An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative Study

Fear is a factor contributing to poor return to sport after an anterior cruciate (ACL) injury, however the identification and assessment of fear is challenging. To improve understanding of fear, this study qualitatively and quantitatively assessed responses to videos depicting threat to knee stabili...

Full description

Bibliographic Details
Main Authors: Cameron Little, Andrew P. Lavender, Cobie Starcevich, Christopher Mesagno, Tim Mitchell, Rodney Whiteley, Hanieh Bakhshayesh, Darren Beales
Format: Article
Language:English
Published: MDPI AG 2022-11-01
Series:Sports
Subjects:
Online Access:https://www.mdpi.com/2075-4663/10/11/183
_version_ 1797463905014906880
author Cameron Little
Andrew P. Lavender
Cobie Starcevich
Christopher Mesagno
Tim Mitchell
Rodney Whiteley
Hanieh Bakhshayesh
Darren Beales
author_facet Cameron Little
Andrew P. Lavender
Cobie Starcevich
Christopher Mesagno
Tim Mitchell
Rodney Whiteley
Hanieh Bakhshayesh
Darren Beales
author_sort Cameron Little
collection DOAJ
description Fear is a factor contributing to poor return to sport after an anterior cruciate (ACL) injury, however the identification and assessment of fear is challenging. To improve understanding of fear, this study qualitatively and quantitatively assessed responses to videos depicting threat to knee stability in people who had experienced an ACL injury. ACL-injured participants who had above average fear on the Tampa Scale of Kinesiophobia and were at least 1-year post-injury/surgery were eligible. Participants were shown four videos depicting sequentially increasing threat to their knee stability (running, cut-and-pivot, feigned knee injury during cut-and-pivot, series of traumatic knee injuries). Qualitative interviews explored participants feeling related to viewing the videos. Participants quantitatively self-rated fear and distress in response to each video. Seventeen participants were included in this study (71% female, with an average time since last ACL injury of 5 ½ years). Five themes were identified: (1) Evoked physiological responses, (2) Deeper contextualisation of the meaning of an ACL injury influencing bodily confidence, (3) Recall of psychological difficulties, (4) Negative implications of a re-injury, and (5) Change to athletic identity. Quantitatively, direct proportionality was noticed between threat level and reported fear and distress. Specifically, participants reported increasing levels of fear and distress as the videos progressed in threat level, with the largest increase seen between a cut-and-pivot movement to a feigned injury during a cut and pivot. The results support the notion that in addition to being a physical injury, an ACL injury has more complex neurophysiological, psychological, and social characteristics which should be considered in management. Using video exposure in the clinic may assist identification of underlying psychological barriers to recovery following an ACL injury, facilitating person-centred care.
first_indexed 2024-03-09T18:00:18Z
format Article
id doaj.art-a7d235c498014981967ecde5b0cc6cb7
institution Directory Open Access Journal
issn 2075-4663
language English
last_indexed 2024-03-09T18:00:18Z
publishDate 2022-11-01
publisher MDPI AG
record_format Article
series Sports
spelling doaj.art-a7d235c498014981967ecde5b0cc6cb72023-11-24T10:00:32ZengMDPI AGSports2075-46632022-11-01101118310.3390/sports10110183An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative StudyCameron Little0Andrew P. Lavender1Cobie Starcevich2Christopher Mesagno3Tim Mitchell4Rodney Whiteley5Hanieh Bakhshayesh6Darren Beales7Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA 6102, AustraliaInstitute of Health and Wellbeing, Federation University Australia, Ballarat, VIC 3350, AustraliaCurtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA 6102, AustraliaInstitute for Health & Sport, Victoria University, Melbourne, VIC 3011, AustraliaPain Options, Perth, WA 6151, AustraliaAspetar Sports Medicine Hospital, Doha 29222, QatarCurtin School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Perth, WA 6102, AustraliaCurtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA 6102, AustraliaFear is a factor contributing to poor return to sport after an anterior cruciate (ACL) injury, however the identification and assessment of fear is challenging. To improve understanding of fear, this study qualitatively and quantitatively assessed responses to videos depicting threat to knee stability in people who had experienced an ACL injury. ACL-injured participants who had above average fear on the Tampa Scale of Kinesiophobia and were at least 1-year post-injury/surgery were eligible. Participants were shown four videos depicting sequentially increasing threat to their knee stability (running, cut-and-pivot, feigned knee injury during cut-and-pivot, series of traumatic knee injuries). Qualitative interviews explored participants feeling related to viewing the videos. Participants quantitatively self-rated fear and distress in response to each video. Seventeen participants were included in this study (71% female, with an average time since last ACL injury of 5 ½ years). Five themes were identified: (1) Evoked physiological responses, (2) Deeper contextualisation of the meaning of an ACL injury influencing bodily confidence, (3) Recall of psychological difficulties, (4) Negative implications of a re-injury, and (5) Change to athletic identity. Quantitatively, direct proportionality was noticed between threat level and reported fear and distress. Specifically, participants reported increasing levels of fear and distress as the videos progressed in threat level, with the largest increase seen between a cut-and-pivot movement to a feigned injury during a cut and pivot. The results support the notion that in addition to being a physical injury, an ACL injury has more complex neurophysiological, psychological, and social characteristics which should be considered in management. Using video exposure in the clinic may assist identification of underlying psychological barriers to recovery following an ACL injury, facilitating person-centred care.https://www.mdpi.com/2075-4663/10/11/183knee injuryanterior cruciate ligament (ACL)fearvideos
spellingShingle Cameron Little
Andrew P. Lavender
Cobie Starcevich
Christopher Mesagno
Tim Mitchell
Rodney Whiteley
Hanieh Bakhshayesh
Darren Beales
An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative Study
Sports
knee injury
anterior cruciate ligament (ACL)
fear
videos
title An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative Study
title_full An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative Study
title_fullStr An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative Study
title_full_unstemmed An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative Study
title_short An Investigation of the Nature of Fear within ACL-Injured Subjects When Exposed to Provocative Videos: A Concurrent Qualitative and Quantitative Study
title_sort investigation of the nature of fear within acl injured subjects when exposed to provocative videos a concurrent qualitative and quantitative study
topic knee injury
anterior cruciate ligament (ACL)
fear
videos
url https://www.mdpi.com/2075-4663/10/11/183
work_keys_str_mv AT cameronlittle aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT andrewplavender aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT cobiestarcevich aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT christophermesagno aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT timmitchell aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT rodneywhiteley aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT haniehbakhshayesh aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT darrenbeales aninvestigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT cameronlittle investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT andrewplavender investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT cobiestarcevich investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT christophermesagno investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT timmitchell investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT rodneywhiteley investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT haniehbakhshayesh investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy
AT darrenbeales investigationofthenatureoffearwithinaclinjuredsubjectswhenexposedtoprovocativevideosaconcurrentqualitativeandquantitativestudy