Tears to the anterior cruciate ligament (ACL) represent a serious sport injury that can be physically and psychologically debilitating for athletes. Recovery from ACL surgery is a six to nine month process, though the first four months of rehabilitation represents the key time of recovery. Thus, psychological interventions should occur during these first four months, but then examine athletes' psychological and physical functioning over the longer term. Past research has supported the efficacy of goal setting and imagery in helping athletes during their ACL recovery, and MSC has been shown to help athletes regulate emotions and improve their sport performance. MSC-based interventions, however, have not been examined in relation to injured athletes' psychological functioning and physical recovery. Thus, I examined the relative effects of three psychological interventions (i.e., GS, IM, and MSC) on athletes' post-ACL responses. Overall, I found no significant differences in the effects of GS, IM, or MSC on athletes' athletic identity, confidence in returning to sport, reinjury anxiety, stress related to sport injury, perceptions of ability to cope with injury, and subjective knee functioning. Although non-significant, athletes in the GS group showed slightly larger rates of change in their reinjury anxiety and cognitive appraisal compared to athletes in the IM and MSC groups, while athletes in the IM group showed slightly greater rates of change in subjective knee functioning compared to athletes in the GS and MSC groups. However, these results did not support the original hypotheses that athletes in the MSC group would demonstrate significantly greater outcomes compared to the GS and IM groups.

Thesis (Ed.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Abstract: Recovering from a sport injury can be physically and emotionally challenging for an adolescent athlete. Previous research indicates elevated levels of anxiety, stress, and depression following sport injuries. Providing effective social support following a sport injury has been found to influence an athletes' ability to cope with the experience of being injured and assist in rehabilitation adherence. The aim of the present investigation was to examine emotional disturbance following a sport injury in the adolescent population and determine the effects of social support provided by e-mentoring. The first phase of the research involved a descriptive data analysis to assess emotional disturbance of adolescent athletes ( n =9) sustaining an injury preventing sport participation for six weeks or greater. The Center of Epidemiological Studies on Depression (CES-D) and The Incredibly Short Profile of Mood States (IS-POMS) were administered and analyzed for elevated symptoms of emotional disturbance. The second phase of the research was an examination of social support provided by an e-mentor, a college age athlete with prior experience of a similar injury. Randomly selected participants ( n =4) were assigned an e-mentor for a six week rehabilitation phase of recovery. Three specific questions involving e-mentoring as social support were evaluated: (1) Do injured athletes demonstrate an increased positive awareness of injury rehabilitation and understanding of the injury with e-mentoring? Analysis of e-mentoring conversations indicated the adolescent injured athletes developed a greater awareness of their injury, the rehabilitation process, and the ability to share the physical experience. (2) Does e-mentoring influence emotional disturbance following a sport injury? Not all injured participants suffered emotional disturbance indicated through descriptive data analysis. However, examination of e-mentoring conversations indicated emotional support was provided from the e-mentor relationships. (3) Can the e-mentoring process provide a social support validating the injury and offer a positive experience? This investigation indicates e-mentoring provided physical, emotional and psychological support during a six week rehabilitation phase of an injury. Each injured athlete's interpretation and follow-up responses from the study suggest e-mentoring was a positive social support. Results from this research will raise awareness of emotional disturbance by an adolescent athlete following an injury and the manner in which social support can influence injury knowledge and rehabilitation adherence. The implications of e-mentoring suggest positive social support from an e-mentor can influence the physical, emotional and psychological well-being of an injured athlete affecting emotional recovery following a sport injury. / 2031-01-02

Background & Purpose: Sustaining an acquired brain injury (ABI) can often lead to admission to an inpatient rehabilitation program. The purpose of inpatient rehabilitation is to provide individualized, patient-centered therapy in order to facilitate community re-integration. Considering the patient perspective is beneficial for informing patient-centered care because clinicians and program administrators may develop greater awareness and understanding of patient needs and preferences. There is a lack of qualitative research investigating patient experiences and perspectives of ABI inpatient rehabilitation, and the majority of existing research was conducted in non-Canadian contexts. The present study was thus designed to describe and interpret patient experiences of an ABI inpatient rehabilitation program in urban Ontario. The purpose was to contribute to a patient lens that inpatient rehabilitation staff could consider in their work. Methods: An interpretive description approach was adopted for this qualitative study. Twelve participants were purposively sampled from a regional ABI rehabilitation program. They completed semi-structured interviews about their experiences. Interviews were transcribed, coded, and analyzed to identify major themes. Results: Three major themes were identified from the analysis and arranged around three time points. At the time point prior to admission to inpatient rehabilitation, the theme was “Life Rerouted,” where participants described their lives being diverted from what was “normal” after sustaining an ABI. Inpatient rehabilitation was seen as a way to return to their pre-injury life. The second theme described experiences within inpatient rehabilitation and was entitled, “Autonomy within Rehab.” Under this theme, participants emphasized the importance of personal autonomy over their choices and abilities while in rehabilitation, with three related sub-themes: interactions with clinicians, perceptions of institutional policy, and the involvement of family members. Under a minor theme, not directly related to aspects of autonomy, entitled “social comparisons,” participants also made comparisons of their recovery progress to other patients. The third and final theme reflected participants experiences just after discharge and was entitled, “Life (and Recovery) Go On.” Under this theme, participants described an ongoing recovery process leading to sentiments of both frustration and hope for the future. Discussion: An overarching key message was developed from these themes: “re-establishing personal identity is important to the recovery process.” Two theories (biographical disruption and relational autonomy) are used to interpret this message and describe the strategies and perspectives adopted by patients during inpatient rehabilitation as they attempted to cope with the psychosocial impacts of ABI on their lives. Conclusions: The findings of this study provide knowledge and a theoretical lens in which program staff can view and understand patients’ experiences, needs and preferences. These findings may enhance patient-centered care within the context of ABI inpatient rehabilitation. / Thesis / Master of Science (MSc)

Physical activity can be beneficial to both physical and mental health, but can also lead to injuries. While injury rehabilitation through physical therapy is mostly focused on physical exercise, there are also other factors, which may influence rehabilitation outcome. The factorsreviewed are: rehabilitation adherence, mindfulness meditation, mental imagery, action observation, self-talk, goal-setting and social support. This essay investigates the neural correlates of these factors, as well as how they can affect rehabilitation outcome and wellbeing, to a lesser degree, during rehabilitation. Among the effects found are performance enhancement, increased self-efficacy, increased pain tolerance, increased motivation and reduced strength loss. Suggestions for future research is also provided.

Injuries are a critical and challenging problem for an athlete, especially at elite level. Injury rehabilitation can be demanding both physiological and psychological. The purpose of this study is to explain which motivational factors are significant for maintaining high levels of motivation and adherence during a rehabilitation process. Interview data were analyzed using Operant Conditioning and Self-Determination Theory. Results illustrate six themes/motivational factors: 1. Passion for the sport and the athletic identity, 2. Tangible social support, 3. Informative social support, 4. Practical social support, 5. Progress and goal achievement, 6. Positive thinking. Passion for the sport is the strongest motivational factor. Five out of six identified factors could be connected with Self-Determination Theory’s three basic psychological needs. Social environment provides social support to the athlete. Conclusion: It is difficult to determine which factors are the most important, however the results suggest that these factors may reinforce an athlete’s motivation and adherence to rehabilitation. / Skador är ett kritiskt och utmanande problem för en idrottare, särskilt inom elitidrotten. Skaderehabilitering kan vara krävande både fysiologisk och psykologiskt, där en hög motivation är förknippat med en högre följsamhet och välmående. Genom att undersöka elitidrottares olika motivationsfaktorer, syftar denna studie till att förklara vilka motivationsfaktorer som är viktiga för att upprätthålla en god motivation under en rehabiliteringsprocess. Med hjälp av teorin om operant betingning har idrottarnas förstärkningar av motivationsfaktorer granskats. Motivationsfaktorerna har sedan prövats mot självbestämmandeteorin, genom att undersöka vilka som passar in på de psykologiska grundbehoven. För att få svar utifrån idrottares perspektiv, genomfördes empiriinsamlingen genom direkta intervjuer med sju skaderehabiliterande elitidrottare. Svaren analyserade och sex olika motivationsfaktorer/teman identifierades: 1. Passion för sporten och den atletiska identiteten, 2. Praktiskt socialt stöd, 3. Informativt socialt stöd, 4. Emotionellt socialt stöd, 5. Framsteg och måluppfyllelse och 6. Positivt tänkande. Resultaten visar att passion för sporten i samverkan med att känna en stark atletisk identitet är den främsta motivationsfaktorn till följsamhet av en rehabiliteringsprocess. Positivt tänkande, framsteg och måluppfyllelse förstärker motivationen genom att fokusera på fördelar samt genom en vilja till att ständigt utvecklas. Samtliga idrottare menar på att det emotionella sociala stödet har funnits närvarande, fåtal menar på att de inte gett någon förstärkande effekt. Det praktiska och informativa stödet har däremot resulterat i stärkande förstärkningseffekter. Fem av de sex identifierade motivationsfaktorerna kunde kopplas till självbestämmandeteorins tre grundbehov. Idrottarna har en stark inre motivation, de har samma gemensamma mål som är att ta sig tillbaka till den idrott de älskar och som tillfredsställer alla tre grundbehov. Omgivningen kan påverka i form av ett socialt stöd, samtliga idrottare menar på att det emotionella stödet är välkommande. Ett snabbt praktiskt och informativt stöd kan även detta lindra negativa psykologiska tillstånd. Slutsatsen är att det är svårt att fastslå vilka faktorer som är viktigast, men fynden tyder på att de kan förstärka en elitidrottares motivation och följsamhet till rehabilitering

No / Objective To assess the learning effect, test–retest reliability and measurement error associated with the SEBT. Design Repeated-measures study. Setting Controlled university laboratory environment. Participants Twenty-two healthy recreational athletes (11 male age 22.3 ± 3.7 years, 11 female age 22.8 ± 3.1 years). Main Outcome Measures Repeated-measures ANOVA assessed learning affects. Intraclass correlations coefficients, standard error of measurement and smallest detectable difference values were calculated to assess reliability and measurement error. Results Results showed that excursion distances stabilised after four trials, therefore trials five to seven were analysed for reliability. Test–retest reliability for all reach directions was high, with intraclass correlation coefficients ranging from 0.84 to 0.92. 95% confidence intervals, standard error of measurement and smallest detectable difference ranged from 77.84 to 94.00, 2.21–2.94% and 6.13–8.15%, respectively. Conclusion These statistics will allow clinicians to evaluate whether changes in SEBT scores are due to change in an individual’s performance or random error. The findings of this study show that the SEBT is a reliable measure of lower limb function in healthy recreational athletes. Changes in normalised scores of at least 6–8% are needed to feel confident that a real change in SEBT performance has occurred.

A series of four studies examined the emotional climate of elite sport, and tested the utility of an emotional disclosure intervention during sport injury rehabilitation. Overall, results from the investigations indicated that athletes' usual coping mechanism during injury rehabilitation was to inhibit and suppress felt emotions, while displaying mock emotions that were considered acceptable within their sport climate. Pennebaker's (1989) written disclosure paradigm was shown to address athletes' emotionally inhibitive coping style and encourage psychological and physical well-being. It was found to be a viable alternative to psychotherapy within the sport injury context. Athletes showed improvements in stress and mood disturbance, and fewer grief responses towards their injury. Affective and cognitive linguistic markers also showed changes during the 3-day intervention period, leading to the informed assumption that there was a likely association between changes in athletes' psychological responses to injury post-intervention and changes among the linguistic markers of interest. Results were discussed in the context of the broader sport psychology of injury research and limitations of the present investigations were discussed. Recommendations were made for future research into intervention research targeting the psychological experience of long-term injury.