Psychological factors involved in adherence to sport injury rehabilitation: a systematic review

The objective of this article is to review the extant literature on the psychological factors related to adherence to sport injury rehabilitation among athletes. Published English language articles were identified using electronic databases. The quality of the identified articles was assessed using a hybrid quality assessment tool based on the Effective Public Health Practice Project tool and the Health Technology Assessment Programme for evaluating non-randomised intervention studies. Seventeen papers – one using a treatment intervention, two qualitative articles and 14 descriptive studies fulfilled the inclusion criteria and were systematically reviewed. The results suggested that there were two categories of factors that determine adherence to rehabilitation in this population: person and situational. Person-specific factors included the impact of the injury, justification for adherence, motivation, confidence/self-efficacy, coping, social support, locus of control, cognitive appraisal, coping and psychological skills. Situational factors included the characteristics, strategies and effectiveness of the physical therapist and treatment efficacy. Due to the scant nature and quality of the studies included in this review, we conclude that research of strong design is required to provide a greater evidence-base and to help inform the role that sport psychologists could play in designing interventions to improve adherence to rehabilitation.