What question did this study set out to answer?

This research aims to examine the relationship between body awareness, behavioral changes, injury incidence, and functional recovery in elite runners.

May 16, 2026Frontiers in Psychology0 citationsOpen Access

From awareness to action: behavioral change is associated with functional gains and injury reduction in elite runners—a prospective observational study

KMKoji MurofushiShanghai Institute for Science of Science SMSho MitomoTokyo Medical and Dental University YYYosuke YamadaTohoku University

Puntos clave

This research aims to examine the relationship between body awareness, behavioral changes, injury incidence, and functional recovery in elite runners.
Eighty male collegiate runners participated in a 6-month observational study.
Participants completed the Koji Awareness self-screening test, with 63 runners providing pre- and post-season data.
Injury rates were tracked, and analyses were performed using Fisher’s exact test, Student’s t-test, and Mann–Whitney U test.
88.9% of athletes reported increased awareness; 65.1% reported behavioral changes.
Behavioral change correlated with lower injury rates (4.9% in the Behavioral group vs. 22.7% in the Not-behavioral group, p < 0.05).
Increased awareness and behavioral change were significantly correlated (p < 0.05).

Resumen

Background Running-related injuries (RRIs) are a major concern among long-distance athletes. Although body awareness is important for injury prevention, the interplay between awareness, behavioral changes, and functional outcomes has not been fully examined. Objective To investigate how body awareness and behavioral changes, measured through the Koji Awareness (KA) self-screening system, are associated with injury incidence and functional recovery across a competitive season. Methods Eighty male collegiate runners from a single collegiate team participated in this study, and 63 runners completed the KA test before and after the season. The incidence of injury was tracked over 6 months. Participants were categorized into groups based on retrospective post-season self-report questionnaires assessing awareness and implementation of behavioral changes. Group differences in KA scores and injury incidence were analyzed using the Fisher’s exact test, Student’s t -test, and Mann–Whitney U test. Results Among the 63 included athletes, 88.9% reported increased awareness, and 65.1% reported behavioral changes. Awareness alone was not significantly associated with the incidence of RRIs (Not-awareness group: 0%, Awareness group: 12.5%, p = 0.419). However, behavioral change was associated with both a lower injury rate (Not-behavioral group: 22.7%, Behavioral group: 4.9%, p 0.05) and significantly greater functional improvement in the lower extremities. Awareness and behavioral change were significantly correlated ( p 0.05). Conclusion Although awareness alone was not significantly associated with injury incidence, it was linked to improved function and a greater likelihood of behavioral change. Given the observational design, self-reported measures, and the small number of injury events, these findings should be interpreted cautiously. Nevertheless, when body awareness is accompanied by active behavior modification, it may be relevant to injury-related outcomes. The KA screening test may serve not only as a functional assessment tool but also as a potential framework for self-regulation and resilience in performance.

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