{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:13:46Z","timestamp":1778562826346,"version":"3.51.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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\u2019s exact test, Student\u2019s\n                      <jats:italic>t<\/jats:italic>\n                      -test, and Mann\u2013Whitney U test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.419). However, behavioral change was associated with both a lower injury rate (Not-behavioral group: 22.7%, Behavioral group: 4.9%,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05) and significantly greater functional improvement in the lower extremities. Awareness and behavioral change were significantly correlated (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1816142","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:32:40Z","timestamp":1778560360000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From awareness to action: behavioral change is associated with functional gains and injury reduction in elite runners\u2014a prospective observational study"],"prefix":"10.3389","volume":"17","author":[{"given":"Koji","family":"Murofushi","sequence":"first","affiliation":[{"name":"GENTEN Research Center, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sho","family":"Mitomo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Yamada","sequence":"additional","affiliation":[{"name":"Sports and Health Sciences, Graduate School of Biomedical Engineering, Tohoku University","place":["Sendai, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Hirohata","sequence":"additional","affiliation":[{"name":"Clinical Center for Sports Medicine and Sports Dentistry, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetaka","family":"Furuya","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Sonoda Third Hospital","place":["Tokyo, Japan"]},{"name":"Tokyo Medical Institute Tokyo Spine Center","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Katagiri","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Dokkyo Medical University Saitama Medical Center","place":["Saitama, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Akuzawa","sequence":"additional","affiliation":[{"name":"GENTEN Research Center, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Hara","sequence":"additional","affiliation":[{"name":"School of Global Studies and Collaboration, Aoyama Gakuin University","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Ito","sequence":"additional","affiliation":[{"name":"School of Global Studies and Collaboration, Aoyama Gakuin University","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiro","family":"Ohmi","sequence":"additional","affiliation":[{"name":"GENTEN Research Center, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Kaneoka","sequence":"additional","affiliation":[{"name":"Faculty of Sport Sciences, Waseda University","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1136\/bjsports-2016-096849","article-title":"Epidemiology of injuries in judo: a cross-sectional survey of severe injuries based on time loss and reduction in sporting level.","volume":"52","author":"Akoto","year":"2018","journal-title":"Br. 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