Psychological Responses Matter in Returning to Preinjury Level of Sport After Anterior Cruciate Ligament Reconstruction Surgery

Ardern, Clare L; Taylor, Nicholas F.; Feller, Julian A.; Whitehead, Timothy S.; Webster, Kate E.

doi:10.1177/0363546513489284

Cited by 434 publications

(481 citation statements)

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“…A number of studies have found associations between return to sports and psychosocial/psychological variables (kinesiophobia/fear of reinjury, knee-related self-efficacy, confidence). 2,4,5,15,22,35,36 Further evaluation of the impact of these factors, along with that of strength, function, and performance, on return to sports is warranted. Third, only one criterion value (90%) was evaluated in this study, based on what is commonly regarded as acceptable for return-to-sport participation after ACL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs?

Toole

Ithurburn

Rauh

et al. 2017

J Orthop Sports Phys Ther

101

161

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Rupture of the anterior cruciate ligament (ACL) is a devastating injury that occurs with high frequency among individuals who participate in cutting and pivoting sports. 24,48 Anterior cruciate ligament reconstruction is commonly performed with the goal of facilitating return to sports activities. However, recent metaanalysis data from over 7000 participants following ACL reconstruction demonstrated that 65% returned to their previous level of sport and only 55% returned to competitive sports.3 Factors associated with a higher rate of return to preinjury level of sport participation were younger age, male sex, positive psychological U U STUDY DESIGN: Prospective cohort study. U U BACKGROUND: While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. U U OBJECTIVES:To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs. U U METHODS:At the time of return-to-sport clearance, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), quadriceps and hamstring strength limb symmetry index (LSI), and single-leg hop test LSI were assessed. Proportions of participants who met individual (IKDC score of 90 or greater; strength and hop test LSIs of 90% or greater) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following returnto-sport clearance (assessed using the Tegner activity scale) were compared between those who met and did not meet cutoffs. U U RESULTS:Participants included 115 young athletes (88 female). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following return-tosport clearance than those who did not (81.3% versus 60.2%, P = .02). U U CONCLUSION:The proportions of young athletes after ACL reconstruction recently cleared for return to sports who met the combined criterion cutoffs were low. Those who met the criterion cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not. U U LEVEL OF EVIDENCE: Prognosis, level 2b.

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Section: Discussionmentioning

confidence: 99%

Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs?

Toole

Ithurburn

Rauh

et al. 2017

J Orthop Sports Phys Ther

101

161

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“…13 Analogous with RTS after anterior cruciate ligament (ACL) reconstruction, RTS after a hamstring strain injury is likely to be influenced by fear of reinjury and the subsequent psychological readiness of the injured athlete. [14][15][16] In ACL reconstructions, the psychological readiness to RTSs has been successfully evaluated with the ACL RTS after injury. 16 This scale measures the athlete's psychological state and has been shown to be associated with RTS and can potentially identify athletes at risk.…”

Section: Discussionmentioning

confidence: 99%

At return to play following hamstring injury the majority of professional football players have residual isokinetic deficits

Tol

2013

Qatar Foundation Annual Research Forum Volume 2013 Issue 1

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Background There is an ongoing debate regarding the optimal criteria for return to sport after an acute hamstring injury. Less than 10% isokinetic strength deficit is generally recommended but this has never been documented in professional football players after rehabilitation. Our aim was to evaluate isokinetic measurements in MRI-positive hamstring injuries. Methods Isokinetic measurements of professional football players were obtained after completing a standardised rehabilitation programme. An isokinetic strength deficit of more than 10% compared with the contralateral site was considered abnormal. Reinjuries within 2 months were recorded. Results 52 players had a complete set of isokinetic testing before clinical discharge. There were 27 (52%) grade 1 and 25 (48%) grade 2 injuries. 35 of 52 players (67%) had at least one of the three hamstring-related isokinetic parameters that display a deficit of more than 10%. The percentage of players with 10% deficit for hamstring concentric 60°/s, 300°/s and hamstring eccentric was respectively 39%, 29% and 28%. There was no significant difference of mean isokinetic peak torques and 10% isokinetic deficits in players without reinjury (N=46) compared with players with reinjury (N=6). Conclusions When compared with the uninjured leg, 67% of the clinically recovered hamstring injuries showed at least one hamstring isokinetic testing deficit of more than 10%. Normalisation of isokinetic strength seems not to be a necessary result of the successful completion of a football-specific rehabilitation programme. The possible association between isokinetic strength deficit and increased reinjury risk remains unknown.

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“…This scale was shown to discriminate between athletes who returned to sport and who did not return to sport due to fear of re-injury after ACL reconstruction (7,10). Ardern et al suggested that a score of less than 56 points on the ACL-RSI may indicate an increased risk of not returning to the preinjury level and may help clinicians to identify at-risk athletes (7). In the present study, ACL-RSI score of the participants was 52.7 points which show that the participants may not psychologically be ready to return to sport at 6 months post-surgery.…”

Section: Discussionmentioning

confidence: 45%

Relation of Self-Reported Knee Function and Physical Performance with Psychological Responses in Anterior Cruciate Ligament Reconstructed Individuals

Harput¹,

Tok²,

Tunay³

2016

Türk Fizyoterapi Ve Rehabilitasyon Dergisi

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Purpose: The aim of this study was to investigate the correlation between anterior cruciate ligament return to sport index after injury (ACL-RSI) score and self-reported knee function, and physical performance in anterior cruciate ligament reconstructed individuals.Methods: Ninety ACL reconstructed individuals at 6 months post-surgery were included in this study. To evaluate psychological responses, ACL-RSI score; and to assess self-reported knee function, International Knee Documentation Committee Subjective Knee Form (IKDC), Knee Injury and Osteoarthritis Outcome (KOOS) and Lysholm scores were selected. One leg hop test and anterior, posteromedial and posterolateral reach distances of star excursion balance test were used to measure physical performance. Pearson correlation test was used for statistical analysis.Results: ACL-RSI score was positively correlated with IKDC, Lysholm and KOOS scores; one leg hop test; and posteromedial and posterolateral reach distances of the star excursion balance test (p<0.05).Discussion: Psychological responses were correlated with self-reported knee function and physical performance in anterior cruciate ligament reconstructed individuals. Therefore, maximizing knee function and performance is important to overcome individuals' fear of re-injury which affects return to sport after surgery, negatively. Tartışma: Ön çapraz bağ cerrahisi geçirmiş bireylerde psikolojik yanıt hasta bildirimli diz fonksiyonu ve fiziksel performansla ilişkili bulundu. Bu nedenle, ön çapraz bağ cerrahisi sonrası bireylerin spora dönüşünü olumsuz yönde etkileyen tekrar yaralanma korkusunu yenmeleri için diz fonksiyonunun ve performansın arttırılması önemlidir.

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Psychological Responses Matter in Returning to Preinjury Level of Sport After Anterior Cruciate Ligament Reconstruction Surgery

Cited by 434 publications

References 49 publications

Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs?

Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs?

At return to play following hamstring injury the majority of professional football players have residual isokinetic deficits

Relation of Self-Reported Knee Function and Physical Performance with Psychological Responses in Anterior Cruciate Ligament Reconstructed Individuals

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