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Updated: May 28, 2026

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
From Slump to Comeback: Psychological Determinants of Performance Decline, Burnout, and Recovery in Competitive
Yajuvendra Singh Rajpoot1, Prashant Kumar Choudhary2, Suchishrava Choudhary2
1Department of Sports Management & Coaching, Lakshmibai National Institute of Physical Education, Gwalior 474002, India.
Background:
Psychological determinants are increasingly recognized as central contributors to both performance decline and recovery in competitive sport; however, contemporary evidence integrating injury-related and non-injury performance contexts remains fragmented.
Objective:
This systematic review synthesized empirical evidence (2016-2025) examining psychological determinants associated with return to sport (RTS), reinjury risk, burnout, injury incidence, and performance decline among competitive athletes.
Methods:
Conducted in accordance with PRISMA 2020 guidelines, a systematic search of PubMed, Scopus, Web of Science, and SPORTDiscus identified peer-reviewed studies published between January 2016 and December 2025. Eligibility criteria were defined using a PICO framework. Prospective cohort studies, longitudinal multi-wave investigations, one randomized controlled trial, matched cohort studies, diary-based designs, and injury-related observational studies were included. Due to heterogeneity in constructs and outcomes, findings were synthesized narratively.
Results:
Fourteen studies met the inclusion criteria, including prospective cohort studies, multi-wave longitudinal designs, one randomized controlled trial, one matched cohort study, and a diary-based investigation. Seven independent cohorts examined psychological readiness using the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI) in athletes with anterior cruciate ligament (ACL) injuries (sample sizes ranging from n = 39 to n = 384), consistently demonstrating that higher readiness predicted successful RTS at 6-24 months, while two prospective studies reported contrasting associations with second ACL injury risk. Four longitudinal studies (n = 93-491) showed that increased burnout and controlled motivation predicted performance decline and dropout trajectories, whereas higher resilience and mental toughness reduced burnout progression. One seasonal longitudinal study (n = 21) linked elevated cognitive anxiety and mood disturbance to increased injury incidence.
Conclusion:
Psychological determinants operate across deterioration and restoration pathways. Psychological readiness shows the strongest predictive consistency for RTS, while burnout, motivational climate, and resilience significantly shape long-term performance sustainability and injury-related outcomes.
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