Treatment motivation for rehabilitation after a sport injury: Application of the trans-contextual model

Objectives: Two studies employed the trans-contextual model (TCM) to understand the relationships between sport motivation, treatment motivation, and autonomy support. Study 1 tested TCM among recreational athletes, while Study 2 examined the effects of causality orientations and autonomy support from coaches in the TCM among professional athletes. Methods: In Study 1, recreational athletes (N 1⁄4 115) with ruptured anterior cruciate ligaments completed questionnaires measuring sport motivation, autonomy support from physiotherapists, and treatment motivation for injury rehabilitation. In Study 2, professional athletes (N 1⁄4 206) with experiences of moderate to severe sport injury completed questionnaires assessing sport motivation, general causality orientation, autonomy support from coaches and physiotherapists, and treatment motivation and treatment intention based on a hypothetical injury scenario. Results: In Study 1, autonomous sport motivation and controlled sport motivation formed positive associations with autonomous and controlled treatment motivation, when controlling for the effect of autonomy support from physiotherapists. In Study 2, the relationship between sport motivation and treatment motivation corroborated findings of Study 1. In addition, autonomy orientation formed positive associations with autonomous sport and treatment motivation and autonomy support from coaches and physiotherapists. Controlled orientation positively predicted controlled sport and treatment motivation. Autonomy support from physiotherapists, instead of that from coaches, positively predicted autonomous treatment motivation. Conclusion: The TCM is effective in explaining the transfer of motivation between sport and treatment contexts. Athletes with higher autonomous motivation in sport may be more likely to be autonomously motivated in their rehabilitation when injured. 2010 Elsevier Ltd. All rights reserved. Sport injury (e.g., musculoskeletal and soft tissue injuries) appears to be a fact of life that frequently occurs in sport participants of all levels of expertise (Conn, Annest, & Gilchrist, 2003; Schneider, Seither, Tonges, & Schmitt, 2006). Such injuries not only lead to time-out from sport but also increase the likelihood of re-injury (Knowles et al., 2006). Proper rehabilitation therefore is essential to enhance recovery and prevent further injury. However, not all sport participants with injuries completely adhere to prescribed treatment by rehabilitation specialists such as physiotherapists and sport injury experts. Poor treatment adherence and dropout from treatment protocols among sports participants who require clinic-based or home-based physical therapy have often been reported (Bassett & Prapavessis, 2007; Sluijs, Kok, & van der Zee, 1993). While an increasing amount of evidence suggests that motivation to undertake rehabilitation is a critical factor to determine the treatment adherence of outpatients (Chan, Lonsdale, Ho, Yung, & Chan, 2009; Hagger, Chatzisarantis, Griffin, & Thatcher, 2005; Ryan, Patrick, Deci, & Williams, 2008; Williams, 2002), very few studies have examined the motivational factors in the context in which the injury has taken place. Therefore, the current study aims to apply a theory-based integrated model of motivation, the trans-contextual model (Hagger, Chatzisarantis, Barkoukis,Wang, & * Corresponding author. Personality, Social Psychology, and Health Research Group, School of Psychology, University of Nottingham, University Park, Nottingham, Nottinghamshire, NG7 2RD, United Kingdom. Tel.: þ44 07531626672; fax: þ44 115 9515324. E-mail addresses: [email protected], [email protected] (D.K.-C. Chan). 1 Martin S. Hagger, Personality, Social Psychology, and Health Research Group, School of Psychology, University of Nottingham. Christopher M. Spray, School of Sport, Exercise and Health Sciences, Loughborough University. 2 The authors would like to acknowledge Dr Chris Lonsdale for his advice and research ideas given at the early stage of this project.