MINDFULNESS: A NEW CONCEPT IN THE SPORTS INJURIES’ PREVENTION?

MINDFULNESS: A NEW CONCEPT IN THE SPORTS INJURIES’ PREVENTION?

Solé, S., Palmi,J. (PhD)INEFC, Lleida University, Lleida, Spain

CONTACT ADRESSES

jpalmi@inefc.es

ssole@inefc.es

           

STUDY MINDFULNESS-BASED INTERVENTION

NUMBER/CHARACTERISTICS OF SUBJECTS STUDY DESIGN

CONTROL GROUP

EVALUATION SCALES

 MAIN FINDINGS

Gardner and Moore, 2004A Mindfulness-Acceptance-Commit ment-Based approach to athletic performance enhancement: theoretical considerations.

MAC12 sessions. 1 session per week. 1 hour per session5 phases: Psychoeducation, Mindfulness, Value identification and commitment, Acceptance, Integration and practice

Case study 1: 22 year-old intercollegiate swimmer. The protocol was extended by 4 weeks

during the competitive sesssion  

Case study 2: 37-year-old master's-level female power-lifter 

N=1   PSWQ, SAS, AAQ-16

Case study 1: Performance: best competitive season, winning two meets and achieving two personal-best times Psychological skills: 39% less in anxiety (PSWQ, SAS) and a 38,2% less in experiencial avoidance (AAQ)Case study 2:Performance: best performance and lifted 15% beyond her best master’s level competitive performancePsychological skills: a reduction of 55,5% in anxiety (SAS) and 44,1% in experiencial avoidance ( AAQ)

Lutkenhouse, 2007The case of Jenny: a freshman collegiate athlete experiencing performance dysfunction

MAC8 sessions. Exercises to do between sessions Some contacts by e-mail after protocol.

19 year-old female lacrosse player classified as experiencing performance dysfunction by the

Multilevel Classification System for Sport Psychology (MCS-SP)

N=1   SPQ, YSQ-SF, PSWQ, SAS, AAQ-

R

Performance: reduction of 25 seconds in her best mile run time. A 61,5% increase in scores performance (SPQ). She no longer met criteria for Performance Dysfunction. Self –evaluation: personal and sportive growth and development, improvement of performance and her capacity to handle frustration.

 Bernier et al, 2009Mindfulness and Acceptance approaches in sport performance

Case study 1: qualitative interviews

Case study 2: MAC 4 introductory sessions. 1 session every month. Applied exercise was implemented during the competition period

Case study 1: 10 elite swimmers. 40% women.

Case study 2: 7 elite young golfers (experimental group). 28,5%

women6 elite young golfers (control group). 16,6% women

Case 1: Qualitative interviewsCase 2: Quasi Exp

Traditional psychological skills training: goal setting, imagery, …

 OMSAT-3 Case study 1: improvement in the nine flow dimensions (Jackson and Csikszentmihalyi, 1999) and the finding of a new characteristic: the awareness and acceptance of their bodily sensations during the preperformance moments. Case study 2: The coaches emphasized that the 57,1% of golfers in experimental group became more aware and lucid in their approach to golf and said the intervention was usedful and relevant. Performance: the 66% of golfers in experimental group improved their national rankings Psychological skills evaluated with the OMSAT-3 improved significantly in experimental group (p<0.03)

Kauffman et al, 2009Evaluation of Mindful Sport Perfor mance (MSPE): a new approach to promote flow in athletes

MSPE4 sessions. 1 session per week. 2,5-3 hours per session

N= 32/29 . 28,1% women. Amateur athletes from Washington

21 golfers/2 dropouts 11 archers/1 dropouts

Only 11 athletes completed the 4 sessions

QuasiExperime.

  BQ, SAS, MPS, CSCI, TOQS, KIMS, DFS-W,

CEM, TMS, DML, DSPL, FSS-2, EXT

Performance: no significant diferences pre-post intervention. The athletes’ opinion about the workshop’s influence on their performance was 6,62 (0-10), and their satisfaction level with their performance increased significantly (p<0.01) after workshop.Phsychological skills: no significant diferences in golfers. In the archers significant disminution (p<0.10) of thought ocurrence (TOQS), increase (p<0.10) of self-conficence (CSCI) and significant increase (p<0.01) of mindfulness levels (KIMS, TMS). State psychological skills: significant increase of mindfulness level in archers (p<0.10) and flow level in all athletes (p<0.05).

Schwanhausser, 2009Application of the Mindfulness-Acceptance-Commitment (MAC) protocol with an adolescent springboard diver

MAC adapted (7 phases)9 sessions. 1 session per week45 minuts per session 

12 year-old male, high level springboard and platform diver

 

N=1   PCQ, PHMS, SAS, AAQ-2, MAAS, FS

Performance: an increase of 73,3% (PCQ)Psychological skills: increase of a 23% in mindfulness (PHMS y MAAS), a 35,1% in acceptance (AAQ), and a 6,6% in flow levels (DFS-2, FSS-2). Disminution of a 6,4% in anxiety (SAS)

 Aherne, Moran, Lonsdale, 2011The effect of mindfulness training on athletes’ flow: an initial investigation

Mindfulness training inspired in Mindfulness-Based Stress Reduction (MBSR)6 sessions. 1 session per week Daily work with CD

13 high level university athletes, average experience of 8,69 years. Participants of different

sports.Experimental group: 6 (33,3% women)

Control group: 7 (28,5% mujeres)

Experimen.RCT

The same information but had no contact

with the teachers.

 FSS-2, CAMS-R Flow: significant increase (p<0.05) in the experimental group (CAMS-R y FSS-2)The increase in FSS-2 global scores from Time 1 to Time 2 was large (p<0.01) for the experimental group and non significant (p>0.05) for the control group. Additional research is needed to investigate the cognitive benefits of mindfulness training and its potential to increase sport performance

Thompson et al, 2011One year follow-up of Mindful Sport Performance Enhancement (MSPE) with archers, golfers and runners

MSPE4 sessions. 1 session per week. 2,5-3 hours per session * See De Petrillo et al, 2009 and Kaufman et al, 2009   

From the original 52 athletes 25:4 archers, 8 golfers and 13 long-distance runners

participated in the one-year follow-up of this study.

QuasiExperim.

 

  AQ, GQ, RQ, CEM, FQ, FQ-R, KIMS,

TOQS, SAS, CSCI, DFS-2, MPS

Performance: athletes’ scores were significantly lower during the year after the workshop: p=0.041 in golfers and p=0.038 in long-distance runners. In a Likerst scale from 0-5 asking about the performance’s change during the last year, the mean result was 3,62 and most of them (3 in the Likert scale) said that the changes could be attributed to the MSPE workshop. Psychological skills: significant increase (p=0.034) in flow levels (DFS-2), Mindfulness levels (p<0.01) measured with KIMS and significant decrease (p<0.05) of anxiety (SAS)

              

Introduction

Mindfulness is defined as the nonjudgmental focus of one’s attention on the experience that occurs in the present moment (Kabat-Zinn, 1990).There are many mindfulness-based therapies such as Mindfulness-based Stress Reduction or MBSR ( Kabat-Zinn, Op. Cit) and Mindfulness-based Cognitive Therapy or MBCT (Segal, Williams, Teasdale, 2002) and they are being used for different health problems such as chronic pain, anxiety and depression, stress, psoriasis or cancer.The aim of this study is to identify the actual use of mindfulness therapies in sports psychology and to investigate the possible aplications of this concept in the prevention and treatment of sports’ injuries.

Methods

A literature research was undertaken using Medline, Psychinfo, Web of Science, Cochrane, Ebscohost, Isi Web of Knowledge databases and references of retrieved articles. The search included original articles, books and dissertations published up to 2012. For the final selection the books and dissertations were excluded. The main search terms were mindfulness, sports, stress, sport injury, and risk factor, in different combinations as needed. All articles were coded for their design, type of control, study population, and outcome measures. Seven studies were considered eligible for the present review and are presented in the next table.

Discussion and Conclussions

The use of mindfulness in sports psychology is very new and it’s been focused in enhancing athletes’ performance (Birrer, 2012) In our review we observed the next findings: there are a few number of studies, with little samples and most of them are nonrandomized studies. We also find three case studies. Most of them use two new mindfulness-based interventions: MSPE and MAC, with a very well defined intervention protocols.

There is not yet sufficient evidence to determinate the magnitude of the effects of these interventions due to the methodological limitations of the studies. But the results could suggest that these two mindfulness-based interventions, the Mindfulness-Acceptance-Commitment-Based Approach (MAC) and Mindfulness Sport Performance Enhancement (MSPE) can be helpful to enhance performance in sport. They also increase the levels of mindfulness, concentration, acceptation, sense of control, awareness of bodily sensations and decreases the stress and anxiety levels. These are important variables and risk factors for sports’ injuries prevention and rehabilitation as well.

To our knowledge, there are no studies using these interventions to prevent sports’ injuries but the influence of psycho-social factors is well known (Andersen & Williams, 1993, Heil, 1993, Palmi, 2001). The benefits for the athletes of this new psychological approach in different variables such as concentration levels, mindfulness, acceptance or anxiety levels could be used in the prevention and treatment of sports’ injuries. They are being used only to enhance performance for the moment.

New mindfulness-based interventions for prevention and treatment of sport’s injuries, adapted to different sports and athletes are suggested and will be the objective of future studies.

References

Birrer, D., Rothlin, P., & Morgan, G. (2012). Mindfulness to enhance athletic performance: theoretical considerations and possible impact mechanisms. Mindfulness. DOI 10.1007/s12671-012-0109-2

Gardner, F., & Moore, Z. (2009). A Mindfulness-Acceptance-Commitment-Based approach to athletic performance enhancement: theoretical considerations. Behavior Therapy, 35, 707-723.

Jackson, S.A., & Csikszentmihalyi, M. (1999). Flow in sports: The key to optimal experience and performances. Champaign, IL: Human Kinetics.

Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Delacourte.

Kauffman, K., Glass, C., & Arnkoff, D. (2009). Evaluation of Mindful Sport Performance Enhancement (MSPE): a new approach to promote flow in athletes. Journal of Clinical Sports Psychology, 4, 334-356.

Palmi, J. (2001). Visión psico-social en la intervención de la lesión deportiva. Cuadernos de psicología del deporte, 1, 69-80.

SCALES: PSWQ (Penn State Worry Questionnaire), SAS (Sport Anxiety Scale), AAQ-16 (Acceptance and Action Questionnaire), SPQ (Sport Performance Questionnaire), YSQ-SF (Young Schema Questionnaire-Short Form), AAQ-R (Acceptance and Action Questionnaire-Revised), OMSAT-3 (Ottawa Mental Skills), BQ (Background Questionnaire), TOQS (Thought Ocurrence Questionnaire for Sport), MPS (Multidimensional Perfectionism Scale), KIMS (Kentucky Inventory of Mindfulness Skills), CEM (Workshop and Expectations Measure), TMS (Toronto Mindfulness Scale), PQ (Postworkshop Questionnaire), DFS-2 (Dispositional Flow Scale-2), DML (Daily Mindfulness Log), DSPL (Daily Sport Performance Log), FSS-2 (Flow State Scale-2), EXT (Exit Questionnaire), PCQ (Performance Classification Questionnaire), PHMS (Philadelphia Mindfulness Scale), AAQ-2 (Action and Acceptance Questionnaire-2), MAAS (Mindfulness Attention Awareness Scale), CAMS-R (Cognitive and Affective Mindfulness Scale-Revised) , AQ (Archery Questionnaire), GQ (Golf Questionnaire), RQ (Runner Questionnaire), FQ (Follow Up Questionnaire), FQ-R (Follow-up Questionnaire for Runners) , CSCI (Carolina Sport Confidence Inventory).