Adherence to sport injury rehabilitation programs: an integrated psycho‐social approach

Abstract

The aim of the present study was to examine an adapted integrated psycho-social model to predict sport injury rehabilitation adherence. A longitudinal prospective design was used whereby 70 patients attending private physiotherapy clinics completed a battery of questionnaires both pre- and post-rehabilitation treatment based on the adapted framework. All participants were receiving treatment for tendonitis-related injuries. Adherence was monitored prospectively over the entire rehabilitation program using an observational measure of clinic adherence, a self-report measure of home-based adherence, in addition to monitoring attendance at rehabilitation sessions. In the initial phase of rehabilitation learning goal orientation, attitudes and perceived severity were found to predict rehabilitation intention. Intentions were also found to mediate the relationship between the aforementioned variables and clinic rehabilitation. Self-efficacy and self-motivation were predictors of clinic rehabilitation and attendance but not home rehabilitation. During the maintenance phase of rehabilitation coping ability and social support were predictors regarding all three measures of adherence. Implications for practitioners rehabilitating injured athletes are discussed.

Injury Rehabilitation Overadherence: Preliminary Scale Validation and Relationships With Athletic Identity and Self-Presentation Concerns

“…Collectively, the results involving self-presentation from studies 1 and 2 support previous research: intrapersonal factors highlighted in the Wiese-Bjornstal et al 9 model, such as self-efficacy, self-motivation, and personal coping, have been associated with rehabilitation adherence. 32,33 These findings also lend further credence to the contention that athletes who are worried about making desired impressions on others may engage in compensatory efforts by overadhering to their injury rehabilitation. Longitudinal research is needed to examine whether rehabilitation overadherence ultimately leads to negative consequences such as poor clinical rehabilitation (eg, insufficient physical healing, poor proprioception, muscular strength) and diminished return-to-sport outcomes (eg, reduced confidence in return to play abilities, poor postinjury performances).…”

Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement

“…Second, the Sport Injury Rehabilitation Adherence Scale was utilized to assess adherence during clinic-based rehabilitation sessions. A total clinic rehabilitation adherence score was derived from summing each of the SIRAS responses for each item”35…”

Use of a goal setting intervention to increase adherence to low back pain rehabilitation: a randomized controlled trial

“…This is consistent with previous findings indicating a relationship between increased self-efficacy, and adherence. 16,[38][39][40] Levy et al 38,40 found that belief in the efficacy of treatment significantly predicted clinical rehabilitation adherence, and that task support from the clinician and being self-efficacious were perceived to aid adherence in recreational athletes. In addition, Mannion et al 39 found a significant correlation with multidimensional adherence and self-efficacy in 37 patients suffering from low back pain.…”

“…Bandura 41 suggested that perceived self-efficacy determines the amount of effort invested and persistence in the face of obstacles. It is possible the current performance profiling goal setting intervention may have resulted in the therapist 'yielding' control of treatment to the patient, 38 thereby promoting self-efficacy and a series of performance accomplishments. 9 When comparing scores for treatment efficacy across the groups, no significant difference was found between the experimental goal setting group and either C1 or C2.…”