Negative psychological responses of injury and rehabilitation adherence effects on return to play in competitive athletes: a systematic review and meta-analysis

Figures & data

Figure 1 Description of the selection process for included studies.

Table 1 Overview of the studies included in the meta-analysis

Study	Design	Population	n	Injuries	Variables	Definition of RTP
Brewer et al^Citation35	Prospective study	Competitive and recreational athletes	95	Acute ACL injury	Negative responses, adherence	NA
Heredia et al^Citation16	Prospective study	Competitive athletes	20	All types of injuries	Negative responses, adherence, RTP	The period between the date when the athlete was declared medically fit and the data on which the athlete returned to play
Lentz et al^Citation36	Prospective study	Injured athletes	60	Acute ACL injury	Negative responses, RTP	RTP
Lu and Hsu^Citation37	Cross-sectional study	Collegiate student athletes	224	All types of injuries	Negative responses, adherence	NA
Muller et al^Citation38	Prospective study	Injured athletes	40	Acute ACL injury	Negative responses, RTP	RTP 7 months after surgery
Podlog et al^Citation39	Cross-sectional study	High-school students (study 1), collegiate athletes (study 2)	118 (study 1) 105 (study 2)	All types of injuries	Negative responses, adherence	NA
Shin et al^Citation40	Prospective study	Competitive athletes	40	All types of injuries	Adherence, RTP	RTP

Note: n, sample size.

Abbreviations: RTP, return to play; ACL, anterior cruciate ligament; NA, not available.

Table 2 Results of meta-analyses and homogeneity tests for the relationships between negative responses after injury, rehabilitation adherence, and return to sport

Relationship	k	n	Effect size (r)	95% CI	FSN	I^2(%)
Negative responses-rehabilitation adherence	9	1058	−0.11	−0.15, 0.07	20	20
Negative responses-return to sport	3	120	−0.32	−0.42, −0.21	7	0
Rehabilitation adherence-return to sport	2	60	0.54	0.34, 0.69	NA	0

Notes: k, number of effect sizes; n, total number of participants.

Abbreviations: CI, confidence interval; FSN, fail-safe number; NA, not available.

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