Date of Graduation


Document Type


Degree Type



College of Physical Activity and Sport Sciences


Sport and Exercise Psychology

Committee Chair

Michelle A Sandrey

Committee Co-Chair

Damien Clement

Committee Member

Drue Stapleton


Context: Sport injuries occur in National Collegiate Athletic Association (NCAA) sanctioned sports during preseason, in season, and post season competition. In order for optimal return to play outcomes, rehabilitation programs must be implemented and enforced. However, the literature reports inconsistent adherence rates and few studies have evaluated adherence rates by including both the athlete and athletic trainer at the Division III level. Objective: The purpose of this study was to determine if there was a difference in adherence rates to rehabilitation between a pre and posttest for a Division III institution. Design: The study was a prospective exploratory study. Setting: The testing took place at a Division III institution. Only one clinician administered the testing. Patients and Other Participants: Athletes (n=12) from three teams or multiple teams and Athletic Trainers (n=3) at a Division III institution volunteered for the study. Inclusion criteria for athletes included sustaining a musculoskeletal injury resulting in withdrawal from sport participation for ten or more days in order to complete rehabilitative activities, athletes must be at least 18 years of age or older, with a physical on file, be a member of a sport team, and participating in practices and/or games prior to injury. Inclusion criteria for athletic trainers included being a practicing licensed athletic trainer at the Division III institution working with team and individual sport athletes. Exclusion criteria for athletes included not having a musculoskeletal injury, rehabilitation resulting in less than ten days missed, being younger than 18 years, not having a physical on file, and not being a member of a sport team. Exclusion criteria for athletic trainers included not being licensed in the state of Pennsylvania and not working with sport teams or individual athletes at the Division III institution. Interventions: The athlete participants were asked to complete a demographic survey, athletic identity measurement scale (AIMS), and the Rehabilitation Over Adherence Questionnaire (ROAQ) during the initial meeting. The ROAQ was administered following a pre and post-test format. The athletic trainer participants competed the Sport Injury Rehabilitation Adherence Scale (SIRAS) and the Rehabilitation Adherence Measure for Athletic Training (RAdMAT) during the initial visit and at the end of data collection. Data collection as measured by the questionnaires was held over a three-week period. Main Outcomes Measures: The dependent variable is adherence based on responses to the questionnaire. Results: Using three separate 1x2 repeated measures ANOVA, ROAQ for the athlete was not significant (F=2.382, P=0.151), nor were the SIRAS (F=.786, P=0.394), and RAdMAT (F=.592, P=0.458) for the athletic trainer. There was a moderate correlation for the AIMS and ROAQ pre-test (r=3.14, P=.320) and post-test (r=.319, P=.313) along with a moderate correlation for the years of participation and the AIMS (r=.353, P=.261). A large, significant correlation for the SIRAS total and the RAdMAT total (r=.901, P>0.01) was evident. Conclusions: Based on the information gathered through this prospective exploratory study, athletes and athletic trainers report similar scores regarding adherence to sport injury rehabilitation over the course of a three-week period. Athletic trainers are in a special position in being able to work with athletes daily in the athletic training room. In order to have optimal return to play outcomes, athletes must be adherent to the sport injury rehabilitation protocol, which is prescribed by the athletic trainer.