title: Certified athletic trainers' perspectives on rehabilitation adherence in collegiate athletic training settings.
abstract: BACKGROUND
  Adherence to sport-injury rehabilitation protocols may be pivotal in ensuring successful rehabilitation and return-to-play outcomes.
  
  
  OBJECTIVE
  To investigate athletic trainers' perspectives related to the degree to which rehabilitation adherence is an issue in collegiate athletic training settings, gain insight from certified athletic trainers regarding the factors contributing to rehabilitation nonadherence (underadherence and overadherence), and ascertain views on the most effective means for promoting adherence.
  
  
  METHODS
  Cross-sectional, mixed methods.
  
  
  METHODS
  Collegiate athletic training in the United States.
  
  
  METHODS
  Certified athletic trainers (n = 479; 234 male, 245 female).
  
  
  METHODS
  Online survey consisting of 3 questions regarding rehabilitation adherence, each followed by an open-ended comments section. Descriptive statistics were calculated for quantitative items; hierarchical content analyses were conducted for qualitative items.
  
  
  RESULTS
  Most (98.3%) participants reported poor rehabilitation adherence to be a problem (1.7% = no problem, 29.2% = minor problem, 49.7% = problem, 19.4% = major problem), while most (98.96%) participants reported that they had athletes who exhibited poor rehabilitation adherence (1% = never, 71.4% = occasionally, 22.5% = often, 5% = always). In addition, the majority (97.91%) of participants reported that overadherence (eg, doing too much, failing to comply with activity restrictions, etc) was at least an occasional occurrence (2.1% = never, 69.3% = occasionally, 26.3% = often, 1.9% = always). Hierarchical content analyses regarding the constructs of poor adherence and overadherence revealed 4 major themes: the motivation to adhere, the development of good athletic trainer-athlete rapport and effective communication, athletic trainers' perception of the coaches' role in fostering adherence, and the influence of injury- or individual- (eg, injury severity, sport type, gender) specific characteristics on rehabilitation adherence.
  
  
  CONCLUSIONS
  These results suggest that participants believe that underadherence (and to a lesser extent overadherence) is a frequent occurrence in collegiate athletic training settings. Strategies for enhancing rehabilitation adherence rates and preventing overadherence may therefore be important for optimizing rehabilitation outcomes.
authors: Dept of Kinesiology, University of La Verne, La Verne, CA.
authors: Megan D
authors: MD
authors: Granquist
authors: Leslie
authors: L
authors: Podlog
authors: Joanna R
authors: JR
authors: Engel
authors: Aubrey
authors: A
authors: Newland
mesh_terms: D001265:Athletic Injuries / Q000523:psychology / Q000534:rehabilitation*; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology; D011369:Professional-Patient Relations; D013178:Sports Medicine; D011795:Surveys and Questionnaires; D014481:United States; D014495:Universities