Abstract
Background
Injury is an inevitable component of competitive football and has a significant influence on the psychological and physical well-being of the athletes. Psychological readiness to return to sport following injury is a multidimensional construct encompassing emotional, cognitive and contextual factors that influence an athlete's transition back to training and competition.
Objective
This study aims to evaluate the level and multidimensional structure of psychological readiness to return to sport in elite female football players using the Psychological Readiness of Injured Athletes to Return to Sport (PRIA-RS) questionnaire.
Methods
A cross-sectional questionnaire-based study was conducted, which included 84 elite and semi-professional female football players who were undergoing the final stages of rehabilitation or preparing to return to full training post a sports-related injury. The psychological readiness of these athletes was assessed using the PRIA-RS instrument. Descriptive statistics and exploratory factor analysis (EFA) were performed to identify the underlying psychological dimensions associated with the return-to-sport readiness.
Results
Most athletes reported positive perceptions of rehabilitation progress, mood, functional recovery, and overall readiness to return to training. Approximately 64.3% of the respondents rated rehabilitation progression as “very good,” while 70.2% reported having a very positive attitude at the end of rehabilitation. However, a substantial proportion reported anxiety (29.8%) and uncertainty risk towards a reinjury (23.8%) related to returning to sport. Exploratory factor analysis identified four components explaining 61.2% of total variance, representing emotional confidence, fear and anxiety, perceived functional safety, and external pressure.
Conclusion
Elite female football players generally report a high level of psychological readiness to return to sport following an injury, although anxiety and fear of reinjury remain prevalent in a meaningful portion of the athletes. Inclusion of psychological tools such as PRIA-RS into return-to-sport decision-making alongside physical rehabilitation provides the necessary psychological support to the athletes before them to return to full training and competition. The findings support the importance of evaluating psychological readiness as a multidimensional construct alongside physical recovery when making return to sport decisions.
Keywords: Women’s football, Psychological readiness, PRIA-RS, Return to sports, Sports injury
Introduction
Football is a physically demanding sport that is characterised by high-intensity movements, which places the athletes at a considerable risk of musculoskeletal injury [7]. Injury incidence rates in elite football have an estimated range of 6 to 9 injuries per 1000 exposure hours [14]. In particular, female football players demonstrate higher risks of specific injuries, which contribute substantially to the overall injury burden in the sport [12].
Over the years, increased competitiveness has been found in women's football, accompanied by higher training intensity, and increased professionalisation of the sport [20]. These developments have contributed to the expansion of the risks of injury among female athletes. Injuries not only have a physical impact on an athlete but can also negatively affect psychological well-being. There has been a clear demonstration of how injuries due to sports are associated with psychological responses of anxiety, reduced confidence, emotional distress, fear of re-injury and frustration in an athlete [1, 3, 25]. Psychologically, the responses of an athlete towards a sports injury include anxiety, fear of reinjury, emotional distress and fluctuation in confidence. These responses evolve dynamically through the process of rehabilitation,while anxiety and fear may increase as return to sport approaches, confidence is expected to improve during the later stages of rehabilitation [10]. Therefore, returning to sports should not be conceptualised solely as a physical milestone but as a multidimensional process that encompasses physical, and psychological.
The return-to-sport decision is one of the most critical and challenging stages of injury management. Premature return to training or competition has been known to be associated with an increased risk of re-injury and prolonged absence, leading to compromised long-term performance [3]. Injury rates remain high in football, with a high probability of recurrent injury resulting in longer absence from the sport and greater functional impairment than initial injuries [10, 22]. Historically, physical criteria of an injury have been given more weightage by routine assessments rather than psychological readiness within the return-to-sport protocols [17].
Psychological readiness to return to sport has been identified as “the athlete’s perceived confidence, emotional state, absence of fear, and belief in their ability to perform sport-specific tasks safely and effectively following injury [18].” It has been suggested that athletes who return to sports with unresolved psychological concerns are prone to avoid high-risk action during a game, experience performance decrements, and adopt maladaptive movement strategies, all these leading to an increase in susceptibility to reinjury [21].
To assess the psychological readiness of an athlete who is rejoining sports, a number of tools and assessment instruments have been developed. The most used assessments are Injury-Psychological Readiness to Return to Sport (I-PRRS), the Re-Injury Anxiety Inventory (RIAI), and injury-specific scales such as the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI). While these instruments provide valuable insights into injury-related psychological response. They differ in scope in their scope and application. Injury-specific tools focus primarily on confidence, emotion and risk appraisal related to a particular injury type.
On the contrary, Psychological Readiness of Injured Athletes to Return to Sport (PRIA-RS) was developed to capture psychological readiness across multiple dimensions that are relevant to football participation, including emotional state, functional safety, perceived reinjury and external pressure. This multidimensional structure, that are considered by the PRIA-RS, makes it suitable for examining overall psychological readiness during the return to sport phase rather than injury-specific psychological assessment [10].
The psychological challenge experienced by a female athlete during and post an injury is unique. These challenges are influenced by several factors, which include the pattern of injury, support during and after injury, expectations in respect of socio-cultural norms and availability of resources to deal with the injury [19]. Researchers must understand the impact of these psychological factors specifically for female football athletes to equip themselves in developing rehabilitation strategies that are catered more specifically to diverse gender needs [20].
Despite an increase in recognition of the psychological aspect of return to sport post an injury, there is limited research which addresses the situation specifically for elite football players. The majority of the existing studies either examine mixed-sport populations or emphasise the outcomes of physical rehabilitation, with limited focus on psychological readiness. In addition, most of the studies commonly use injury-specific tools for psychological assessments, which are unable to gauge the multidimensional psychological factors that influence the readiness of an athlete after an injury towards returning to training and competition.
Therefore, this study aimed to evaluate psychological readiness to return to sport in elite female football players during the final stages of rehabilitation using the PRIA-RS questionnaire. The Study specifically sought to examine an athlete's perception towards the rehabilitation progress, confidence in physical condition, external pressure to return to sporting activities, emotional state, and perceived risk of reinjury. Athletes who had fully returned to unrestricted training or competitive match play at the time of data collection were not included. It was hypothesised that athletes would report generally high perceived readiness to return to sport, while a meaningful proportion would still report anxiety and fear of reinjury.
Materials and methods
Research design
A cross-sectional questionnaire-based study was conducted to assess psychological readiness to return to sport in female football players in the final phase of rehabilitation. This technique is based upon a descriptive research design that has the ability to assess the psychological readiness of women footballers to return to sports after experiencing an injury [4]. The research employs a standardised self-report questionnaire to collect the data. The questionnaire was administered to a set of respondents during their final phase of rehabilitation. The application of quantitative research techniques allows for the quantification of the data and generates results that are mathematical and free from biases, whereas the descriptive approach allows for effective description of the results and focuses on describing the data rather than just stating it [6].
Ethical permission and informed consents
To conduct the study, a research permit was provided by the “Ethics Commission of the Chamber of Physiotherapy in Kosovo,” Prishtina, Kosovo (date 24.08.2021; number: 38/21) before the commencement of data collection. The study process was designed based on local and international guidelines for a good scientific approach, data protection standards, and Helsinki Declaration on Human Experiments.
Before participation, all the athletes were informed about the purpose of the study with a clear explanation of the procedure involved, potential risks and benefits of participation and their right to withdraw. All participants were required to submit a written informed consent prior to the study and were assured about the confidentiality and anonymity of the data as per established data protection laws.
Participants
Responses were collected from 84 individual athletes who represented multiple football clubs at levels of elite and semi-professional players of various organised women’s football leagues in Kosovo. The research ensured that all athletes participating in the questionnaire were actively registered at the time of injury and rehabilitation. The inclusion and exclusion criteria of the study are given in Table 1 below.
Table 1.
Participants’ inclusion and exclusion criteria
| Inclusion Criteria | Exclusion Criteria |
|---|---|
| Age between 18 and 35 years | Presence of chronic or unresolved injuries |
| Part of an elite or semi-professional women's football club | Ongoing medical conditions preventing return to football participation |
| History of a significant sport-related injury resulting in time loss from training or competition within the previous six months | Incomplete rehabilitation or inability to resume training activities |
| Completion of a structured rehabilitation program or imminent clearance for return to full training | Lack of informed consent |
Instrument
Psychological readiness was assessed by using the PRIA-RS questionnaire. The questionnaire consists of 10-line items, which are there to be analysed as a self-reporting tool. These questions are designed to evaluate the psychological readiness of an athlete who is recovering from an injury that occurred during a sporting event. Each line item in the questionnaire is rated on a “Likert-type scale” reflecting the athlete’s perceptions towards recovery from the injury and readiness to play again. The multiple psychological dimensions that are considered and assessed by the PRIA-RS are: Perceived Progress during rehabilitation; Emotional state and mood; Confidence in physical condition for returning to training: Functional perception of the injury; Perceived safety during specific movements; Presence of discomfort or limitations; Anxiety related to returning to training; Perceived likelihood of a reinjury; Perceived external pressure to return; Overall readiness for return to full training.
The PRIA-RS questionnaire allows for the assessment of psychological readiness across multiple domains rather than focusing solely on injury-specific psychological responses. The multidimensional structure of the instrument creates a reliable environment for the researchers to identify potential psychological barriers that may influence the decisions of the athletes in their perception towards their decision to return to sport.
Procedure
To determine the eligible participants based on the inclusion and exclusion criteria, the researcher collaborated with the medical team and rehabilitation staff. On selection of the participants, the PRIA-RS questionnaire was administered individually to all the participants. The participants were required to complete the questionnaire in a quiet, peaceful, and calm environment. This was followed by providing a peaceful environment that allowed the participant to think and evaluate the questions more deeply. Every participant who participated in the questionnaire was given a set of instructions that were clear to allow them to understand the questions clearly. The participation of every participant was ensured to be voluntary, and each of the participants was assured of the confidentiality of their identities and responses given by them. Participants completed the questionnaire individually and anonymously.
Data analysis
Data were analysed using IBM SPSS Statistics (v27) (IBM [11]. Descriptive statistics were calculated for all questionnaire items, which included means (continuous variables), frequencies, and percentages (categorical variables). This was done to summarise the characteristics of the study sample and the responses to the PRIA-RS questionnaire.
Exploratory factor analysis (EFA) using principal component analysis with varimax rotation was conducted to identify underlying psychological dimensions associated with return-to-sport readiness. The approach follows an identification of latent psychological constructs which explain the relationships between questionnaire items. Sampling adequacy was assessed using the Kaiser–Meyer–Olkin (KMO) measure, and the correlation matrix was assessed using Bartlett’s test of sphericity. Factors with eigenvalues > 1 were retained, and the items were interpreted based on their factor loading. Statistical significance for the analysis was set at p < 0.05.
Results
Anthropometric characteristics of the participants were collected to provide contextual information regarding the sample. The mean age of participants was 24.7 ± 3.9 years. Average height was 178.6 ± 6.4 cm, and mean body mass was 75.2 ± 7.8 kg. The mean body mass index (BMI) was 23.6 ± 1.9 kg/m2. These characteristics were consistent with profiles reported for elite women football players in previous literature.
Exploratory factor analysis
The Kaiser–Meyer–Olkin value was 0.595, indicating acceptable sampling adequacy for factor analysis. Exploratory factor analysis identified four components explaining 61.2% of the total variance as psychological constructs. These components represented emotional confidence, fear and anxiety, perceived functional safety, and perceived external pressure. The results of EFA further highlight that the psychological readiness of an athlete cannot be gauged through a single construct but is a combination of multidimensional phenomena, emphasising the importance of incorporating psychological assessment tools to enhance the recovery of injured women athletes.
The overall findings of the study indicate that the athletes reported a high level of psychologically readiness to return to sports in the final stages of their rehabilitation process. The majority of the athletes report a positive attitude towards their progress in rehabilitation, emotional well-being, functional recovery, and physical readiness. Though the results also indicate a subset of athletes who have residual psychological concerns, these concerns underscore the overall importance of addressing psychological factors alongside physical progress.
Perceived progress and emotional state
The overall indication from the responses to the questionnaire highlights a positive perception of the athletes towards the rehabilitation process. The participants report that during the rehabilitation process; they have a favourable perception towards their emotional state and overall readiness to return to the training. The findings are suggestive of the fact that the majority of athletes experience a more positive psychological trajectory during rehabilitation.
In alignment with the perception of progress, the athletes reported having a positive attitude towards their mood and emotional state. Most participants indicated stable emotional conditions, indicating the effectiveness of the rehabilitation process (Table 2).
Table 2.
Opinion according to the questionnaire (PRIA-RS)
| Very bad | Bad | Neither good nor bad | Good | Very good | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| N | % | N | % | N | % | N | % | N | % | |
| How do you evaluate the progression you have experienced during the rehabilitation/sport functional recovery period since your injury | 0 | 0.0% | 0 | 0.0% | 3 | 3.6% | 27 | 32.1% | 54 | 64.3% |
| How is your mood? | 0 | 0.0% | 0 | 0.0% | 2 | 2.4% | 23 | 27.4% | 59 | 70.2% |
| What is your physical state in view of a potential return to the team? | 0 | 0.0% | 0 | 0.0% | 7 | 8.3% | 31 | 36.9% | 46 | 54.8% |
| How do you evaluate the functional status of your damaged area? | 0 | 0.0% | 0 | 0.0% | 2 | 2.4% | 15 | 17.9% | 67 | 79.8% |
| How secure do you feel when performing physical actions or movements in the injured area? | 0 | 0.0% | 0 | 0.0% | 1 | 1.2% | 32 | 38.1% | 51 | 60.7% |
| How would you evaluate your overall condition in view of a potential return to full training? | 0 | 0.0% | 0 | 0.0% | 1 | 1.2% | 36 | 42.9% | 47 | 56.0% |
| Yes | Don’t know | No | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Do you feel any discomfort or limitations that prevent you from training as normal? | 0 | 0.0% | 23 | 27.4% | 61 | 72.6% | ||||
| Are you feeling nervous about returning to regular training with the team? | 25 | 29.8% | 20 | 23.8% | 39 | 46.4% | ||||
| 80–100% | 60–80% | 40–60% | 20–40% | 0–20% | ||||||
| Give an estimated percentage of how likely you are to experience a recurrence of the injury soon | 1 | 1.16% | 0 | 0.0% | 10 | 11.9% | 25 | 29.7% | 48 | 57.1% |
| Excessive | High | Normal | Low | None | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| What level of pressure do you feel in your surroundings to return to training with the team? | 0 | 0.0% | 13 | 15.5% | 21 | 25.0% | 13 | 15.5% | 37 | 44.0% |
Physical condition and functional perception
Participants reported high confidence in their physical condition and functional recovery. The responses indicated that the injured athletes felt physically prepared to resume sport-specific activities as they had confidence in the functional capacity of the injured area. Evaluation of the functional status of the injured area yielded particularly positive results similar to those of physical condition. These results suggest a high level of confidence in functional recovery among the majority of participants, as they typically regain confidence in movement patterns and sport-specific tasks (Table 3).
Table 3.
(PRIA-RS) Questionnaire description
| N | Minimum | Maximum | Mean | Std. Deviation | |
|---|---|---|---|---|---|
| How do you evaluate the progression you have experienced during the rehabilitation/sport functional recovery period since your injury | 84 | 3 | 5 | 4.6 | .560 |
| How is your mood? | 84 | 3 | 5 | 4.7 | .519 |
| What is your physical state in view of a potential return to the team? | 84 | 3 | 5 | 4.5 | .648 |
| How do you evaluate the functional status of your damaged area? | 84 | 3 | 5 | 4.8 | .475 |
| Do you feel any discomfort or limitations that prevent you from training as normal? | 84 | 3 | 5 | 4.5 | .897 |
| Are you feeling nervous about returning to regular training with the team? | 84 | 1 | 5 | 3.3 | 1.724 |
| How secure do you feel when performing physical actions or movements in the injured area? | 84 | 3 | 5 | 4.6 | .518 |
| Give an estimated percentage of how likely you are to experience a recurrence of the injury soon | 84 | 1 | 5 | 4.4 | .795 |
| What level of pressure do you feel in your surroundings to return to training with the team? | 84 | 2 | 5 | 3.9 | 1.145 |
| How would you evaluate your overall condition in view of a potential return to full training? | 84 | 3 | 5 | 4.5 | .524 |
| Valid N (listwise) | 84 |
Perceived safety and discomfort
Perceived safety during sport-specific movements was rated positively by most participants. However, a subset of athletes reported uncertainty regarding discomfort during training. In contrast to the results of perceived safety, the perceptions of discomfort during participation in the sporting activity revealed greater variability. Although no participants explicitly reported significant discomfort that would harm their training their was a section of athletes who still experienced residual apprehension regarding the physical consequences of returning to sport (Table 3).
Anxiety, fear of reinjury and perceived pressure
A notable proportion of athletes reported anxiety related to returning to team training. Anxiety related to returning to regular team training was reported by a subset of players. A substantial number of respondents reported “no nervousness” in respect to returning to training, while only limited responses were indicative of “felt nervous” regarding returning to training.
Similarly, perceptions regarding the likelihood of reinjury varied among athletes, with a meaningful proportion reporting moderate to high perceived reinjury risk, while almost all of the athletes perceived the risk of reinjury as low.
The observations of the results indicate that psychological readiness to return to sport is not solely determined by the physical readiness of an athlete but is also influenced by the emotional and cognitive factors experienced by the individual during the rehabilitation process of an injury (Table 3).
Discussions
The present study aimed to evaluate the psychological readiness of elite women football players who were to return to sports. Overall, the findings suggest that most of the athletes report a high level of perceived readiness, positive emotional states, and high confidence in physical and functional recovery. The results obtained support the findings that emphasise the importance of psychological recovery, along with the importance of physical rehabilitation for injured football athletes, aligning with previous research findings [8]. Having a structured rehabilitation program has a substantial contribution in a positive manner to not only physical recovery but also the psychological well-being of patients, thus providing a holistic environment for the athlete to recover in full [23].
However, despite having a generally positive attitude towards readiness perception, one-third of the participants complained of feeling nervous when asked to return to play. The observations of the results shed light on the psychological concerns that might even persist after it is assumed that an athlete has achieved complete physical recovery. These observations of the findings are in agreement with those of [3], which also state that athletes often perceive they are physically and mentally fit,however, at the time of reintroduction to the sport, they become sub-consciously anxious, thus revealing a deep insight into the mentality of an athlete.
These observations are validated by the findings, as they depict that athletes do have a fear of re-injuring themselves. Though they perceive the risk of a reinjury as quite low, the fear of an injury occurring again or the same injury being repeated is high within the population surveyed. This perception of cautious behaviour to protect themselves from a reinjury is coined as “Avoidance Behaviour” as described by [15]. Athletes experiencing fear of re-injury may adopt protective movement patterns, avoiding high-risk actions or demonstrating reduced competitive engagement as observed by [9]. This ultimately results in impairment of their performance and increases the likelihood of reinjury. Consequently, psychological readiness should be considered as a critical component of rehabilitation programmes to prepare the athletes to re-enter sporting activities.
Another notable aspect that emerged from gathering the participants' perceptions is the role of social and environmental influences during rehabilitation. The majority of the athletes surveyed perceive low external pressure when it comes to them rejoining football, whereas some of the participants reported expectations from the sporting environment. These findings are in alignment with the integrated model of response to sport injury proposed [25], and psychological response due to sports injury presented by [5]. The athletes expect implicit or explicit behaviour from the various individuals, which may or may not include teammates, organisations, or coaches, thus resulting in influencing their perceptions towards experiencing external pressure in determining their psychological readiness in return to the sport. Previous research has suggested that external pressure can contribute to premature return to sport, increasing the risk of reinjury as the athletes have not achieved complete physical and psychological recovery [18]. Consequently, sport medical practitioners need to be aware of the potential influence that social and environmental factors have on an injured athlete when evaluating their potential readiness to return to sport [24].
The analysis conducted through the exploratory factor techniques provides the underlining towards the impoirtance of a multidimensional psychological analysis in order to understand the psychology of the athletes. It highlights the essentiality of considering various factors to determine the psychological readiness, which would influence the behaviour of an athlete once she rejoins playing football post an injury.
The EFA indicates that multiple psychological components underlie the psychology of athletes, which influences their perceived behaviour while returning to sports [14]. The multidimensional nature of psychology supports the conceptual framework of PRIA-RS and highlights the importance of integrating psychological assessment as a core component of the rehabilitation of injured athletes. The exploratory factor analysis supports the multidimensional nature of psychological readiness within this sample. However, the present findings do not allow for conclusions regarding the criterion or predictive validity of PRIA-RS, which needs to be examined in future longitudinal studies.
The perceptions expressed by the injured athletes provide valuable insight into the psychological dimensions of the rehabilitation process. Overall, it was observed that participants reported a general positive perception regarding their progress, emotional state, and physical readiness to return to sport. The observations align with previous studies, which suggest that athletes experience improved confidence and emotional stability when reaching the final stage of rehabilitation [8, 16].
However, these perceptions do not necessarily indicate complete psychological readiness. A portion of the athletes reported uncertainty and anxiety towards returning to full team training [3] and Kurz et al., 2025 demonstrate that even after meeting physical criteria, athletes may still experience psychological barriers. Such psychological barrier factors may influence athletes' movement behaviour and decision-making when returning to competition [2, 13].
Taken together, the personal perspectives of the athletes reinforce the argument that return-to-sport readiness should be understood as a multidimensional process involving physical recovery, psychological confidence, and social context. Integrating psychological assessment tools such as the PRIA-RS questionnaire within rehabilitation protocols may therefore help clinicians identify athletes who require additional psychological support before returning to full training or competition.
Practical implications
The study lays emphasis on the importance of integrating psychological assessment with the readiness of an athlete to return to sports. The application of routine psychological assessment through screening tools, as demonstrated in the study, would prove to be an assistance to medical staff, physiotherapists, and coaching staff to identify athletes who require additional support before returning to full-time training. Further, the integration of psychological assessment and physical rehabilitation tools enables improving decision-making, reduces the risk of reinjury and supports long-term athletic and personal well-being.
Strengths and limitations
The study provides a novel insight towards the psychological readiness of a women's football athlete to return to sport after encountering an injury by using a sport-specific assessment tool. The study shows strength in the ability to undertake a multidimensional evaluation of psychological factors and present a relationship between these factors. Additionally, the focus of the study to examine an underresearched sporting population (Elite Women Football Players) makes a valuable contribution towards the existing literature on women's psychological wellbeing and injury rehabilitation.
The limitations of the study also needed to be acknowledged along with its strengths. The cross-sectional design of the study limits the establishment of causal relationships that exist between the psychological readiness of an athlete and their successful return to sport outcomes. Further, the study may suffer from response biases that are due to self-reported questionnaires. Furthermore, the study lacks generalisability due to a limited population size from a specific geographical location, and the cross-sectional design limits the ability to capture the dynamic and evolving nature of psychological readiness across different rehabilitation stages.
Future research
Future research related to the current study should examine the longitudinal changes of psychological readiness throughout the rehabilitation process. This would allow us to understand how the psychological readiness evolves along with the progress made by the injured player and may provide valuable insight into relationships between psychological recovery and physical rehabilitation. Additionally, further studies can investigate the multinational population of elite women football players and understand whether contextual or cultural factors have an influence on the psychological readiness.
Conclusion
This study demonstrates that elite female football players generally report high levels of psychological readiness to return to sport during the final stages of rehabilitation. However, anxiety and fear of reinjury remain present in a substantial proportion of athletes. The findings highlight the importance of integrating psychological assessment into return-to-sport decision-making alongside physical rehabilitation. The application of multidimensional assessment tools such as the PRIA-RS questionnaire can support sports medicine professionals in the identification of athletes who require additional psycological report before returning to full training and competition.
Acknowledgements
We express our gratitude to all athletes from the premier clubs of the women’s soccer league in Kosovo who consented to partake in this research. We really value the contributions of the medical and technical professionals for their aid in conducting this research.
Abbreviations
- PRIA-RS
Psychological Readiness of Injured Athletes to Return to Sport
- EFA
Exploratory factor analysis
- I-PRRS
Injury-Psychological Readiness to Return to Sport
- RIAI
Re-Injury Anxiety Inventory
- ACL-RSI
Anterior Cruciate Ligament - Return to Sport after Injury
- KMO:
Kaiser–Meyer–Olkin
Authors’ contributions
F.G. and I.SH. conceptualized and designed the study; F.G. and Zh. D. collected the data; F.G., and Zh.D. analysed and interpreted the data; F.G., and B.H. drafted the manuscript; F.G., and T.K. wrote, reviewed, and edited the manuscript; T.K. supervised the process. All authors read and approved the final manuscript.
Funding
None.
Data availability
The corresponding author can provide the data described in this study upon request.
Declarations
Ethics approval and consent to participate
To conduct the study, a research permit was provided by the “Ethics Commission of the Chamber of Physiotherapy in Kosovo,” Prishtina, Kosovo (date 24.08.2021; number: 38/21) before the commencement of data collection. The study process was designed based on local and international guidelines for a good scientific approach, data protection standards, and Helsinki Declaration on Human Experiments. Before participation, all the athletes were informed about the purpose of the study with a clear explanation of the procedure involved, potential risks and benefits of participation, and their right to withdraw. All participants were required to submit a written informed consent prior to the study and were assured about the confidentiality and anonymity of the data as per established data protection laws.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The corresponding author can provide the data described in this study upon request.