Current status and future challenges in psychological research of sport injury prediction and prevention : a methodological perspective

The purpose of this critical review was to propose methodological developments in sport injury prediction and prevention research. Altogether, 24 studies (e.g., quantitative, qualitative, and prevention intervention studies) conducted from 2006 forward were analysed, related to the "stress-injury model." The injury prediction studies were mostly based on prospective designs, using regression analysis, and studied trait anxiety and life stress. The qualitative studies used mainly thematic analysis, and the intervention studies showed some promising effects, but also inconclusive results. We proposed five specific needs for future research: (a) focus on separate research cohorts, (b) variation in preventive intervention designs, including sound protocols conducting experimental studies, (c) focus on behaviours in relation to cognition, (d) application of repeated-measure designs, and (e) use of statistics that could test complex interactions and intraindividual differences. Future research attention should also be oriented towards the psychology of overuse injuries, biopsychosocial perspectives, and health economic evaluations. While progress has been made in research on psychological antecedents of sport injury, prevention, and intervention in the last 10-15 years, several methodological issues still remain to be further developed, as outlined in this article.El propósito de esta revisión crítica es proponer una serie de progresos metodológicos en la investigación sobre predicción y prevención de lesiones. Para ello, se analizaron conjuntamente 24 estudios (cuantitativos, cualitativos y de intervención preventiva) llevados a cabo desde el año 2006 en adelante relacionados con el "modelo de estrés-lesión". Los estudios de predicción de lesiones utilizaron mayoritariamente diseños prospectivos, utilizando el análisis de regresión y estudiando el rasgo ansiedad y los eventos vitales. Los estudios cualitativos utilizaron principalmente el análisis temático. Los estudios de intervención mostraron resultados promisorios, aunque todavía no definitivos. En este trabajo proponemos cinco necesidades específicas para la investigación futura: (a) centrarse en diferentes cohortes, (b) variar los diseños de intervención preventiva, incluyendo protocolos experimentales, (c) centrarse en las conductas relacionadas con las cogniciones, (d) utilización de diseños de medidas repetidas, y (e) utilización de estadísticos que puedan verificar las complejas interacciones y las diferencias individuales. El foco de la investigación futura también debe orientarse hacia la psicología de las lesiones por desgaste excesivo, las perspectivas biopsicosociales y las evaluaciones económicas del impacto en la salud. Si bien en los últimos 10-15 años se han conseguido importantes avances en la investigación sobre los antecedentes psicológicos de la lesión deportiva, la prevención y la intervención, algunas cuestiones metodológicas deben ser aún desarrolladas, tal y como se señala en este artículo.O objectivo desta revisão crítica é propor uma série de progressos metodológicos na investigação sobre a predição e prevenção de lesões. Para tal, analisaram-se conjuntamente 24 estudos (quantitativos, qualitativos e de intervenção preventiva), realizados a partir do ano de 2006, relacionados com o "modelo de stress-lesão". Os estudos de predição de lesões utilizaram maioritariamente delineamentos prospectivos, utilizando a análise de regressão e analisando o traço de ansiedade e os acontecimentos de vida. Os estudos qualitativos utilizaram principalmente a análise temática. Os estudos de intervenção revelaram resultados promissores, embora ainda não definitivos. Neste trabalho propomos cinco necessidades específicas para futuras investigações: (a) foco em diferentes grupos, (b) variar os delineamentos de intervenção preventiva, incluindo protocolos experimentais, (c) abordar os comportamentos relacionados com as cognições, (d) utilização de delineamentos de medidas repetidas, e (e) utilização de métodos estatísticos que permitam verificar as interacções complexas e as diferenças individuais. O foco da investigação futura também deve ser direccionado para a psicologia das lesões por desgaste excessivo, as perspectivas biopsicossociais e as avaliações económicas do impacto na saúde. Embora nos últimos 10-15 anos se tenham conseguido importantes progressos na investigação sobre os antecedentes psicológicos da lesão desportiva, a prevenção e a intervenção, algumas questões metodológicas necessitam ainda de ser desenvolvidas, tal como se assinala neste artigo

Psychological injury prevention and cost analysis in elite floorball

Floorball is a growing indoor team sport. Like many sports with fast turns and stops, the likelihood to sustain injuries is evident. The epidemiology of sport injures is well documented and prevention strategies have been suggested. Elite players are probably experiencing stress due to high demands in their sport paralleling with studies or work. The relation between stress and risk for injury has been reported in earlier research. Consequently, a psychological injury prevention programme at team level is of interest. The injuries can be divided into either traumatic or overuse injuries. So far, the research has not been able to find possible psychological factors that may explain the onset of overuse injuries. Most individuals with sport-related injuries need some kind of rehabilitation. Examinations and rehabilitations of sport injuries are most likely afflicted to costs. The documentation of costs of floorball injuries is sparse. The primary objective with this project was to evaluate a psychological skills training programme in terms of injury prevention in Swedish elite floorball during the season that the intervention was implemented and also during the consecutive season. The project had two additionally objectives; to investigate possible psychological risk factors to overuse injuries and to estimate the cost of floorball injuries at elite level. For this purpose, 23 elite floorball teams were included in this project. The teams were allocated to an intervention group or a control group. The intervention group consisted of 11 teams (males n=94 and females n=99). The remaining 12 teams were included in the control group (males n=109 and females n= 99). The occurrence of injuries was prospectively recorded in both groups during two seasons. All injuries that occurred were registered according to time loss definition. The teams in the intervention group participated in a groupbased psychological skills training consisting of six sessions during the season 2010/2011. The control group did not receive any intervention. During the consecutive season, 2011/2012, injury recordings continued without any intervening. The injuries that occurred during the second season, 2011/2012, were followed up with a questionnaire regarding cost related to each injury. Eleven floorball players, who were diagnosed with overuse injuries, were interviewed regarding possible psychological factors that may have contributed to overuse injuries. In total, the first season, 142 players (35%) out of the 401 players sustained 197 injuries, 0.45/injuries per player in the intervention group and 0.53 injury/player in the control group. The second season resulted in 93 (27%) injured players out of the 346 participating players during the game season, 0.31/injuries per player in the intervention group and 0.41 injury/player in the control group. None of the analyses showed statistical significant group differences. The effect size Cohen’s d was considered as small 0.02. The estimated means of cost of injuries in floorball showed that mean costs per mild injuries (<7 days absence from floorball) was 332 euro (SD 451), the cost per moderate injury (7-30 days) was 987 euro (SD 2868), and the mean cost per severe injury (> 30 days off) was 2358 euro (SD 2122). Knee injuries were the most costly ones as well as the traumatic injuries in female players. The interviews resulted in five core themes with possible influencing factors that contributed to overuse injuries: history of stressors, person factors, psycho-physiological factors, psychosocial factors and ineffective coping. The conclusion of this project was that no statistical significant differences were shown after the intervention. The value, however, with fewer injuries in both the intervention group and the control group should be considered to be of clinical importance. The cost of floorball injuries increases with the level of severity. Those injuries are possible risk factors to new injuries or future complaints. Therefore, it is important to evaluate preventions strategies also from a health economic perspective. To minimise risk factors to sport injuries, also psychological factors must be considered when prevention strategies are planne

The Role of the Results of Functional Tests and Psychological Factors on Prediction of Injuries in Adolescent Female Football Players

Football is a popular sport among adolescent females. Given the rate of injuries in female footballers, identifying factors that can predict injuries are important. These injuries are often caused by complex reasons. The aim of this study was to investigate if the combination of demographic (age, number of training and match play hours/week), psychosocial (perceived stress, adaptive coping strategies) and physiological factors (functional performance) can predict a traumatic injury in adolescent female footballers. A cohort consisting of 419 female football players aged 13–16 years was established. Baseline questionnaires covered potential risk factors for sport injuries, and measurements included football-related functional performance tests. Data were collected prospectively with a weekly online questionnaire for 52 weeks covering, e.g., injuries, training, and match play hours/week. A total of 62% of the players reported at least one traumatic injury during the 52 weeks. The coping strategy “positive reframing” had the strongest association with the risk of traumatic injuries. The combination of more frequent use of the coping strategy, positive reframing, and high levels of physical performance capacity may prevent a traumatic injury in adolescent female footballers. Coaches are encouraged to adopt both physiological and psychological factors when preventing injuries in young female footballers.publishedVersio

Longitudinal membrane function in functionally anuric patients treated with APD: Data from EAPOS on the effects of glucose and icodextrin prescription

Longitudinal membrane function in functionally anuric patients treated with APD: Data from EAPOS on the effects of glucose and icodextrin prescription. Background: Peritoneal dialysis is associated with changes in membrane function that can lead eventually to ultrafiltration (UF) failure. Factors driving these changes are thought to include hypertonic glucose exposure, but previously reported associations are confounded by the presence of residual renal function. Methods: Longitudinal membrane function (solute transport and UF capacity) were measured annually in a prospective cohort of 177 functionally anuric patients as part of the European Automated Peritoneal Dialysis Outcomes Study (EAPOS). Subgroup analysis was performed according to glucose exposure and icodextrin use at baseline. Results: The whole cohort experienced an increase in solute transport and reduction in UF capacity at 12 and 24 months that could not be explained by informative censoring. These changes were accelerated and more severe in patients using either 2.27% or 3.86% glucose, or those not using icodextrin at baseline. These differences could not be explained by age, comorbidity score, previous time spent on renal replacement, differential dropout from the study, peritonitis rates, or, by definition, residual renal function. Patients using icodextrin at baseline had worse membrane function and were more likely to be diabetic. There was an association between membrane function changes and achieved 24-hour ultrafiltration over the 2-year study period. Conclusion: Anuric automated peritoneal dialysis (APD) patients experience significant detrimental changes in membrane function over a relatively short time period. Glucose appears to enhance these changes independent of residual renal function. Icodextrin use in these circumstances is associated with less deterioration in membrane functio

The effects of a mindfulness-based program on the incidence of injuries in young male soccer players

We tested the effectiveness of a mindfulness-based program in reducing sport injury incidence. 168 young male elite soccer players were randomly assigned to mindfulness (MG) and control (CG) groups. The MG consisted of 7 sessions based on the Mindfulness-Acceptance-Commitment approach while the CG consisted of 7 presentations on sport injury psychology. Athlete-exposure and injury data were recorded during one season. State and trait mindfulness, sport anxiety, stress, and attention control of participants were assessed. Number of injuries, average of injuries per team, and days lost to injury in the MG weresignificantly lower than in the CG. Mindfulness and attention control werelower and sport anxiety and stress were higher in injured players than innon-injured players. Psychological variables were associated with injury. Mindfulness training may reduce the injury risk of young soccer players due to improved mindfulness and attention control and reduced sport anxiety

Making champs and super-champs - Current views, contradictions, and future directions

In our 2016 paper (Collins et al., 2016a), we proposed that superchamps (athletes who have achieved the highest level in their sport) were differentiated from their less successful counterparts by their use of positive proactive coping and a "learn from it" approach to challenge. This skill-based focus to talent development (TD) is supported extensively in the literature (e.g., MacNamara et al., 2010a,b) and suggests that the differences between levels of adult achievement relate more to what performers bring to the challenges than what they experience (Collins et al., 2016a). In this focused review we present and discuss a number of key concepts related to this paper and other parallel research in TD. We begin by presenting our pragmatic objectives and the importance of considering how we evaluate the research with an emphasis on its application to the applied setting. We then consider commonalities and differences in recent psychological approaches to TD, namely the experiential, attitudinal, and skill-based. The paper then provides further exploration of the Psychological Characteristics of Developing Excellence and their role in TD processes. We conclude with a consideration of future research and the application of research in TD. Reflecting our pragmatic stance as researchers, we hope that this focused review provides suggestions for progress and stimulates critical debate amongst practitioners, researchers and policy makers

Specific Binding and Mineralization of Calcified Surfaces by Small Peptides

Several small (<25aa) peptides have been designed based on the sequence of the dentin phosphoprotein, one of the major noncollagenous proteins thought to be involved in the mineralization of the dentin extracellular matrix during tooth development. These peptides, consisting of multiple repeats of the tripeptide aspartate-serine-serine (DSS), bind with high affinity to calcium phosphate compounds and, when immobilized, can recruit calcium phosphate to peptide-derivatized polystyrene beads or to demineralized human dentin surfaces. The affinity of binding to hydroxyapatite surfaces increases with the number of (DSS)n repeats, and though similar repeated sequences—(NTT)n, (DTT)n, (ETT)n, (NSS)n, (ESS)n, (DAA)n, (ASS)n, and (NAA)n—also showed HA binding activity, it was generally not at the same level as the natural sequence. Binding of the (DSS)n peptides to sectioned human teeth was shown to be tissue-specific, with high levels of binding to the mantle dentin, lower levels of binding to the circumpulpal dentin, and little or no binding to healthy enamel. Phosphorylation of the serines of these peptides was found to affect the avidity, but not the affinity, of binding. The potential utility of these peptides in the detection of carious lesions, the delivery of therapeutic compounds to mineralized tissues, and the modulation of remineralization is discussed

A systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches and officials

Full search for the psychinfo database. (DOCX 16 kb