Cited by 62Sports injuries and preventionSport Psychology and PerformancePsychological Treatments and Assessments

Psychological interventions used to reduce sports injuries: a systematic review of real-world effectiveness

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Gledhill, Adam, Forsdyke, Dale, Murray, Eliot·2018·British Journal of Sports Medicine

Abstract

Objective: To systematically review studies examining the role of psychological interventions in injury prevention. The primary research question was: What is the real-world effectiveness of psychological intervention in preventing sports injuries? Design: Mixed methods systematic review with best evidence synthesis. Data sources: CINAHL, MEDLINE, PsycARTICLES, PsycINFO, SPORTDiscus, Science Direct and PubMed. Eligibility criteria for selecting studies: Randomised controlled trials (RCT), non-RCTs that included a comparison group, before and after study designs and qualitative methods. Studies were required to outline specific unimodal or multimodal psychological interventions used in relation to injury prevention in the real-world setting. Outcome measure: Studies were independently appraised with the Mixed Methods Appraisal Tool. Results: Thirteen papers (incorporating 14 studies) met the eligibility criteria, of which 93% (13/14) reported a decrease in injury rates (effect size range=0.2–1.21). There was an overall moderate risk of bias in reporting (52%). There is a dominance of stress management-based interventions in literature due to the prominence of the model of stress and athletic injury within the area. Summary/conclusions: Psychological interventions demonstrate small (0.2) to large (1.21) effects on sports injury rates. The research area demonstrates a cumulative moderate risk in reporting bias (52%). PROSPERO registration number: CRD42016035879.

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  1. Theisen D, Malisoux L, Seil R, et al. . Injuries in youth sports: Epidemiology, risk factors and prevention / Verletzungen im jugendsport: Epidemiologie, risikofaktoren und prävention. Dtsch Z Sportmed 2014;65(9): 248-252.
  2. Ristolainen L, Kettunen JA, Kujala U, et al. Sport injuries as the main cause of sport career termination among Finnish top-level athletes. Eur J Sports Sci 2012; 12(3): 274-282
  3. Forsdyke D, Smith A, Jones M et al. Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review. Br J of Sports Med 2016; 50:537-544.
  4. Ardern CL, Österberg A, Tagesson S, et al. The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction. Br J Sports Med 2014; 48:1613-1619.
  5. Sandon A, Werner S,Forssblad M. Factors associated with returning to football after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthros 2015; 23: 2514 -2521
  6. Ekstrand J. Keeping your top players on the pitch: the key to football medicine at a professional top level. Br J Sports Med 2013; 47(12): 723-4
  7. Meeuwisse WH. Assessing causation in sports injury: a multifactorial model. Clin J Sport Med 1994; 4: 166-170
  8. Alexanders J, Anderson A, Henderson S. Musculoskeletal physiotherapists' use of psychological interventions: A systematic review of therapists' perceptions and practice. Physiotherapy 2015; 101(2):95-102.
  9. Heaney C, Walker N, Green A, et al. Sport psychology education for sport injury rehabilitation professionals: A systematic review. Phys Ther Sport 2015; 16:72-79.
  10. Heaney C. Physiotherapists' perceptions of sport psychology intervention in professional soccer. Int J Sport Exerc Psychol 2006; 4: 73-86 13
  11. Ivarsson A, Johnson U, Podlog L. Psychological predictors of injury occurrence: A prospective investigation of professional Swedish soccer players. J Sport Rehab 2013; 22: 19 -26.
  12. Johnson U. Athletes experiences of psychosocial risk factors preceding injury. Qual Res Sport Exerc Health. 2011;3:99-115.
  13. Thompson NJ, Morris RD. Predicting injury risk in adolescent football players: The importance of psychological variables. J Ped Psych 1994; 19(4): 415 -429.
  14. Johnson U, Ivarsson A. Psychological Predictors of sports injuries among junior soccer players. Scand J Med Sci Sports 2011;21(1):129-136.
  15. Maddison R, Prapavessis H. A psychological approach to the prediction and prevention of athletic injury. J Sport Exer Psychol 2005;27:289-310.
  16. Steffen K, Pensgaard A, Bahr R. Self-reported psychological characteristics as risk factors for injuries in female youth football. Scand J Med Sci Sports 2009;19(3):442-451.
  17. Ivarsson A, Johnson U, Lindwall M, et al. Psychosocial stress as a predictor of injury in elite junior soccer: A latent growth curve analysis. J Sci Med Sport 2014; 17: 366 -370.
  18. Andersen M, Williams J. A model of stress and athletic injury: Prediction and prevention. J Sport Exer Psychol 1988; 10(3): 294-306.
  19. Williams J, Andersen M. Psychosocial antecendents of sport injury: Review and critique of the stress and injury model. J Appl Sport Psychol 1998; 10(1):5-25.
  20. Appaneal RN, Perna FM. Biopsychosocial model of injury. In: Eklund R, Tenenbaum G, editors. Encyclopedia of sport and exercise psychology. Thousand Oaks, CA: Sage Publications, Inc.; p. 74-77.
  21. Tranaeus U, Ivarsson A, Johnson U. Evaluation of the Effects of psychological prevention interventions on sport injuries: A meta-analysis. Sci Sport 2015;30(6):305-313
  22. Ivarsson A, Johnson U, Andersen MB, et al. Psychosocial factors and sports injuries: A meta-analysis for prediction and prevention. Sports Med 2017; 47(2): 353-365.
  23. van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med 1992; 14: 82-99
  24. van Tiggelen D, Wickes S, Stevens V, et al. Effective prevention of sports injuries: a model integrating efficacy, efficiency, compliance and risk-taking behavior. Br J Sports Med 2008; 42: 648-652
  25. Ivarsson A, Andersen MB. What counts as "evidence" in evidence-based practice? Searching for some fire behind all the smoke. J Sport Psychol Action 2016; 7: 11 -22.
  26. Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2015:g7647.
  27. Gledhill A, Harwood C, Forsdyke D. Psychosocial factors associated with talent development in football: A systematic review. Psychol Sport Exer 2017; 31: 93-112
  28. Ardern CL, Taylor NF, Feller JA et al. A systematic review of the psychological factors associated with returning to sport following injury. Br J Sports Med 2013; 47: 1120 - 1126.
  29. Davis J. Sports injuries and stress management: An opportunity for research. Sport Psychol 1991;5:175-182
  30. Tranaeus U, Johnson U, Ivarsson A, et al. Sports injury prevention in Swedish elite floorball players: Evaluation of two consecutive floorball seasons. Knee Surg Sports Traumatol Arthrosc 2015a;23:899-905.
  31. Perna F, Antoni M, Baum A, et al. Cognitive behavioural stress management effects on injury and illness among competitive athletes: A randomized clinical trial. Ann Behav Med 2003; 25(1):66-73.
  32. Kerr G, Goss J. The effects of a stress management program on injuries and stress levels. J Appl Sport Psychol 1996; 8:109-117.
  33. Kolt G, Hume P, Smith P, et al. Effects of a stress management program on injury and stress of competitive gymnasts. Percept Mot Skills 2004; 99:195-207.
  34. Edvardsson A, Ivarsson A, Johnson U. Is a cognitive-behavioural biofeedback intervention useful to reduce injury risk in junior football players? J Sports Sci Med 2012;11:331-338.
  35. Olmedilla-Zafra A, Rubio VJ, Ortega E, et al. Effectiveness of a stress management pilot program aimed at reducing the incidence of injuries in young football (soccer) players. Phys Ther Sport 2016; doi: 10.1016/j.ptsp.2016.09.003 · DOI
  36. Arnason A, Engebretson L, Bahr R. No effect of a video-based awareness program on the rate of soccer injuries. Am J. Sports Med 2005; 33(1): 77-84
  37. Tranaeus U, Johnson U, Engstrom B, et al. A psychological injury prevention group intervention in Swedish floorball. Knee Surg Sports Traumatol Arthrosc 2015b;23:3414- 3420.
  38. Moberg K. The oxytocin factor. Cambridge, MA: Don Capo Press Inc 50
  39. Hänsel A, Hong S, Cámara RJA et al. Inflammation as a psychophysiological biomarker in chronic psychosocial stress. Psychophysiological Biomarkers of Health 2010; 35 (1): 115-121
  40. Gabbett TJ, Ullah S, Jenkins D et al. Skill qualities as risk factors for contact injury in professional rugby league. J Sports Sci 2012; 30: 1421-1427
  41. Meichenbaum D. Stress Inoculation Therapy. Elmsford: Pergamon Press 55
  42. Wittes J. Sample size calculations for randomised controlled trials. Epidemiol Rev 2002; 24: 39-53 56
  43. Whitley E, & Ball J. Statistics review 4: Sample size calculations. Crit Care 2002; 6: 335- 341
  44. Schweizer G, Furley P. Reproducible research in sport and exercise psychology: The role of sample sizes. Psychol Sport Exerc 2016; 23: 114-122.
  45. Forsdyke D, Gledhill A, Ardern C. Psychological readiness to return to sport: three key elements to help the practitioner decide if the athlete is REALLY ready. Br J Sports Med 2016; 51: 555 -556
  46. Decety J Neural representation for action. Reviews in the Neurosciences 1996; 7: 285-297 21
  47. Munzert J, Lavey B, Zentgraf K. Cognitive motor processes: The role of motor imagery in the study of motor representation. Brain Res Rev 2009; 60 (2): 306-326
  48. Lebon F, Guillot A, Collet C. Increased muscle activation following motor imagery during the rehabilitation of the Anterior Cruciate Ligament. Appl Psyhophysiol Biofeedback 2012; 37: 45-51
  49. Adams RJ, Smart P, Huff AS. Shades of Grey: Guidelines for working with the grey literature in systematic reviews for management and organizational studies. International Journal of Management Reviews 2016; doi: 10.1111/ijmr.12102 · DOI · Paper page

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Authors
Gledhill, A., Forsdyke, D., & Murray, E.
Affiliations
  • Leeds Beckett University (GB)
  • York St John University (GB)
Corresponding author
Gledhill, Adam
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2018-02-20
Volume
52
Issue
15
Pages
967-971
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
OpenAlex
W2786687024
Cited by
62
References
11
Citations by year
2026: 1 · 2025: 13 · 2024: 7 · 2023: 9 · 2022: 8 · 2021: 15 · 2020: 4 · 2019: 4 · 2018: 1
FWCI
1.23
Type
journal article
Language
en
Locations
  • British Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Leeds Beckett Repository (Leeds Beckett University) (submittedVersion)
  • Research at York St John (York St John University) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Social Sciences › Psychology › Developmental and Educational Psychology › Sport Psychology and Performance
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
sports injury prevention, psychological intervention, stress management, injury rates, real-world effectiveness, multimodal intervention
MeSH terms
Self-Control, Athletic Injuries, Emotions, Goals, Humans, Stress, Psychological, Randomized Controlled Trials as Topic, Imagery, Psychotherapy, Mindfulness, Non-Randomized Controlled Trials as Topic

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