affective subscale of the McGill Pain Questionnaire. Provision was made for handouts to be included in the program which can then be given to patients after each therapy session. To be able to determine whether the program was successful in assisting physiotherapists and biokineticians in their treatment of injured athletes, the program was evaluated in the next chapter. Feedback from both patients, physiotherapists and biokineticians using the program were received. Two short questionnaires were used for this purpose. Finally, conclusions were drawn from the information received from the program and recommendations based on these conclusions were made. Key words: Sports injuries, injury rehabilitation. / AFRIKAANSE OPSOMMING: Die doel van die huidige studie was die ontwikkeling en implementering van 'n model vir die rehabilitasie van sportbeserings. Beserings is, sonder twyfel, van die belangrikste struikelblokke in die weg van sportprestasie. Baie min, indien enige, atlete spring beserings vry. Dit wil ook voorkom of alle fisiek aktiewe individue, ongeag hulle ondervinding en vermoë, op een of ander stadium van hulle loopbane 'n besering opdoen. Fundamenteel aan volgehoue deelname aan sport, is die vermoë om beserings te vermy en om atlete suksesvol te rehabiliteer indien 'n besering welopgedoen word. In die verlede het rehabilitasie-intervensies hoofsaaklik die fisieke dimensies van beserings aangespreek sonder inagname van die sielkundige dimensies. Slegs on1angs het daar 'n klemverskuiwing begin plaasvind deurdat daar begin is om sielkundige beginsels in te sluit in behandelingsprosedures. Heil (1993) en Pargman (1993a) was van die eerste skrywers wat werke oor hierdie onderwerp gepubliseer het. 'n Uitgebreide literatuuroorsig is onderneem. In die eerste hoofstuk was aandag geskenk aan die rol wat persoon1ikheid speel in die voorkoms van beserings en die suksesvolle rehabilitasie daarvan, met spesiale klem op Andersen en Williams (1993) se model van stres en sportbeserings. Hierdie model is deur Grove (1993) uitgebrei deur inagname van die rol van persoon1ikheid, hanteringsvaardighede, kognisies, intervensies en ander beserings- en behandeling-verwante faktore in die rehabilitasieproses. Die volgende hoofstuk was gewy aan die oorsake van, en die stres verbonde aan, beserings. Onderwerpe wat aangespreek is, het ingesluit die ooroefeningsindroom, begrip van beserings soos gesien vanuit die atleet, medikus en sielkundige se oogpunte, asook presies watter faktore stres tydens beserings veroorsaak. Spesiale aandag is aan die konsep van pyn en al sy dimensies, die sosiale welstand van die beseerde atleet en die impak van beserings op die selfkonsep en identiteit van die atleet geskenk. In die volgende hoofstuk is die sielkundige aanpassing by beserings bespreek. Die konsepte van "verlies" en ''rou'' en die toepaslikheid van rouresponsmodelle in besonder, is bespreek. In antwoord op rou responsmodelle is kognitiewe waarderingsmodelle (Brewer, 1994) en die geïntegreerde model van Wiese-Bjornstal et al. (1998) bespreek. Aandag is ook geskenk aan faktore wat 'n rol in volgehoue deelname aan rehabilitasieprosedures speel, met klem op atlete met skynsiektes. Navolging van voorbeelde deur eweknieë as 'n hanteringsvaardigheid is ondersoek, asook die rol en effek van sosiale ondersteuning. Die volgende hoofstuk het gefokus op die ontwikkeling van die diensleweraar-model vir sportbeseringrehabilitasie. Vanuit die aanvanklike literatuuroorsig het dit geblyk dat van al die persone betrokke by die behandeling van beseerde atlete, dit waarskynlik fisioterapeute en biokinetici is wat die langste by hulle betrokke is. Tydens die ontwikkeling van die model vir rehabilitasie van beserings, is as basis die tradisionele mediese model gebruik, maar met sekere aanpassings om sielkundige beginsels in te sluit. 'n Rekenaarprogram is geskryf om fisioterapeute en biokinetici te ondersteun in die behandeling van beseerde atlete. Die program het gebruik gemaak van bestaande psigometriese toetse, maar dit was aangepas om as nie-potlood-en-papiertoetse gebruik te kan word. Die toetse wat gebruik is, is die Emotional Responses of Athletes to Injury Questionnaire (ERAIQ), die Incredibly Short POMS (ISP), 'n pyntekeninginstrument, 'n visueelanaloogskaal en die affektiewe subskaal van die McGill Pain Questionnaire. Voorsiening is gemaak na afloop van elke behandelingsessie om uitdeelstukke aan pasiënte beskikbaar te stel. Om te bepaal of die program suksesvol was om fisioterapeute en biokinetici tydens behandeling van beseerde atlete te ondersteun, is die program in die volgende hoofstuk kortliks geëvalueer. Terugvoer vanaf beide die pasiënte, fisioterapeute en biokinetici wat die program gebruik het, is verkry. Twee kort vraelyste is vir dié doel gebruik. Laastens is gevolgtrekkings op grond van die terugvoer gemaak en aanbevelings vir aanpassings is gedoen. Sleutelwoorde: Sportbeserings, rehabilitasie

This study was designed to determine if differences exist between the personalities of injured and non-injured athletes, injured and non-injured athletes in individual sports, and injured and non-injured athletes in team sports. Subjects were forty-three female athletes selected from six intercollegiate teams. The test instrument was the Cattell Sixteen Personality Factor Questionnaire. Data were analyzed by the two-way analysis of variance. Alpha was .05. Conclusions of the investigation were that the personality of injured athletes does not differ from the personality of non-injured athletes, that non-injured athletes in individual sports are more self-assured than non-injured athletes in team sports, and that the personality of athletes in team sports does not differ from the personality of athletes in individual sports.

The purpose of this study was to assess Head Athletic Trainers (ATC) of NCAA Division I collegiate institutions perceived adequacy of professional preparation in implementing injury-related sport psychology skills and strategies. A survey instrument was developed and sent to all Head ATCs at NCAA Division IA institutions. Descriptive statistics were computed for information regarding educational background,. years of experience, number of varsity sports served, sport psychology backgrounds, specific sport psychology management strategies used and related perceived competence. Also, independent t-tests were conducted to examine differences in responses between professional preparation/backgrounds of the respondents and their perceived adequacy of preparation when utilizing sport psychology management strategies. Results indicate that 48% of NCAA Division IA Head ATCs have completed a formal course in sport psychology, and that perceived confidence when utilizing sport psychology skills and strategies are higher for this group. Better understanding of the role sport psychology plays in injury rehabilitation will allow ATCs to enhance their athletes' physical recovery from injury. / School of Physical Education

This study has examined the aspect of psychological care for the injured athlete at the Division 1A collegiate level. The specific areas examined were those of the mental impact of injury, services available, potential barriers, funding, and referrals. An additional aspect of this study that was examined was differences between conferences in the psychological care practices of the injured athlete. It was found that the largest barrier to successful psychological rehabilitation of the injured athlete was athlete compliance, despite support from others and available services. No significant differences were found to exist between conferences and the psychological care of the injured athlete. / School of Physical Education

This study investigates the effects of cumulative mild head injury on the cognitive functioning of elite rugby players. A comprehensive battery of neuropsychological tests was administered to top national (Springbok) rugby players (n=26), national Under 21 rugby players (n= 19), and a non-contact sport control group of national hockey players (n=21). The test results of the Total Rugby group (Springbok Rugby and Under 21 Rugby players), the Under 21 Rugby group, the hockey controls, and the Total Rugby and Under 21 Rugby forward and backline players respectively, were each compared with established normative data. Results showed significant differences in the direction of a poorer performance relative to the norms for the Total Rugby and Under 21 Rugby groups, and for the Total Rugby Forwards and Under 21 Rugby Forwards, on tests sensitive to the effects of diffuse brain damage. On the other hand, the Hockey Control group and the Total Rugby Backs and Under 21 Rugby Backs tended to perform within the normal range or better than the norm on some tests. These results confirm the hypothesis that rugby players, and the forward players in particular, are at risk of adverse cognitive effects consequent on cumulative mild head injury. The theoretical implications are that the aggregate effects of multiple exposures to mild head injuries in the rugby players served to reduce their brain reserve capacities and acted as a threshold-lowering influence associated with symptom onset.

sustained multiple concussions may be at risk of cumulative impairment. The role of neuropsychological testing in the management of sports-related concussion is a contentious and challenging issue which has gained credibility given the lack of clear and well-established guidelines pertaining to the diagnosis, assessment and return-to-play decisions following concussion. Despite various traditional paper and pencil tests being shown to be effective indicators of postconcussive neuropsychological dysfunction, testing has not been widely implemented, due to time- and labour-demands. ImPACT, a computer-based neuropsychological assessment instrument, has been recognised as a valid and reliable tool in the monitoring of athletes' symptoms and neurocognitive functioning preseason and postconcussion. As a part of larger-scale concussion research conducted on top-team university rugby players, this is an in-depth case study conducted on a 20-year old participant with a history of multiple concussions, who was referred following a concussion sustained during the season. The objectives of the study were: (i) to determine the sensitivity of ImPACT versus WAIS-III Digit Span and Trail Making Test during the acute postconcussive phase; and (ii) to examine the sensitivity of ImPACT versus a comprehensive battery of neuropsychological tests to possible residual deficits as a result of the multiple concussions. ImPACT was determined to be more sensitive to acute postconcussive impairment following concussion than Digit Span and Trail Making Test. Furthermore, the ImPACT preseason baseline scores appear to be sensitive to neurocognitive dysfunction, possibly due to cumulative concussive injuries.

Neuropsychological testing is recognised as one of the cornerstones of concussion evaluation, contributing significantly to both an understanding of the injury as well as management of the recovery process. Despite the high incidence of concussion at school level, traditional paper-and-pencil neuropsychological testing has generally been absent from school concussion management programmes, largely due to time and cost constraints. Now, the recent development of computerised neuropsychological testing is providing the opportunity for including neurocognitive assessment in this process. The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a valid and reliable instrument of this type and normed on 13 - 18 year old North American high school athletes, as well as adult groups. The current recommendation is that athletes are baselined preseason in order to provide an individualised comparative level against which to monitor recovery and provide return-to-play recommendations. This in itself is quite a cumbersome process, thus the present study set out to ascertain whether baseline testing of all athletes is necessary, or whether the use of US or SA normative data alone would provide an appropriate standard against which to interpret the postinjury scores. From a leading South African rugby playing school, the 1st and 2nd rugby teams, (16 - 18 years) were baselined using ImPACT. Three athletes, who were subsequently referred with concussion during the rugby season, were followed up with serial testing on ImPACT. An analysis of the follow up scores was conducted to chart the athletes' recovery process, in relation to the athletes own baseline scores (using US and SA reliable change indices) and age appropriate US and SA normative ranges. The relative utility of individual baselines scores versus these normative ranges was then critically evaluated. It was concluded that a combination of both baseline and normative data provided optimal management of the athlete, with the methods complementing each other in the interpretation of post-injury results. Overall, the SA normative ranges seemed to provide slightly better management guidelines than the US normative ranges when used with this sample of South African high school athletes.

The study sought to determine whether there is evidence for the presence of residual (chronic) deleterious effects on cognition due to repetitive mild traumatic brain injury in top team university level rugby players, using ImPACT 3.0, Trail Making Test (TMT) and Digit Span. The initial sample of 48 participants was divided into groups; Rugby (n = 30) and Controls (n = 18), Rugby Forwards (n = 14) and Rugby Backs (n = 16). A reduced sample (N = 31) comprised of Rugby (n = 20) and Controls (n = 11), Rugby Forwards (n = 9) and Rugby Backs (n = 11). Comparative subgroups were equivalent for estimated IQ but not for age and educational level in the full sample; in the reduced sample there was equivalence for all three variables of age, education and estimated IQ. All cognitive test measures were subjected to independent t-test analyses between groups at the pre- and post-season, and dependent t-test analyses for Rugby and Controls at pre- versus post-season. Overall, the results implicated the presence of deleterious effects of concussive events on Rugby players in the areas of speed of information processing, working memory and impulse control. Significant practice effects were found on the TMT and Digit Span for controls, but not on ImPACT 3.0, supporting the use of this computer-based programme in the sports management context.

The present study comprises the second phase of a larger and ongoing research study investigating the brain damage effects of cumulative mild head injury in rugby. The purpose of this study was to determine whether cumulative mild head injury sustained in the game of rugby would cause brain injury as evidenced by impaired performance on sensitive neuropsychological tests. Participants were Springbok professional rugby players (n = 26), Under 21 rugby players (n = 19), and a non-contact sport control of national hockey players (n = 21). Comparisons of performance were carried out across a spectrum of neuropsychological tests for the three rugby groups (Total Rugby, Springbok Rugby, and Under 21 Rugby) versus the performance of the non-contact sport control group (Hockey Control), as well as comparisons of performance f9r the subgroups of Rugby Forwards versus Rugby Backs. Comparisons revealed a consistent pattern of poorer performance across all rugby groups relative to the performance of the controls on tests highly sensitive to the effects of diffuse brain damage. Within rugby group comparisons (Forwards versus Backs) showed significantly poorer performance for Total Rugby Forwards and Springbok Rugby Forwards relative to the performance of the respective Total Rugby Backs and Springbok Rugby Backs on sensitive, as well as on somewhat less sensitive, neuropsychological tests. The performance of Under 21 Rugby Forwards relative to Under 21 Rugby Backs demonstrated similar trends. Brain reserve capacity theory was used as a conceptual basis for discussing the implications of these findings.