Readiness to Return to Sport After ACL Reconstruction: A Combination of Physical and Psychological Factors

Cheney, Sarah; Chiaia, Theresa A.; Mille, Polly de; Boyle, Caroline; Ling, Daphne

doi:10.1097/jsa.0000000000000263

Cited by 34 publications

(22 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…49,50 Results following ACL surgery are extremely satisfactory but current evidence suggests that, besides the role of patient's individual risk factors, no specific technique, no graft choice, and no fixation device is able to provide superior outcomes. 51,52 Therefore, biologic augmentation soon came into play: as expected, the literature revealed that PRP-products are the most commonly used in this particular field, due to their easier preparation protocol and lower costs compared to cell-based approaches. A comprehensive analysis of the literature can be appropriately performed if we consider ACL reconstruction and ACL repair separately.…”

Section: Discussionmentioning

confidence: 95%

Biologic agents to optimize outcomes following ACL repair and reconstruction: A systematic review of clinical evidence

Kon

Matteo

Altomare

et al. 2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

Treatment options for anterior cruciate ligament (ACL) injuries have greatly developed over the past decades. Although reconstruction surgery is a concrete reality, stimulation of ACL healing through biological techniques could represent a revolutionary conservative approach. The use of biologic products, such as plateletrich plasma (PRP) or mesenchymal stem cells (MSCs), to treat partial ruptures or to enhance ligamentization after reconstruction, could thoroughly improve clinical outcomes. The aim of the present paper is to systematically review the available literature on this topic, to (i) describe the current state of the art in available biologic techniques; (ii) clarify the outcomes of their application; (iii) identify areas needing further investigation and possible future development. A systematic review of the literature on the use of biologically active agents (PRP and MSCs) to enhance outcomes of ACL surgery was performed: 31 studies were included. Based on the ACL injury pattern, 6 papers investigated biologic agents in ACL partial tears whereas 25 papers in ACL reconstruction. Sixteen of twenty-five studies dealing with ACL reconstruction were randomized controlled trials, whereas only case series are available for partial ACL tears. Current evidence is still lacking sound data to support the use of biological agents: no clinical superiority has been described when using PRP in ACL reconstruction. Concerning ACL healing in partial tears, the application of PRP has led to encouraging outcomes, but these findings should be confirmed by appropriately designed RCTs.

show abstract

Section: Discussionmentioning

confidence: 95%

Biologic agents to optimize outcomes following ACL repair and reconstruction: A systematic review of clinical evidence

Kon

Matteo

Altomare

et al. 2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…As the athlete progresses to RTS tasks, biomechanics, neurocognitive training, psychological readiness, and cardiopulmonary conditioning all converge. 103 If any of these factors have not been addressed prior to RTS tasks, they will likely hinder an athlete's ability to return to full activity safely. 104 Repetitive tasks such as walking, biking, and jogging should be seen as opportunities for neuromuscular retraining and neurocognitive training.…”

Section: Nervous System Integration With the Cardiopulmonary Systemmentioning

confidence: 99%

A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Nervous System

Chaput

Ness

Lucas

et al. 2022

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

Postoperative rehabilitation of anterior cruciate ligament (ACL) reconstruction mainly focuses on the restoration of strength and range of motion with a long-term goal to return athletes to their prior level of activity. Of those wanting to return to sport, many are either unable and/or experience protracted recovery despite extensive rehabilitation. To holistically care for patients recovering from ACL reconstructions, reframing rehabilitation to consider a comprehensive systems approach (including musculoskeletal, cardiovascular, endocrine, and neurologic systems) may help improve treatment outcomes. The American Physical Therapy Association has adopted a vision statement that embraces the concept of a 'movement system,' but validation of the movement system has been challenging. Application of a multi-physiologic systems approach may provide a unique perspective to better understand the nervous system and its interactions after ACL reconstruction. The purpose is to focus on the nervous system contributions to a multi-physiologic system approach to rehabilitation from ACL reconstruction.

show abstract

“…[9][10][11]13 At this time, there is a lack of standardized assessment components for return to sport or agreement on the criteria for determining readiness for sport participation. 14 Furthermore, although assessment of psychological readiness for sport has been recommended, 15 it is not performed as frequently. Poor correlation between physical and psychological measures suggests that these are separate factors that cannot be used as surrogates for each other.…”

Section: Introductionmentioning

confidence: 99%

Advanced training enhances readiness to return to sport after anterior cruciate ligament reconstruction

Meierbachtol

Obermeier

Yungtum

et al. 2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

Patients with anterior cruciate ligament reconstruction (ACLR) are often psychologically and physically under-prepared for sports participation. This study compared readiness to return to sport based on completion of advanced training after ACLR. Patients with ACLR who self-selected participation in a 6-week group-format advanced training program (TRAINING) were compared to age-and sex-matched patients who did not participate (NoTRAINING). Each group had 23 participants (14 females). Advanced training consisted of plyometric, strengthening, and agility exercises. Baseline and follow-up testing included psychological measures (Anterior Cruciate Ligament Return to Sport after Injury [ACL-RSI]; Tampa Scale for Kinesiophobia [TSK-11]; Knee Activity Self-Efficacy [KASE]; and fear intensity for the primary fear-evoking task or situation) and a hop test battery. Return to sport criteria were ACL-RSI score ≥70 points and limb symmetry index ≥90% on all hop tests. At follow-up, KASE score was higher in TRAINING than NoTRAINING (92.7 vs. 89.1 points; respectively), but ACL-RSI, TSK-11 and fear intensity scores were not significantly different between groups. Return to sport criteria passing rate was not significantly different between groups at baseline (TRAINING: 13%, NoTRAINING: 30%) or follow-up (TRAINING: 52%, NoTRAINING: 43%); however, the distribution of criteria met at follow-up differed with more patients in TRAIN-ING than NoTRAINING meeting hop test criteria (30% vs. 4%, respectively) and more patients in NoTRAINING than TRAINING failing to meet any criteria (25% vs. 0%, respectively). Advanced training after ACLR facilitated readiness for sport participation by improving confidence and hop performance, but may not have a preferential effect on fear.

show abstract

Readiness to Return to Sport After ACL Reconstruction: A Combination of Physical and Psychological Factors

Cited by 34 publications

References 40 publications

Biologic agents to optimize outcomes following ACL repair and reconstruction: A systematic review of clinical evidence

Biologic agents to optimize outcomes following ACL repair and reconstruction: A systematic review of clinical evidence

A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Nervous System

Advanced training enhances readiness to return to sport after anterior cruciate ligament reconstruction

Contact Info

Product

Resources

About