Return to Play Decision-Making Following Anterior Cruciate Ligament Reconstruction: Multi-Factor Considerations

Nyland, John; MacKinlay, Kenneth G. W.; Wera, Jeff; Krupp, Ryan

doi:10.1007/978-3-642-36569-0_107

Cited by 2 publications

(8 citation statements)

References 30 publications

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“…Factors such as self-efficacy, kinesiophobia, cognitive reinjury risk perceptions, and health locus of control should be evaluated as well. 3 , 24 , 58 Release back to unrestricted sports participation timing based solely on time postsurgery does not assure that adequate neuromuscular control activation has been re-established to protect the surgical knee joint. 68 …”

Section: Improving Clinical Outcome Measurement Methodsmentioning

confidence: 99%

“…Clinical outcome measures need to be developed, which more precisely and responsively measure each of these factors across the recovery continuum while concurrently identifying essential links between physical, psychobehavioral, and cognitive components. 3 This is a very fertile area for interdisciplinary research.…”

Section: Improving Clinical Outcome Measurement Methodsmentioning

confidence: 99%

“… 2 We still have much to learn regarding the subtleties of neuromuscular control activation responsiveness with knee joint loading. 3 Interestingly, native ACL, 1 , 4 – 10 meniscus, 11 and associated knee structure surgical anatomy 12 – 15 continues to be debated and elucidated. A growing body of research evidence suggests that an anatomical ACL reconstruction approach may be superior to a nonanatomical approach, particularly when remnant tissue is preserved.…”

Section: Surgical Anatomical Discoveries and Growing Understandingmentioning

confidence: 99%

“…Through this type of training with a more intact neurosensory system, they may be able to activate protective neuromuscular responses with greater acuity and precision as they effectively perform movement tasks. 3 , 25 , 26 Although neuromuscular control activation training can somewhat restore a less impaired balance between hip, knee, and ankle contributions to composite lower extremity extension, regular movement-specific training long after the rehabilitation and return to sports decision-making process may be needed to maintain this important function, particularly in the presence of a compromised sensorimotor system. 3 , 25 – 27 …”

Section: Central Representation Changes and The Sensorimotor Cerebralmentioning

confidence: 99%

“… 24 This decision-making process requires information related to actual and perceived physical function, psychobehavioral status, general conditioning level, and many other factors. 3 Multiple inputs from multiple sources generally leads to the most accurate assessment. On the basis of the pre- and postsurgery Tegner Activity Level Scale scores of 99 subjects post-ACL reconstruction, Rodriguez-Roiz et al 59 reported that 91.9% of patients returned to regular sports activity, and 75% returned within the first postoperative year.…”

Section: Returning To the Same Sport At The Same Or Higher Levelmentioning

confidence: 99%

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Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update

Nyland¹,

Mattocks²,

Kibbe³

et al. 2016

OAJSM

Self Cite

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Anatomical discoveries and a growing appreciation of the knee as a complex organ are driving innovations in patient care decision-making following anterior cruciate ligament (ACL) injury. Surgeons are increasing their efforts to restore combined mechanical-neurosensory ACL function and placing more consideration on when to reconstruct versus repair native anatomical structures. Surgical options now include primary repair with or without reinforcing the injured ACL with suture-based internal bracing, and growing evidence supports biological augmentation using platelet-rich plasma and mesenchymal stem cells to enhance tissue healing. Physical therapists and athletic trainers are increasing their efforts to facilitate greater athlete cognitive engagement during therapeutic exercise performance to better restore nonimpaired neuromuscular control activation amplitude and timing. Knee brace design and use needs to evolve to better match these innovations and their influence on the rehabilitation plan timetable. There is a growing appreciation for the multifaceted characteristics of the rehabilitation process and how they influence neuromuscular, educational, and psychobehavioral treatment goal achievement. Multiple sources may influence the athlete during the return to sports process and clinical outcome measures need to be refined to better evaluate these influences. This update summarizes contemporary ACL surgical, medical, and rehabilitation interventions and future trends.

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Section: Improving Clinical Outcome Measurement Methodsmentioning

confidence: 99%

Section: Improving Clinical Outcome Measurement Methodsmentioning

confidence: 99%

Section: Surgical Anatomical Discoveries and Growing Understandingmentioning

confidence: 99%

Section: Central Representation Changes and The Sensorimotor Cerebralmentioning

confidence: 99%

Section: Returning To the Same Sport At The Same Or Higher Levelmentioning

confidence: 99%

See 3 more Smart Citations

Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update

Nyland¹,

Mattocks²,

Kibbe³

et al. 2016

OAJSM

Self Cite

View full text Add to dashboard Cite

show abstract

Examining Return to Play Protocols for ACL Injuries using the International Classification of Functioning, Disability, and Health (ICF): A Rapid Review

Jain,

Tomas,

Rosenbaum

2024

Preprint

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Purpose Anterior cruciate ligament (ACL) injuries are a common occurrence, especially in sports. These injuries require a comprehensive return-to-play (RTP) protocol that is suited for the individual. This review aims to assess existing RTP protocols for ACL injuries, using the WHO’s International Classification of Functioning, Disability, and Health (ICF) framework. The objective is to identify trends and gaps in RTP protocols based on the domains of the ICF framework. Methods A rapid review was conducted from the following databases: Embase, MEDLINE, and CENTRAL. Studies were screened using Covidence and reviewed using National Collaborating Centre for Methods and Tools (NCCMT) guidelines. The analysis examined the included return-to-play protocols and assessed them through the lens of the ICF framework. Results Fifteen studies were included in the review. Based on the protocols of the included studies, three key trends were observed: 1) Focus on functioning and disability rather than contextual factors, 2) Player’s psychological needs are considered in only a few studies (n = 4), and 3) Most return-to-play protocols were fairly rigid. Conclusion This review highlights key trends and gaps in existing RTP protocols for ACL injuries. The protocols can be improved by aligning themselves with the ICF, specifically through the inclusion of environmental and personal factors. This could potentially pave the way for a standardized ACL RTP protocol. Level of Evidence: II

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Return to Play Decision-Making Following Anterior Cruciate Ligament Reconstruction: Multi-Factor Considerations

Cited by 2 publications

References 30 publications

Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update

Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update

Examining Return to Play Protocols for ACL Injuries using the International Classification of Functioning, Disability, and Health (ICF): A Rapid Review

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