ACL injuries: the secret probably lies in optimising rehabilitation

Culvenor, Adam G; Barton, Christian J

doi:10.1136/bjsports-2017-098872

Cited by 19 publications

(19 citation statements)

References 9 publications

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“…Participation in ACL rehabilitation is considered critical to facilitate return to sport [14,51,88]. In this scoping review, 71 articles relating to adherence and participation in ACL rehabilitation published between 1997 and 2019 were identified.…”

Section: Discussionmentioning

confidence: 99%

“…Despite significant advances in surgical technique, the outcomes following ACL reconstruction continue to be reported as poor [7]. Research demonstrates that only 55% of patients who undergo ACL reconstruction make a return to competitive sport [8], and between 15 and 23% of young athletes will suffer a re-rupture or injure the contralateral knee [9].…”

Section: Introductionmentioning

confidence: 99%

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The Influence, Barriers to and Facilitators of Anterior Cruciate Ligament Rehabilitation Adherence and Participation: a Scoping Review

2020

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Background: Outcomes following anterior cruciate ligament (ACL) reconstruction are considered poor. There are many factors which may influence patient outcomes. As such, the purpose of this review was to report on the influence, barriers to and facilitators of rehabilitation adherence and participation after ACL reconstruction, providing information to help clinicians and patients make quality decisions to facilitate successful rehabilitation. Methods: A systematic search of five electronic databases was undertaken in identifying studies from inception to 18 July 2019. The search included English language articles reporting on the influence, barriers to and facilitators of adherence and participation in rehabilitation of patients who have undergone ACL reconstruction. Data extraction and synthesis of included studies were undertaken. Results: Full text articles (n = 180) were assessed for eligibility following screening of titles and abstracts (n = 1967), yielding 71 studies for inclusion. Forty-four articles investigated 'rehabilitation prescription and participation' and 36 articles investigated 'rehabilitation barriers and facilitators'. The results indicate that a moderately or minimally supervised rehabilitation program is at least as effective as a fully supervised high-frequency rehabilitation program, although a longer duration of supervised rehabilitation is associated with improvement in a multitude of functional outcomes. A number of psychological factors associated with rehabilitation adherence were also identified. The most commonly investigated concepts were self-motivation, athletic identity and social support. Patients perceived the therapeutic relationship, interaction with family and friends, self-motivation, fear of reinjury, organisation/lack of time and interpersonal comparison as the most common barriers to and facilitators of rehabilitation. Conclusions: A longer duration of supervised rehabilitation is associated with an increased chance of meeting functional and return to sport criteria; however, the optimal supervised rehabilitation frequency is yet to be determined. Identification of the barriers to and facilitators of adherence and participation in ACL rehabilitation provides an opportunity for further research to be conducted to address personal, environmental and treatmentrelated factors, with the aim to improve rehabilitation outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Influence, Barriers to and Facilitators of Anterior Cruciate Ligament Rehabilitation Adherence and Participation: a Scoping Review

2020

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“…Even when loss of function is restored and secondary injury is avoided, recent evidence indicates that successful return to pre-injury level of activity following ACL reconstruction (ACLR) is lower than formerly thought; approximately 35% of individuals suffering an ACL injury fail to return to previous activity levels [107,143,156]. The high re-injury rate and inability to restore functional capability indicates that current standards of care including ACLR and rehabilitation may not adequately address the deficits that may have preceded and/or propagated the initial injury [28,56,71,129]. Novel therapeutic methods are therefore warranted to reduce re-injury rates, increase return-to-play rates, and improve post-injury quality of activity, particularly in youth athletes who are most susceptible to primary and secondary injury [118,132,158].…”

Section: The Problem: Anterior Cruciate Ligament Injuries In Youthmentioning

confidence: 99%

Can We Capitalize on Central Nervous System Plasticity in Young Athletes to Inoculate Against Injury?

Diekfuss

Hogg

Grooms

et al. 2020

J. of SCI. IN SPORT AND EXERCISE

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There are numerous physical, social, and psychological benefits of exercise, sport and play for youth athletes. However, dynamic activities come with a risk of injury that has yet to be abated, warranting novel therapeutics to promote injuryresistance and to keep an active lifestyle throughout the lifespan. The purpose of the present manuscript was to summarize the extant literature and potential connecting framework regarding youth brain development and neuroplasticity associated with musculoskeletal injury. This review provides the foundation for our proposed framework that utilizes the OPTIMAL (Optimizing Performance Through Intrinsic Motivation and Attention for Learning) theory of motor learning to elicit desirable biomechanical adaptations to support injury prevention (injury risk reduction), rehabilitation strategies, and exercise performance for youth physical activity and play across all facets of sport (Prevention Rehabilitation Exercise Play; PREP). We conclude that both young male and females are ripe for OPTIMAL PREP strategies that promote desirable movement mechanics by leveraging a unique time window for which their heightened state of central nervous system plasticity is capable of enhanced adaptation through novel therapeutic interventions.

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“…50 %. Hier sind auch die Daten von Noyes et al [24] zu erwähnen, laut denen das Vorkommen einer Osteoarthritis nach VKB-Verletzungen zwischen 50 % und 90 % liegt [25] und bereits 1 Jahr nach dem Trauma erkannt werden kann [26]. Bei einer wiederholten Verletzung des VKB und einer Revision der Bandrekonstruktion ist der Knorpelschaden signifikant höher [27] [28].…”

Section: Hintergrund Und Prävalenzunclassified

Tests und Assessments für die Rehabilitation nach VKB-Rekonstruktion

Boger

Brem

2018

manuelletherapie

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ZusammenfassungDas primäre Ziel der Rehabilitation nach einer Rekonstruktion des vorderen Kreuzbands ist die Rückkehr zur Aktivität bzw. zum Sport. Daher scheint es umso wichtiger, eine Testbatterie nutzen zu können, die verlässliche Werte für die Wiederaufnahme von Training bzw. Sport generiert. Dafür sind standardisierte Tests und Assessments auf der Aktivitäts- und Partizipationsebene am aussagekräftigsten, bei denen die Durchführung, die Auswertung und die Interpretation vorgegeben sind.

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ACL injuries: the secret probably lies in optimising rehabilitation

Cited by 19 publications

References 9 publications

The Influence, Barriers to and Facilitators of Anterior Cruciate Ligament Rehabilitation Adherence and Participation: a Scoping Review

The Influence, Barriers to and Facilitators of Anterior Cruciate Ligament Rehabilitation Adherence and Participation: a Scoping Review

Can We Capitalize on Central Nervous System Plasticity in Young Athletes to Inoculate Against Injury?

Tests und Assessments für die Rehabilitation nach VKB-Rekonstruktion

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