A Multidisciplinary Study of the ‘Yips’ Phenomenon in Golf
A Multidisciplinary Study of the ‘Yips’ Phenomenon in Golf
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高尔夫“Yips”现象的多学科研究
作者：
Aynsley M. Smith;S. Malo;E. Laskowski;M. Sabick;W. P. I. Cooney;S. Finnie;D. Crews;Joseph J. Eischen;I. Hay;Nicole Detling;K. Kaufman
摘要背景：“yips”是一种影响高尔夫推杆动作的心理神经肌肉障碍。在高尔夫锦标赛期间，抽搐、震颤和冻结等Yips症状经常发生，并可能导致性能问题。在高焦虑和低焦虑的推杆条件下，易普斯影响的高尔夫球手在18洞高尔夫球的成绩中增加了大约4.7杆，并且比未受影响的高尔夫球手有更多的前臂肌电图活动和更高的竞争焦虑。易激综合征的病因尚不清楚。
目的：确定易激综合征是否是一种因焦虑而加剧的神经问题，或者这种行为是否由焦虑引发并导致永久性神经肌肉障碍。
研究方法：在第一阶段，高尔夫专业人士协助调查人员制定了一份yips问卷，该问卷被发送给锦标赛球员（<12差点），以确定yips的患病率和特征。第二阶段测量的是在导致yips反应的情景中的投放行为。四个自我报告的yips和3个未受影响的高尔夫球手使用未矫正的抓地力和标准长度推杆的103个场景。心率被叠加在录像带上，推杆握杆时用应变仪测量握杆力。肌电图和相对推杆性能也进行了测量。
结果：问卷被发送到2630锦标赛球员，其中1031（39%）回答（986名男性和45名女性）。其中，541人（52%）认为他们经历了yips，而490人（48%）没有。yips影响的高尔夫球手报告说，最麻烦的推杆是3，4和2英尺（0.9，1.2和0.6米）的洞。快速，下坡，从左到右的突破推杆和比赛也引起了yips反应。与未受影响的高尔夫球手相比，受yips影响的高尔夫球手平均心率更快，肌电图活动模式增加，握力更大，推杆表现更差。
结论：对于<10差点的男球手和<12差点的女球手，易激综合征的患病率在32.5%~ 47.7%之间，在认真的球手中比例很高。如此高的患病率表明，医生需要了解yips现象的病因，以便确定干预措施，并测试其缓解症状的有效性。虽然以前的研究者认为易激综合征是一种神经肌肉障碍，但不是由焦虑引起的，我们认为易激综合征代表了一个连续体，其中“窒息”（焦虑相关）和肌张力障碍症状锚的极端。病因很可能是心理神经肌肉影响的相互作用。未来的研究将测试药物如β受体阻滞剂的作用，这将有助于更好地确定这些因素对yips现象的贡献。
AbstractBackground: The ‘yips’ is a psychoneuromuscular impediment affecting execution of the putting stroke in golf. Yips symptoms of jerks, tremors and freezing often occur during tournament golf and may cause performance problems. Yips-affected golfers add approximately 4.7 strokes to their scores for 18 holes of golf, and have more forearm electromyogram activity and higher competitive anxiety than nonaffected golfers in both high and low anxiety putting conditions. The aetiology of the yips is not clear.
Objective: To determine whether the yips is a neurological problem exacerbated by anxiety, or whether the behaviour is initiated by anxiety and results in a permanent neuromuscular impediment.
Methods: In phase I, golf professionals assisted investigators in developing a yips questionnaire that was sent to tournament players (<12 handicap) to establish the prevalence and characteristics of the yips. Phase II measured putting behaviour in scenarios that contribute to the yips response. Four self-reported yips and 3 nonaffected golfers putted 3 scenarios using an uncorrected grip and a standard length putter. Heart rate was superimposed on the videotape and the putter grip was instrumented with strain gauges to measure grip force. Electromyograms and relative putting performance were also measured.
Results: The questionnaire was sent to 2630 tournament players, of whom 1031 (39%) responded (986 men and 45 women). Of these, 541 (52%) perceived they experienced the yips compared with 490 (48%) who did not.Yips-affected golfers reported that the most troublesome putts were 3, 4 and 2 feet (0.9, 1.2 and 0.6 metres) from the hole. Fast, downhill, left-to-right breaking putts and tournament play also elicited the yips response. Golfers affected by the yips had a faster mean heart rate, increased electromyogram activity patterns and exerted more grip force than nonaffected golfers and had a poorer putting performance.
Conclusions: For <10 handicap male golfers and <12 handicap female golfers, the prevalence of the yips is between 32.5% and 47.7%, a high proportion of serious golfers. This high prevalence suggests that medical practitioners need to understand the aetiology of the yips phenomenon so that interventions can be identified and tested for effectiveness in alleviating symptoms. Although previous investigators concluded that the yips is a neuromuscular impediment aggravated but not caused by anxiety, we believe the yips represents a continuum on which ‘choking’ (anxiety-related) and dystonia symptoms anchor the extremes. The aetiology may well be an interaction of psychoneuromuscular influences. Future research to test the effect of medications such as β-blockers should assist in better identifying the contributions these factors make to the yips phenomenon.