Factors Associated With Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction Surgery

Webster, Kate E.; Nagelli, Christopher V.; Hewett, Timothy E.; Feller, Julian A.

doi:10.1177/0363546518773757

Cited by 185 publications

(196 citation statements)

References 36 publications

(57 reference statements)

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“…Also, psychological aspects are not taken into account. Recent studies have shown an influence of psychological parameters on performance and progress for return to sport [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Functional Knee Performance Differences in Handball are Depending on Playing Class

Rühlemann

Mayer

Haversath³

et al. 2020

Int J Sports Med

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Handball is one of the most traumatic sports. The knee is the most commonly injured joint. To prevent knee injuries, optimal functional knee stability is of great importance. Nevertheless, there is still no consensus about objective criteria for knee function. Depending on playing class, injury rates seem to differ. The purpose of this study was to evaluate knee function in handball depending on playing class and to establish reference data for functional knee stability. 261 handball players (25.1±5.8 years) performed a functional test including two- and one-legged stability assessments, jump tests, speed and agility analysis. Except for balance, differences between playing classes were detected in all tests with superior performance of high-class players (Germany’s 1st (“Oberliga”) and 2nd (“Verbandsliga”) non-elite playing class). High-class players achieved significant better results in jumping height (p≤0.011–0.029), relative power per body weight in the two-legged counter movement jump (p≤0.023) and speed and agility tests (p≤0.001). This study illustrates the relevance of playing class specific screening. Sports and playing class-specific databases will help to identify individual deficits and strengths in order to prevent injury and increase performance. Moreover, objective criteria for return to sports can be established.

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“…Also, psychological aspects are not taken into account. Recent studies have shown an influence of psychological parameters on performance and progress for return to sport [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Functional Knee Performance Differences in Handball are Depending on Playing Class

Rühlemann

Mayer

Haversath³

et al. 2020

Int J Sports Med

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“…The use of a psychometrically robust outcome measure of perceived knee function is crucial for clinicians and researchers alike. A patient's perceived knee function is associated with a number of recovery outcomes, including a fear of re-injury, 9 and a readiness to return to sport, 10 both of which have been identified as risk factors in failing to return to sport 4 and sustaining a second ACL injury upon return. 11 Furthermore, failing to return to sport and subsequent injury have been shown to detrimentally affect patients' long-term quality of life.…”

Section: Introductionmentioning

confidence: 99%

The structural validity of the IKDC and its relationship with quality of life following ACL reconstruction

Williams

Burley

Evans

et al. 2020

Scandinavian Med Sci Sports

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Objective The purpose of this study was to (a) examine the structural validity of the International Knee Documentation Committee Subjective Knee Form in light of previously reported dimensionality issues, and (b) examine the relationships between the IKDC and patients’ knee‐related quality of life 2‐9 years after anterior cruciate ligament (ACL) reconstruction. Methods A prospective research design was employed, wherein 319 patients (mean age = 29.07, SD = 9.03) completed the IKDC before surgery, 191 patients (mean age = 29.71, SD = 9.36) completed the IKDC at 6 months post‐surgery, and 132 patients (mean age = 34.34, SD = 7.89) completed the IKDC and the Anterior Cruciate Ligament Quality of Life Survey (ACL‐QOL) at 2‐9 years post‐surgery. Results Bayesian structural equation modeling analysis confirmed the two‐factor structure (symptom & knee articulation and activity level) represented the most accurate conceptualization of perceived knee function across the three time‐points. Moreover, findings revealed that of the two IKDC subscales pre‐operatively, activity level was most strongly associated with long‐term quality of life at 2‐9 years following surgery, whereas 2‐9 years post‐operatively, symptoms and knee articulation was most strongly associated with long‐term quality of life. Conclusions The IKDC provides clinicians with a convenient total score to assess patients’ perceived knee function, but its unidimensional factor structure is a poor representation of its items and fails to detect discrepancies in patients’ post‐operative quality of life, such as the relative importance of perceived knee activity level before reconstructive surgery.

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“…Psychological readiness for return-to-sport (a common goal of ACLR), and fear of reinjury was measured by the ACL Return to Sport Index (ACL-RSI) (68). The ACL-RSI is valid, reliable and responsive to change (MIC = 19 points)(40), with higher scores associated with better self-reported symptoms and function (69). The global rating of change (GROC) on a 7-point Likert scale ("much worse" to "much better") measured separately for knee pain and knee function; and the change in proportion of patients answering "yes" to the patient acceptable symptom state (PASS) question (35) were evaluated.…”

Section: Secondary Subjective Outcomesmentioning

confidence: 99%

Exercise-therapy and education for individuals one year after anterior cruciate ligament reconstruction: a pilot randomised controlled trial

Patterson

Barton

Culvenor

et al. 2020

Preprint

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Background: Guided rehabilitation beyond 6-months is rare following anterior cruciate ligament reconstruction (ACLR), despite high prevalence of unacceptable symptoms and quality of life (QoL). We aimed to: i) determine the feasibility of a randomised controlled trial (RCT) evaluating the effectiveness of a physiotherapist-guided lower-limb focussed exercise-therapy intervention for individuals 1-year post-ACLR with persistent symptoms, and ii) estimate the effects of this intervention compared to a trunk-focussed intervention on knee-related QoL.Design: Participant- and assessor-blinded, pilot feasibility RCT.Methods: Participant eligibility criteria: i) 12–15 months post-ACLR; ii) < 87.5/100 on the Knee injury and Osteoarthritis Outcome Score (KOOS) QoL subscale; and one of: a) one-leg rise test < 22 repetitions; b) single-hop < 90% limb symmetry; or c) Anterior Knee Pain Scale < 87/100. Participants were randomised (2:1 ratio) to lower-limb focussed exercise-therapy and individualised education, or trunk-focussed exercise-therapy and standardised education. Both interventions involved eight face-to-face physiotherapy sessions over 16-weeks, to guide allocated exercise-therapy programs. Feasibility was assessed by: i) recruitment (participants/month), ii) retention (< 20% drop-out), iii) physiotherapy attendance, and iv) unsupervised exercise-therapy program adherence (> 80% of 3 sessions/week). Knee-related QoL was evaluated using the KOOS-QoL subscale and ACL-QoL questionnaire, with between-group differences compared to published minimally important difference (MID) scores (KOOS-QoL = 10 points; ACL-QoL = 12 points).Results: 27 participants (3 participants/month; 48% men, 34 ± 12 years) were randomised. Two did not commence treatment, and two were lost to follow-up (16% drop-out). Physiotherapy attendance was > 80% for both groups but reported adherence to the unsupervised program was low (< 55% of prescribed exercises). KOOS-QoL improvement (mean ± SD) in the lower-limb focussed (23 ± 15) and trunk-focussed (16 ± 12) groups resulted in a between-group difference (mean, 95%CI) lower than the MID (7.1, -12.3 to 26.4). ACL-QoL improvement in the lower-limb focussed (20 ± 17) and trunk-focussed (22 ± 13) groups resulted in a between-group difference lower than the MID (-2.5, -18.2 to 13.2).Conclusions: A larger-scale RCT evaluating the effectiveness of a physiotherapist-guided lower-limb focussed program for individuals 1-year after ACLR with persistent symptoms is feasible. This intervention is associated with large within-group knee-related QoL improvements, but may not be superior to a trunk-focussed intervention.Trial Registration: Prospectively registered (ACTRN12616000564459).

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Factors Associated With Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction Surgery

Cited by 185 publications

References 36 publications

Functional Knee Performance Differences in Handball are Depending on Playing Class

Functional Knee Performance Differences in Handball are Depending on Playing Class

The structural validity of the IKDC and its relationship with quality of life following ACL reconstruction

Exercise-therapy and education for individuals one year after anterior cruciate ligament reconstruction: a pilot randomised controlled trial

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