Kin 1070A
REHABILITATION PSYCHOLOGY
Lecture #1
Sport Phycology: what hinders someone to take part in high performance sport
- Understand sport behavior
- Feel and engage in sport behavior
- Improving sport performance
GPS and GIS:
- Finds position of people and ping them, helps learn geography of where they are located
PAL technology:
- Identifies if someone is sitting, standing, walking
Exercise Psychology: understand the contributions of technology to compare sedentary
behavior vs exercise behavior
- Measure exercise and sedentary
Health Psychology: physiological consequences of exercise
- Using exercise to Better health habits
Rehabilitation Psychology: psychological prediction of injury
● Psychological processes of injury recovery
● Could physiological factors through intervention to reduce injury?
● What role does Psychology play in injury recovery
Rehabilitation Psychology
Injury Prediction:
William and Andersen Model:
- Stress Response:
- Cognitive appraisal of demands
- Appraisal demands exceeds this resource capabilities = stress
- Physiological/Attentional demands
- Stress = immediate response (sweat, heart rate increase), varies by
person
- Each stress response can linked to one another
1. Personality: highly anxious, risk-taking (can vary by person)
2. History of stressors: prior experience with injury
3. Coping resources: social support availability, own ability to cope with stressors
● Moderator Variable: quantitative variable which shows how the nature, strength, or
direction of a relation is affected between independent (life stress) and dependent
variable (injury)
● Injury assessment: sport injury occurs if someone misses at least a day of activity
○ Exposure to show how much activity they were in
● Conjunctive Manner: Low Social Support with low coping skills = 22% (super high)
time loss from injury
, ○ Psychological factors should be addressed as much as physical factors to
help understand and aid in injury rehabilitation
Injury Prevention:
● Reducing Stress
○ Altering cognitive appraisal: thinking that demands of situation do not exceed
resource capability
○ Modify their way of reacting to situation
○ Change moderator Variable (coping resources and personality)
Kerr and Goss Study: stress management affect on injuries
● Better cope with stress = reduction of injury
● Design: allocated by chance (pre season, mid season, championship)
○ Dependant measure: whenever injury occurred
● Delivered bi weekly (1 hr/day) - thought patterns
● Results: stress overall reduced at time
○ Incidence of injury reduced = negative stress
Tranaeus Study: meta-analysis on the Psychological
prevention for sport injury
● Using other studies to compare results on the
psychological intervention
○ Objective: systematic review of multiple
articles
● Used 7 substantial information articles and put
through eligibility criteria
● Forest plot diagram: one line down the middle
provided that it lies right in between both favours (
= null/neutral)
○ For Tranaeus Study: Favors B = intervention
○ Favors A = controlled
○ Diamond = Average
● Kerr and Goss interval crosses null = not confident enough
● Conclusion: large effect occurring when integrating psychological injury prevention
Injury Recovery & Placebo:
Cupal and Brewer Study:
● Individuals: 30 participants who had ACL Reconstructive surgery
a. 6 month rehab
● ACL recovery is positive for studies due to long rehab
a. More time for study to partake and learn
● Measures:
a. Pain: subjective experience
b. Re-injury Anxiety: concern of re-injury
c. Knee Strength: comparing knee ability between one another (cybex isokinetic
dynamometer)
● Procedure:
, a. Randomly assigned between control, placebo, and treatment
■ Placebo: comparing if treatment is making a difference or just providing
encouragement and attention
● Greater knee Strength led to lower anxiety and pain
● Limitations: no mechanism of why imagery worked or relaxation worked
a. Psychological imagery: more personal control of treatment = greater strength
b. Physiological mechanism: reduces stress = better immune-inflammatory
response = promotes tissue regeneration
● Results: Psychological based intervention provides enhanced cognitive outcomes during
rehab
Observational Learning/Modeling:
● Bandura's Model: Powerful means of transmitting behavior change, attitudes, patterns of
thoughts and behaviour
○ Attention - retention - production - motivation - response
● Information available throughout before, during, and after
Application of Rehab Psychology
● Setting
● modeling intervention (self model vs peer model)
● Mastery vs Coping Model (peer model)
○ Mastery: demonstrate the behaviour high level of skill (flawless technique)
■ Verbalize confidence (positive attitude)
■ Low task difficulty, errorless performance
○ Coping: dealing with emotional issues that one faces and challenges during
period of time (emotional), coping needs to be mastered
■ Concrete strategies to deal with stress
■ Believe in what they doing
■ Watches a model with someone coping well = perform better and cope
better, display distress (but decreases it)
■ Progressive self-efficacy beliefs, approach or achieve mastery
● outcomes - performance or psychological issues
○ Adherence, errors
○ Mood, anxiety, RPE
Medical Literature:
● Prepare patients for Non-surgical and surgical procedures
● Using video for patient education and skill development
Rehabilitation wellness settings:
● High anxiety within (white coat phenomenon)
○ Elevated blood pressure while going to clinic
● Kulik and Mahler study: patients meet with people who have already done the operation
they about to do
○ Using coping model to exposure of postoperative people better prepares the
observer by listening to cognitive appraisal of other person
Modeling as a Tool:
, ● Powerful for acquisition of psychological a response and behaviour change
○ Helps create positive results for adults undergoing surgery
○ Limited attention
Francis Flint Study:
● Provide coping model instead of no model can provide positive outcomes
● Found coping model creates less time to recover (walking, jogging)
● Athletes after post surgery had more confidence overall, higher athletic competence
○ Limitations: modest sample size, no benefits pre-operatively
Madison/Prapavessis Study:
● Extend work of Flint's study to investigate effect on pre and post op of ACl Recovery
● Hypothesis: attain greater self- efficacy, more improvement in functional milestone
● Studied various milestone after athletic post op (walking without crutches - how long)
● Functional measure:
○ Compared result with international knee documentation committee form
○ Range of motion, knee laxity
● Conclusion:
○ Pre op anxiety No affect
○ Perception of expected pain, positive effect
○ Self-efficacy measures, early effect
○ IKDC and Crutch walking - positive affect
● Future research:
○ Interactive modeling techniques in specific rehabilitation
○ Long rehab treatment modalities (motivation)
Placebo:
● Placebo effect: measurable improvement in health not attributable to treatment
○ Subjective feeling/belief
● FDA must see pill beats Placebo in two clinical trials - flawed approach = low bar
● Nocebo: Placebo can produce negative outcomes if individual finds negative side
effects
● Process-of-treatment theory:
○ Release endorphins believing it helps
○ Triggers physical emotions - reduce stress
● Knee Surgery vs Sham Surgery
○ Arthroscopic Surgery-damaged cartilage is scraped (debridement) or flushed out
(lavage)
● Moseley Finding (sham surgery)
○ Ethical issues: deceit of sham surgery vs. false benefits of actual surgery
○ Insurance: will companies cover the surgery
○ Adverse effects of placebo need to be taken into account - shouldn't have many
issues compare to intervention Condition
○ Placebo are powerful - but should be chosen wisely
Prehabilitation and Injury
Immediate care: elevation, ice, crutches
REHABILITATION PSYCHOLOGY
Lecture #1
Sport Phycology: what hinders someone to take part in high performance sport
- Understand sport behavior
- Feel and engage in sport behavior
- Improving sport performance
GPS and GIS:
- Finds position of people and ping them, helps learn geography of where they are located
PAL technology:
- Identifies if someone is sitting, standing, walking
Exercise Psychology: understand the contributions of technology to compare sedentary
behavior vs exercise behavior
- Measure exercise and sedentary
Health Psychology: physiological consequences of exercise
- Using exercise to Better health habits
Rehabilitation Psychology: psychological prediction of injury
● Psychological processes of injury recovery
● Could physiological factors through intervention to reduce injury?
● What role does Psychology play in injury recovery
Rehabilitation Psychology
Injury Prediction:
William and Andersen Model:
- Stress Response:
- Cognitive appraisal of demands
- Appraisal demands exceeds this resource capabilities = stress
- Physiological/Attentional demands
- Stress = immediate response (sweat, heart rate increase), varies by
person
- Each stress response can linked to one another
1. Personality: highly anxious, risk-taking (can vary by person)
2. History of stressors: prior experience with injury
3. Coping resources: social support availability, own ability to cope with stressors
● Moderator Variable: quantitative variable which shows how the nature, strength, or
direction of a relation is affected between independent (life stress) and dependent
variable (injury)
● Injury assessment: sport injury occurs if someone misses at least a day of activity
○ Exposure to show how much activity they were in
● Conjunctive Manner: Low Social Support with low coping skills = 22% (super high)
time loss from injury
, ○ Psychological factors should be addressed as much as physical factors to
help understand and aid in injury rehabilitation
Injury Prevention:
● Reducing Stress
○ Altering cognitive appraisal: thinking that demands of situation do not exceed
resource capability
○ Modify their way of reacting to situation
○ Change moderator Variable (coping resources and personality)
Kerr and Goss Study: stress management affect on injuries
● Better cope with stress = reduction of injury
● Design: allocated by chance (pre season, mid season, championship)
○ Dependant measure: whenever injury occurred
● Delivered bi weekly (1 hr/day) - thought patterns
● Results: stress overall reduced at time
○ Incidence of injury reduced = negative stress
Tranaeus Study: meta-analysis on the Psychological
prevention for sport injury
● Using other studies to compare results on the
psychological intervention
○ Objective: systematic review of multiple
articles
● Used 7 substantial information articles and put
through eligibility criteria
● Forest plot diagram: one line down the middle
provided that it lies right in between both favours (
= null/neutral)
○ For Tranaeus Study: Favors B = intervention
○ Favors A = controlled
○ Diamond = Average
● Kerr and Goss interval crosses null = not confident enough
● Conclusion: large effect occurring when integrating psychological injury prevention
Injury Recovery & Placebo:
Cupal and Brewer Study:
● Individuals: 30 participants who had ACL Reconstructive surgery
a. 6 month rehab
● ACL recovery is positive for studies due to long rehab
a. More time for study to partake and learn
● Measures:
a. Pain: subjective experience
b. Re-injury Anxiety: concern of re-injury
c. Knee Strength: comparing knee ability between one another (cybex isokinetic
dynamometer)
● Procedure:
, a. Randomly assigned between control, placebo, and treatment
■ Placebo: comparing if treatment is making a difference or just providing
encouragement and attention
● Greater knee Strength led to lower anxiety and pain
● Limitations: no mechanism of why imagery worked or relaxation worked
a. Psychological imagery: more personal control of treatment = greater strength
b. Physiological mechanism: reduces stress = better immune-inflammatory
response = promotes tissue regeneration
● Results: Psychological based intervention provides enhanced cognitive outcomes during
rehab
Observational Learning/Modeling:
● Bandura's Model: Powerful means of transmitting behavior change, attitudes, patterns of
thoughts and behaviour
○ Attention - retention - production - motivation - response
● Information available throughout before, during, and after
Application of Rehab Psychology
● Setting
● modeling intervention (self model vs peer model)
● Mastery vs Coping Model (peer model)
○ Mastery: demonstrate the behaviour high level of skill (flawless technique)
■ Verbalize confidence (positive attitude)
■ Low task difficulty, errorless performance
○ Coping: dealing with emotional issues that one faces and challenges during
period of time (emotional), coping needs to be mastered
■ Concrete strategies to deal with stress
■ Believe in what they doing
■ Watches a model with someone coping well = perform better and cope
better, display distress (but decreases it)
■ Progressive self-efficacy beliefs, approach or achieve mastery
● outcomes - performance or psychological issues
○ Adherence, errors
○ Mood, anxiety, RPE
Medical Literature:
● Prepare patients for Non-surgical and surgical procedures
● Using video for patient education and skill development
Rehabilitation wellness settings:
● High anxiety within (white coat phenomenon)
○ Elevated blood pressure while going to clinic
● Kulik and Mahler study: patients meet with people who have already done the operation
they about to do
○ Using coping model to exposure of postoperative people better prepares the
observer by listening to cognitive appraisal of other person
Modeling as a Tool:
, ● Powerful for acquisition of psychological a response and behaviour change
○ Helps create positive results for adults undergoing surgery
○ Limited attention
Francis Flint Study:
● Provide coping model instead of no model can provide positive outcomes
● Found coping model creates less time to recover (walking, jogging)
● Athletes after post surgery had more confidence overall, higher athletic competence
○ Limitations: modest sample size, no benefits pre-operatively
Madison/Prapavessis Study:
● Extend work of Flint's study to investigate effect on pre and post op of ACl Recovery
● Hypothesis: attain greater self- efficacy, more improvement in functional milestone
● Studied various milestone after athletic post op (walking without crutches - how long)
● Functional measure:
○ Compared result with international knee documentation committee form
○ Range of motion, knee laxity
● Conclusion:
○ Pre op anxiety No affect
○ Perception of expected pain, positive effect
○ Self-efficacy measures, early effect
○ IKDC and Crutch walking - positive affect
● Future research:
○ Interactive modeling techniques in specific rehabilitation
○ Long rehab treatment modalities (motivation)
Placebo:
● Placebo effect: measurable improvement in health not attributable to treatment
○ Subjective feeling/belief
● FDA must see pill beats Placebo in two clinical trials - flawed approach = low bar
● Nocebo: Placebo can produce negative outcomes if individual finds negative side
effects
● Process-of-treatment theory:
○ Release endorphins believing it helps
○ Triggers physical emotions - reduce stress
● Knee Surgery vs Sham Surgery
○ Arthroscopic Surgery-damaged cartilage is scraped (debridement) or flushed out
(lavage)
● Moseley Finding (sham surgery)
○ Ethical issues: deceit of sham surgery vs. false benefits of actual surgery
○ Insurance: will companies cover the surgery
○ Adverse effects of placebo need to be taken into account - shouldn't have many
issues compare to intervention Condition
○ Placebo are powerful - but should be chosen wisely
Prehabilitation and Injury
Immediate care: elevation, ice, crutches
