Which psychosocial factors are associated with return to sport following concussion? A systematic review

Background:Psycho social factors predict recurrent inj ury and return to preinjury level of performance following orthopedic injury but are poorly understood following concussion.Current management protocols prioritize physical measures of recovery.Therefore,the objective of this study was to describe the psychosocial factors associated with return to sport(RTS) and how they are measured in athletes who sustained a concussion.Methods:MEDLINE,Embase,APA PsycINFO,CINAHL,and SPORTDiscus were searched through February 2,2021.Eligible studies included original peer-reviewed publications describing psychosocial factors associated with RTS following a diagnosed concussion.The primary outcome was scales or measures employed and/or key thematic concepts.Results:Of the 3615 studies identified,10 quantitative cohort studies(Oxford Centre for Evidence-Based Medicine Level-3) representing 2032 athletes(85% male;high-school and collegiate collision/contact athletes) and 4 qualitative studies representing 66 athletes(74% male;70% American football;aged 9-28 years) were included.We identified 3 overarching themes and 10 outcome measures related to psychosocial factors associated with RTS following concussion:(a) fear(e.g,of recurrent concussion,of RTS,of losing playing status);(b) emotional factors(e.g,depression,anxiety,perceived stress,mental health,disturbance mood);and(c) contextual factors(e.g,social support,pressure,sense of identity).Conclusion:Although current medical clearance decisions prioritize physical measures of recovery,evidence suggests diverse psychosocial factors influence RTS following concussion.It remains unclear which psychosocial factors contribute to a successful RTS,including the influence of sex/gender and age.Future studies should evaluate the association of psychological readiness with physical measures of recovery at medical clearance,preinjury level of performance,and risk of recurrent concussion to support RTS clinical decision-making.

Collegiate athletes'mental health services utilization:A systematic review of conceptualizations,operationalizations,facilitators,and barriers

Background: While mental health among collegiate athletes is receiving increased attention, research on factors surrounding collegiate athletes' decision to seek mental health services is limited. The goal of the present review was to analyze and synthesize the current literature concerning collegiate athletes' utilization of mental health services, including the facilitators of and barriers to use of these services.Methods: The analysis was guided and organized using a socio-ecological framework, which considered the unique context in which collegiate athletes study and perform. A total of 21 articles, published between 2005 and 2016, which concern U.S. collegiate athletes' mental health services utilization(MHSU) were selected and included for the final analysis. Conceptualizations and operationalizations of MHSU were compared and contrasted. Facilitators of and barriers to athletes MHSU were examined and summarized while appropriately considering the proximity of each factor(facilitator or barrier) to the athletes.Results: Results showed variations in conceptualizations and operationalizations of MHSU in the articles analyzed, which made interpretation and cross comparison difficult. Collegiate athletes are willing to utilize mental health services, but gender, perceived stigma, peer norms—for athletes and coaches—plus service availability impact their MHSU.Conclusion: Key stakeholders, administrators, and public health officials should partner to eliminate MHSU barriers, support facilitators, and generally empower collegiate athletes to actively manage their mental health.

Effects of Yoga Interventions on Psychological Health and Performance of Competitive Athletes:A Systematic Review

Quality of life and psychological health in the field of competitive sport are emergent research topics,specifically for issues such as sport anxiety and depression.With the rise of contemplative practices,yoga has started to be used and included as part of athletes' mental training.This study aimed to systematically review the literature on the impact of yoga interven-tions on quality of life,performance anxiety and sport performance among healthy elite adult athletes.Based on PRISMA guidelines,this systematic review includes articles published up to December 2019.The search strategy was conducted in six databases (PUBMED,EMBASE,PsycINFO,SCOPUS,SportDiscuss and (E)rudit).Screened by two independent researchers,only six of the 37 articles drawn from the search met the preselected inclusion criteria and moved forward to the data extraction process.Data from six trials of poor quality (M =46.91%,SD =13.39,IRR of 92%) were included in this comprehensive literature search,indicating that elite athletes benefit from yoga interventions (with or without mindful-ness),in terms of changes in performance anxiety M =65% (SD =122.49),sport performance M =7.9% (SD =5.46) and life satisfaction.These interventions lasted on average 5.7 weeks (SD =2.07).Based on the collected evidence,methodological and measurement limitations of the sport psychology literature should be addressed to improve the replicability of reported results.Overall,this review provides encouraging but limited evidence for the value of yoga interventions in healthy adult athletes.However,the important reporting inconsistencies and theoretical limitations that have been raised highlight the need for trials with greater methodological rigor.