Rehabilitative Imagery and Placebo Responding: An Objective Measure of Expectancy Effects
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Mental imagery has been used extensively in the context of sport, in particular, as a perforn1ance enhancement technique. More recently, it has been adapted into the rehabilitation aspect of sport in which it becomes an intervention alongside of a physical rehabilitation program. This allows the therapist to address the athlete's psychological state and has shown to decrease anxiety among athletes returning to practice and competition. Additionally, imagery interventions can increase rehabilitation time and capacity, when compared with athletes receiving physical treatments alone. However, the extent to which expectancy effects have an influence, whereby the confidence of the therapist that the imagery intervention will have this positive effect is in question. In these instances, it is useful to differentiate the mechanisms accounting for imagery effectiveness in rehabilitation and whether these effects are in part a placebo response. It was therefore the aim of the proposed study to examine these effects under the conditions of a positive suggestion, including a suggestive therapist and material detailing the benefits of imagery training, versus a neutral therapist and no subsequent information on imagery use in rehabilitation. These two conditions were examined in three kinds of rehabilitative imagery: healing, mastery, and injury-specific. All participants, except the control, received an imagery program in addition to a four week physical therapy program. Placebo responses were measured and compared with treatment responses at the conclusion of the study among groups as a function of success in objective, physical rehabilitation markers including an ankle function, stability, and balance tests.