This review describes the psychosocial factors that affect recovery following anterior cruciate ligament (ACL) injury and reconstructive surgery in athletes. A systematic search in literature with inclusion and exclusion criteria on PubMed, PsycINFO, and Embase was performed. Articles used in this review were divided in five different parts according to the biopsychosocial model of Wiese-Bjornstal, with the addition of intervention studies. The results showed that a high internal Health Locus of Control and a high self-efficacy were useful cognitive factors to facilitate the recovery. Athletes with a low level of fear of reinjury had the best knee outcome after the injury followed by a reconstruction. In addition, athletes who returned to sport had less fear of reinjury and were more experienced and established athletes compared with athletes who did not return to sport. Furthermore, researchers showed that there was a positive relation between goal setting and adherence, which in turn yielded a positive relation with the outcome of the rehabilitation of an ACL injury. There were several psychosocial interventions that appeared to be facilitating the rehabilitation process.
95% CI 1.03e1.71), percent fat OR 1.45 (95% CI 1.19e1.77), fat mass OR 1.23 (95% CI 1.05e1.44). For women the ORs were -BMI OR 1.39 (95% CI 1.22e1.59), waist OR 1.36 (95% CI 1.22e1.52), waist-to-hip ratio OR 1.49 (95% CI 1.21e1.84), percent fat (10%) OR 1.39 (95% CI 1.22e1.57), fat mass OR 1.27 (95% CI 1.15e1.40). Similarly all obesity measures and fat mass measures were associated with LBP disability. The risk of LBP intensity and disability increased in a linear manner in sex-specific quartiles of all obesity measures and fat mass measures such that the individuals in the highest quartile had the highest risk of developing LBP.Conclusions: This study is the first large-scale prospective populationbased cohort study that addresses the association between fat mass with symptomatic LBP. The association was more noticeable among those who had the severest form of disease and there was a tendency of increasing the odds of association in the highest quartiles of fat mass measures. Our study can therefore be viewed as one of the first steps to unravel the link that, apart from loading; chronic inflammatory and atherosclerotic processes play an important role in the pathogenesis of the disease. Understanding this mechanism is important as this will shed light into therapeutic strategies for the prevention of the devastating burden of LBP.
ASSOCIATION BETWEEN RADIOGRAPHIC SEVERITY AND PAIN IN KNEE OSTEOARTHRITIS
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