Razi Journal of Medical Sciences

fa تأثیر مداخلات چندوجهی روانشناختی با و بدون بیوفیدبک بر تعهد ورزشی، خودکارآمدی درد و ترس از فعالیت ورزشکاران حرفه‌ای دارای آسیب ACL زانو در دوره نقاهت پس از عمل جراحی The Effect of Various Psychological Multimodal Interventions with and Without Biofeedback on Sports Commitment, Pain Self-Efficacy and Fear of Activity in Professional Athletes with ACL Knee Injury During the Recovery Period After Surgery روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: تحقیقات مختلفی روش بیوفیدبک را با مداخلات روانشناختی ترکیب کرده‌اند و مزایای آن را بازگشت به فعالیت ورزشی را نشان داده‌اند؛ بنابراین هدف از این تحقیق بررسی تأثیر مداخلات چندوجهی روانشناختی مختلف با و بدون بیوفیدبک بر تعهد ورزشی، خودکارآمدی درد و ترس از فعالیت ورزشکاران حرفه‌ای دارای آسیب ACL زانو در دوره نقاهت پس از عمل جراحی بود. روش کار: بدین منظور از میان ورزشکاران حرفه‌ای دارای آسیب ACL زانو که در دوره نقاهت پس از عمل جراحی قرار داشتند به روش هدفمند و در دسترس تعداد 60 نفر انتخاب شدند و به ورزشکاران با استفاده از جدول اعداد تصادفی به پنج گروه (گروه ترکیب بیوفیدبک و مداخلات چندوجهی اول<a name="_Hlk167218254"> (تصویرسازی، مشاوره، خودگویی)، گروه ترکیب بیوفیدبک و مداخلات چندوجهی دوم (آرام‌سازی،</a> مشاوره، هدف‌گذاری)، گروه مداخلات چند وجهی اول (تصویرسازی، مشاوره، خودگویی)، گروه مداخلات چندوجهی دوم (آرام‌سازی، مشاوره، هدف‌گذاری) و گروه کنترل تقسیم شدند. گروه‌های آزمایشی به مدت دوازده جلسه مورد آموزش و تمرین قرار گرفتد ولی گروه کنترل آموزش و تمرین خاصی را دریافت نکردند. پرسشنامه‌های خودکارآمدی درد، تعهد ورزشی، ترس از حرکت  توسط هر پنج گروه یک روز قبل و بعد از پروتکل 12 جلسه‌ای تکمیل شد. از آزمونی تی همبسته برای مقایسه درون گروهی و از آزمون تحلیل کوواریانس برای مقایسه بین گروه‌ها و آزمون تعقیبی بونفرنی برای پیدا کردن محل تفاوت گروه‌ها استفاده شد. عملیات آماری با استفاده از نرمافزار spss نسخه 22 استفاده شد. یافته‌ها: نتایج این تحقیق حاکی از این بود که همه مداخلات موجب بهبود نمرات تعهد ورزشی، خودکارآمدی و ترس از حرکت شد. بین نمرات تعهد ورزشی گروه های مداخله‌ای تفاوت معنی‌داری وجود نداشت. اما ترکیب بیوفیدبک با مداخلات چند وجهی روانشناختی موجب بهبود بیشتری در نمرات خودکارآمدی درد و ترس از حرکت نسبت به گروه‌های مداخلات چند وجهی روانشناختی بدون بیوفیدبک شد. نتیجه‌گیری: ترکیب بیوفیدبک با مداخلات چند وجهی روانشناختی نسبت به مداخلات چند وجهی روانشناختی موجب بهبود بیشتر نمرات خودکارآمدی درد و ترس از حرکت می‌شود.</div> <div style="text-align: justify;"> Background & Aims: Sports injuries often have significant negative effects on the physical health of athletes. They also have the potential to cause serious psychological distress due to increased anger, depression, anxiety, tension, fear, and low self-esteem. Sports injuries often cause immediate imbalance and disruption in the lives of injured athletes, including loss of health and athletic potential. In the worst case, injuries lead to permanent disability or even death. Such functional loss or inability to continue sports participation can be distressing, disrupt the rehabilitation process, and consequently affect how players emotionally deal with future injuries. Therefore, integrating a component that addresses the psychological recovery of sports injuries into a traditional injury rehabilitation program is critical to preventing and/or reducing the negative psychological consequences of injury and promoting return to active participation in sports-related activities. More than 10 million sports injuries occur among athletes annually. Various studies have combined biofeedback with psychological interventions and demonstrated its benefits in return to sports activity; therefore, this study aimed to investigate the effect of different multimodal psychological interventions with and without biofeedback on sports commitment, pain self-efficacy, and fear of activity in professional athletes with ACL knee injuries during the recovery period after surgery. Methods: For this purpose, 60 people were selected from among professional athletes with ACL knee injuries who were in the recovery period after surgery using a purposeful and accessible method, and the athletes were divided into five groups using a random number table (biofeedback and multimodal intervention group (imagination, counseling, self-talk), biofeedback and multimodal intervention group (relaxation, counseling, goal setting), multimodal intervention group (imagination, counseling, self-talk), multimodal intervention group (relaxation, counseling, goal setting), and control group). The experimental groups were trained and practiced for twelve sessions, but the control group did not receive any special training or practice. Pain self-efficacy, exercise commitment, and fear of movement questionnaires were completed by all five groups one day before and after the 12-session protocol. A paired t-test was used for intragroup comparison, an analysis of covariance test was used for between-group comparison, and Bonferroni post hoc test was used to find the location of group differences. Statistical operations were performed using SPSS version 22 software. Results: The results of this study indicated that all interventions improved scores of exercise commitment, self-efficacy, and fear of movement. There was no significant difference between the scores of exercise commitment of the intervention groups. However, the combination of biofeedback with multimodal psychological interventions resulted in greater improvement in scores of pain self-efficacy and fear of movement compared to the multimodal psychological intervention groups without biofeedback. The results of the Bonferroni post hoc test in Table 4 showed that the control group had significantly lower scores in exercise commitment skills than the other groups. However, there was no significant difference between the scores of exercise commitment between the first and second combined groups and the first and second multimodal intervention groups. Also, the results of the Bonferroni post hoc test showed that the control group had significantly lower scores in pain self-efficacy skills than the other groups. Also, the first and second combination groups did not differ significantly from each other, while these groups were significantly different from the first and second multimodal intervention groups, and the combination groups had better scores than the multimodal intervention groups. Also, there was no significant difference between the scores of the first and second multimodal intervention groups. The results of the Bonferroni post hoc test showed that the control group had significantly lower scores in fear of movement scores than the other groups. Also, the first and second combination groups did not differ significantly from each other, while these groups were significantly different from the first and second multimodal intervention groups, and the combination groups had better scores than the multimodal intervention groups. Also, there was no significant difference between the scores of the first and second multimodal intervention groups. Conclusion: Combining biofeedback with multimodal psychological interventions resulted in greater improvements in self-efficacy scores for pain and fear of movement than multimodal psychological interventions alone. In explaining the positive effects of biofeedback, the findings suggest that the method used here, including measures including biofeedback, heart rate, and abdominal relaxation, is likely to lead to improved self-awareness of the individual's body and subsequent changes that lead to faster recovery. Less decision-making and anxiety In general, due to the reduction of anxiety and stress, the physiological activity of the parasympathetic autonomic nervous system prevails over the sympathetic autonomic nervous system and optimizes the physical, cognitive, and psychological functions of the body, which ultimately leads to optimal motor performance. Therefore, the athlete learns to be aware of and adapt to the various physiological states of his body using the biofeedback device and then continues this process without the use of equipment and feedback. Accordingly, biofeedback has been introduced as a useful tool for competitive athletes. Facilitate learning by self-regulating the learning process and preventing the emergence of negative emotions. The findings of the present study are consistent with the view that methods based on (imagination, counseling, and self-talk) (relaxation, counseling, and goal setting) may act by inducing positive physiological and psychological effects on variables related to focus and stress reduction. The interventions of the present study are proposed to increase awareness of emotional symptoms during the physical practice of a skill through conscious attention to the present moment.</div> مداخلات چندوجهی روانشناختی, بیوفیدبک الکترومیوگرافیک, بازتوانی آسیب زانو, ورزشکاران حرفه‌ای, رباط صلیبی قدامی (ACL) Multimodal Psychological Interventions, Electromyographic Biofeedback, Knee Injury Rehabilitation, Professional Athletes, Anterior Cruciate Ligament (ACL) 1 11 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8206-1&slc_lang=fa&sid=1 Seyed Mojtaba Hosseini سید مجتبی حسینی 3900319475328460090199 3900319475328460090199 No PhD student in sport psychology, faculty of physical education and sport science, university of Tehran. دانشجوی دکتری روانشناسی ورزش، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه تهران Hasan Gharayagh Zandi حسن غرایاق زندی ghzandi110@ut.ac.ir 3900319475328460090200 3900319475328460090200 Yes Assistant professor, faculty of physical education and sport science, university of Tehran استادیار، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه تهران Ali Moghadamzadeh علی مقدم زاده 3900319475328460090201 3900319475328460090201 No Associate professor, faculty of psychology, university of Tehran. دانشیار، دانشکده روانشناسی، دانشگاه تهران. Seyed Hamed Mousavi سید حامد موسوی 3900319475328460090202 3900319475328460090202 No Assistant professor, faculty of physical education and sport science, university of Tehran استادیار، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه تهران