Volume 30, Issue 5 (8-2023)
RJMS 2023, 30(5): 350-359 |
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Research code: 01
Ethics code: IR.IAU.SARI.REC.1403.054
Clinical trials code: 01
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Hosseini S M, Gharayagh Zandi H, Moghadamzadeh A, Mousavi S H. The effect of multimodal psychological interventions with and without biofeedback on Y-balance and HOP jump test scores in professional athletes with ACL knee injuries.. RJMS 2023; 30 (5) :350-359
URL: http://rjms.iums.ac.ir/article-1-8991-en.html
URL: http://rjms.iums.ac.ir/article-1-8991-en.html
Assistant professor, faculty of physical education and sport science, university of Tehran , ghzandi110@ut.ac.ir
Abstract: (518 Views)
Background & Aims: Anterior cruciate ligament (ACL) injuries are among the most prevalent and debilitating musculoskeletal injuries in professional athletes, significantly impacting their physical performance and psychological well-being. These injuries often result in prolonged recovery periods, reduced functional capabilities, and a high risk of re-injury. Beyond the physical impairments, ACL injuries can cause severe psychological distress, including anxiety, fear of movement, fear of re-injury, and a loss of self-confidence, all of which may hinder the athlete's return to peak performance levels. Consequently, effective rehabilitation programs must address both the physical and
psychological aspects of recovery to ensure a comprehensive and sustainable return to sport. In recent years, multifaceted psychological interventions have emerged as a promising approach to aid in the recovery of injured athletes. Techniques such as mental imagery, goal setting, self-talk, counseling, and relaxation strategies have been shown to improve mental readiness, reduce anxiety, and enhance motivation during the rehabilitation process. These interventions not only support the psychological health of athletes but also play a critical role in improving functional recovery and adherence to rehabilitation protocols. Moreover, biofeedback, an advanced technique that provides real-time information about physiological processes, has gained attention for its potential to enhance neuromuscular control and self-regulation. By enabling athletes to monitor and modify their physiological responses, biofeedback facilitates greater awareness and control over movement patterns, which is particularly crucial for preventing re-injury and optimizing performance. While biofeedback and psychological interventions have individually demonstrated effectiveness in rehabilitation, limited research exists on their combined effects in athletes with ACL injuries. This study aims to explore the impact of integrating multifaceted psychological interventions with biofeedback on balance and functional performance in professional athletes recovering from ACL injuries. Using validated measures such as the Y Balance Test and the HOP Test, the research seeks to determine whether the combination of biofeedback and psychological techniques can provide superior outcomes compared to psychological interventions alone. The findings of this study have the potential to inform the development of more effective, holistic rehabilitation protocols, enabling athletes to achieve a faster and more confident return to their sport.
Methods: To conduct this study, 60 professional athletes with ACL knee injuries in the recovery phase following surgery were selected through a purposive and convenience sampling method. These participants were randomly assigned to five groups using a random number table: (1) the combined biofeedback and first multifaceted psychological intervention group (including imagery, counseling, and self-talk), (2) the combined biofeedback and second multifaceted psychological intervention group (including relaxation, counseling, and goal setting), (3) the first multifaceted psychological intervention group (imagery, counseling, and self-talk), (4) the second multifaceted psychological intervention group (relaxation, counseling, and goal setting), and (5) the control group. The experimental groups received training and intervention over twelve sessions, while the control group did not receive any specific intervention. For assessment, the Y Balance Test and the HOP Test were administered to all groups one day before and one day after the completion of the twelve-session protocol. Data analysis was performed using paired t-tests for within-group comparisons and analysis of covariance (ANCOVA) for between-group comparisons. Additionally, Bonferroni post hoc tests were applied to pinpoint the exact location of differences between groups. All statistical analyses were conducted using SPSS software, version 22.
Results: The results of this study indicated that all interventions improved the scores of the Y Balance Test and the HOP Test. The combination of biofeedback with multifaceted psychological interventions led to greater improvements in the Y Balance Test and HOP Test scores compared to the groups that received multifaceted psychological interventions without biofeedback.
Conclusion: The findings of this study demonstrated that both types of interventions multifaceted psychological interventions and the combination of these interventions with biofeedback contributed to the improved performance of professional athletes with ACL injuries. These findings suggest that any intervention aimed at enhancing physical and psychological aspects can have a positive impact on the rehabilitation of athletes. However, the combination of biofeedback with multifaceted psychological interventions showed greater improvements in Y Balance Test and HOP Test scores, which can be attributed to several factors. Biofeedback, by providing real-time and objective feedback on physiological changes in the body, enhances the athlete's self-awareness regarding their physical state and muscle performance. This process can increase the sense of personal control and help athletes adopt better strategies for improving balance and motor performance. Particularly in the Y Balance Test, which requires the ability to maintain dynamic balance and coordination, real-time feedback from biofeedback aids athletes in better managing their center of gravity and avoiding unnecessary deviations. Furthermore, biofeedback can significantly impact jumping and landing performance by improving neuromuscular control and regulating muscle tension. The HOP Test demands precise power management and muscular coordination, and biofeedback can enhance these abilities by increasing the athlete's awareness of muscle activity and strengthening neuromuscular responses. On the other hand, multifaceted psychological interventions directly improve athletic performance by reducing anxiety, enhancing emotional regulation, and boosting motivation. These interventions prepare athletes mentally and help reduce psychological barriers such as fear of movement or reinjury, making them more prepared for executing complex and high-risk movements. When combined with biofeedback, these interventions not only reinforce psychological aspects but also address physiological components, allowing athletes to benefit from dual advantages. Another mechanism that may play a critical role in the greater improvements observed in the combined group is the interaction between the mind and body. Biofeedback helps athletes establish a more effective connection between mental processes (e.g., focus and body awareness) and physiological processes (e.g., muscle control and balance). This optimized interaction results in overall performance improvements and reduces the likelihood of movement errors. Ultimately, these findings highlight the importance of addressing both physical and psychological aspects in designing rehabilitation programs and demonstrate that combining psychological interventions with biofeedback can serve as an effective strategy to enhance the performance of athletes with ACL injuries.
psychological aspects of recovery to ensure a comprehensive and sustainable return to sport. In recent years, multifaceted psychological interventions have emerged as a promising approach to aid in the recovery of injured athletes. Techniques such as mental imagery, goal setting, self-talk, counseling, and relaxation strategies have been shown to improve mental readiness, reduce anxiety, and enhance motivation during the rehabilitation process. These interventions not only support the psychological health of athletes but also play a critical role in improving functional recovery and adherence to rehabilitation protocols. Moreover, biofeedback, an advanced technique that provides real-time information about physiological processes, has gained attention for its potential to enhance neuromuscular control and self-regulation. By enabling athletes to monitor and modify their physiological responses, biofeedback facilitates greater awareness and control over movement patterns, which is particularly crucial for preventing re-injury and optimizing performance. While biofeedback and psychological interventions have individually demonstrated effectiveness in rehabilitation, limited research exists on their combined effects in athletes with ACL injuries. This study aims to explore the impact of integrating multifaceted psychological interventions with biofeedback on balance and functional performance in professional athletes recovering from ACL injuries. Using validated measures such as the Y Balance Test and the HOP Test, the research seeks to determine whether the combination of biofeedback and psychological techniques can provide superior outcomes compared to psychological interventions alone. The findings of this study have the potential to inform the development of more effective, holistic rehabilitation protocols, enabling athletes to achieve a faster and more confident return to their sport.
Methods: To conduct this study, 60 professional athletes with ACL knee injuries in the recovery phase following surgery were selected through a purposive and convenience sampling method. These participants were randomly assigned to five groups using a random number table: (1) the combined biofeedback and first multifaceted psychological intervention group (including imagery, counseling, and self-talk), (2) the combined biofeedback and second multifaceted psychological intervention group (including relaxation, counseling, and goal setting), (3) the first multifaceted psychological intervention group (imagery, counseling, and self-talk), (4) the second multifaceted psychological intervention group (relaxation, counseling, and goal setting), and (5) the control group. The experimental groups received training and intervention over twelve sessions, while the control group did not receive any specific intervention. For assessment, the Y Balance Test and the HOP Test were administered to all groups one day before and one day after the completion of the twelve-session protocol. Data analysis was performed using paired t-tests for within-group comparisons and analysis of covariance (ANCOVA) for between-group comparisons. Additionally, Bonferroni post hoc tests were applied to pinpoint the exact location of differences between groups. All statistical analyses were conducted using SPSS software, version 22.
Results: The results of this study indicated that all interventions improved the scores of the Y Balance Test and the HOP Test. The combination of biofeedback with multifaceted psychological interventions led to greater improvements in the Y Balance Test and HOP Test scores compared to the groups that received multifaceted psychological interventions without biofeedback.
Conclusion: The findings of this study demonstrated that both types of interventions multifaceted psychological interventions and the combination of these interventions with biofeedback contributed to the improved performance of professional athletes with ACL injuries. These findings suggest that any intervention aimed at enhancing physical and psychological aspects can have a positive impact on the rehabilitation of athletes. However, the combination of biofeedback with multifaceted psychological interventions showed greater improvements in Y Balance Test and HOP Test scores, which can be attributed to several factors. Biofeedback, by providing real-time and objective feedback on physiological changes in the body, enhances the athlete's self-awareness regarding their physical state and muscle performance. This process can increase the sense of personal control and help athletes adopt better strategies for improving balance and motor performance. Particularly in the Y Balance Test, which requires the ability to maintain dynamic balance and coordination, real-time feedback from biofeedback aids athletes in better managing their center of gravity and avoiding unnecessary deviations. Furthermore, biofeedback can significantly impact jumping and landing performance by improving neuromuscular control and regulating muscle tension. The HOP Test demands precise power management and muscular coordination, and biofeedback can enhance these abilities by increasing the athlete's awareness of muscle activity and strengthening neuromuscular responses. On the other hand, multifaceted psychological interventions directly improve athletic performance by reducing anxiety, enhancing emotional regulation, and boosting motivation. These interventions prepare athletes mentally and help reduce psychological barriers such as fear of movement or reinjury, making them more prepared for executing complex and high-risk movements. When combined with biofeedback, these interventions not only reinforce psychological aspects but also address physiological components, allowing athletes to benefit from dual advantages. Another mechanism that may play a critical role in the greater improvements observed in the combined group is the interaction between the mind and body. Biofeedback helps athletes establish a more effective connection between mental processes (e.g., focus and body awareness) and physiological processes (e.g., muscle control and balance). This optimized interaction results in overall performance improvements and reduces the likelihood of movement errors. Ultimately, these findings highlight the importance of addressing both physical and psychological aspects in designing rehabilitation programs and demonstrate that combining psychological interventions with biofeedback can serve as an effective strategy to enhance the performance of athletes with ACL injuries.
Keywords: Multifaceted Psychological Interventions, Electromyographic Biofeedback, Knee Injury Rehabilitation, Anterior Cruciate Ligament
Type of Study: Research |
Subject:
Clinical Psychiatry
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