Self-Reported Fear Predicts Functional Performance and Second ACL Injury After ACL Reconstruction and Return to Sport: A Pilot Study

Paterno, Mark V.; Flynn, Kaitlyn A.; Thomas, Staci; Schmitt, Laura C.

doi:10.1177/1941738117745806

Cited by 212 publications

(230 citation statements)

References 38 publications

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“… 10 11 12 Paterno et al, in their retrospective study on 40 ACL-Rs, concluded that patients with greater fear of reinjury were four times more likely to gain lower level of activity, seven times more likely to have a single-hop limb asymmetry, and six times more likely to have a deficit of quadriceps strength greater than 90% compared with the contralateral limb. 13 …”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study

Rosso

Bonasia

Cottino

et al. 2018

Joints

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Purpose To analyze the prognostic factors influencing subjective and objective outcomes and return to play (RTP) after anterior cruciate ligament reconstruction (ACL-R). Methods Primary ACL-Rs using a transtibial technique performed between 2008 and 2012 were included. Data regarding patients, surgery, sports, and rehabilitation, including an on-field rehabilitation (OFR) and duration of the rehabilitation program, were collected. The International Knee Documentation Committee (IKDC) subjective and objective evaluation forms, and the Knee Injury and Osteoarthritis Outcome Score and Lysholm questionnaires were used for the assessment of subjective and objective outcomes. The Subjective Patient Outcome for Return to Sports and ACL–return to sport after injury (RSI) scores were used for RTP evaluation. Several potential predictors of outcome were tested with a univariate analysis. All the variables with p < 0.1 were retested in a logistic regression model to evaluate their association with the outcomes. Results In total, 176 cases were included with an average follow-up of 44.1 months. Of the patients, 92.2% were rated as normal or nearly normal at the IKDC evaluation. In addition, 90.1% of the patients returned to sport, with 57.6% returning to the same preinjury level. Objective outcomes were negatively influenced by late rehabilitation (odds ratio [OR] = 2.75). Performing an OFR phase during the rehabilitation was associated with better subjective outcomes (OR = 2.71). Length of rehabilitation strongly influenced the RTP rate (OR = 13.16). Conversely, higher ACL-RSI score was inversely related to RTP. Objective IKDC score was inversely related to the ACL-RSI (OR = 0.31), whereas subjective score was correlated with both the total ACL-RSI score (OR = 0.15) and the level of activity (OR = 0.20). Conclusion This study confirmed the role of rehabilitation on subjective and objective outcomes and on RTP. Particularly, the complete adherence to a rehabilitation program, including an OFR phase, resulted in better subjective outcomes and higher RTP rate. The relationship between psychological factors, measured through the ACL-RSI score, and RTP was confirmed. Level of Evidence Level III, observational study without a control group.

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Section: Introductionmentioning

confidence: 99%

Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study

Rosso

Bonasia

Cottino

et al. 2018

Joints

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“…We anticipated this in light of research linking psychological factors to movement characteristics in sport athletes and trauma exposure to acute stress reactions, 19 physical health, 21 and pain. 22 As alluded to earlier, self-reported fear predicted physical performance in participants returning to sport after surgery, 15 and psychological distress was linked to injury prevalence in adult populations. 17 Our findings suggest that such mind-body connections may be extrapolated to FM characteristics in a military population.…”

Section: Discussionmentioning

confidence: 89%

“…14 Yet these are unlikely to be the sole determinants. In fact, psychological antecedents of physical performance 15 and injury risk 16 are increasingly being recognized in athletes. In one such study, 15 self-reported fear predicted hop-test performance and isometric leg strength in athletes returning to sport after anterior cruciate ligament reconstruction.…”

mentioning

confidence: 99%

“…In fact, psychological antecedents of physical performance 15 and injury risk 16 are increasingly being recognized in athletes. In one such study, 15 self-reported fear predicted hop-test performance and isometric leg strength in athletes returning to sport after anterior cruciate ligament reconstruction. Further, psychological distress has been linked to increased injury prevalence due to falls, sprains, and strains in adult populations, for which proposed mechanisms included impaired concentration, perceptual errors, and psychomotor dysfunction.…”

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confidence: 99%

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Trauma Exposure and Functional Movement Characteristics of Male Tactical Athletes

Taylor

Hernández

Sessoms

et al. 2020

Journal of Athletic Training

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Context: Tactical athletes commonly experience high levels of physical stress, which may increase their risk of musculoskeletal injury. It is critical to understand psychological predictors of functional movement (FM), which may help prevent musculoskeletal injury in this population.Objective: To determine the associations of combat and trauma exposure with FM characteristics of male tactical athletes. Secondary objectives were to explore confounding influences of age and physical injury history as well as the mediating role of bodily pain.Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: Eighty-two healthy, male, active-duty US Navy Explosive Ordnance Disposal personnel (age ¼ 34.0 6 6.7 years).Main Outcome Measure(s): Participants completed measures of combat exposure, trauma exposure, physical injury history, and bodily pain. We assessed FM characteristics (ie, Functional Movement Screen [FMS], Y-Balance Test), from which we derived a composite functional status (CFS) measure.Hypotheses were tested using correlational and multiple regression (causal-steps) models.Results: In unadjusted models, trauma exposure was inversely associated with the FMS (P ¼ .005) and CFS (P ¼ .009) scores. In adjusted models, these relationships were robust to the confounding influences of age and physical injury history. Trauma exposure and bodily pain were substantive, independent predictors of FMS and CFS in causal-steps models (all P values , .05), implying additive rather than mediated effects (R 2 adj ¼ 0.18-0.20). Combat exposure did not predict FM characteristics.Conclusions: To our knowledge, this is the first evidence of the influence of trauma exposure on the FM characteristics of male tactical athletes, independent of age, physical injury, and bodily pain. This program of research may help to advance the prevention and treatment of musculoskeletal injuries in the tactical environment.Greater trauma exposure was associated with lower scores for functional movement. The influence of trauma exposure on functional movement was neither confounded by physical injury nor mediated by bodily pain. These findings will inform algorithms that are designed to predict injury risk in military and other tactical athletes. Clinicians and researchers in sports medicine and orthopaedic settings should consider the individual's trauma history when performing preparticipation physical screening and assessment after injury.

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“…115,116 Effective surgical interventions are available to repair these injuries and restore short-term function and mobility to preinjury performance levels, but surgical repair does not prevent the early development and rapid progression of PTOA in the knee joint. 117 Furthermore, significant deficits in patient-reported outcomes, 118 neuromuscular function, 119 biomechanical movement patterns, 120 and psychosocial factors 121,122 have been noted even after patients have undergone ACLR and completed a full course of therapy.…”

Section: Secondary and Tertiary Risk And Preventionmentioning

confidence: 99%

Anterior Cruciate Ligament Research Retreat VIII Summary Statement: An Update on Injury Risk Identification and Prevention Across the Anterior Cruciate Ligament Injury Continuum, March 14–16, 2019, Greensboro, NC

Shultz

Schmitz

Cameron

et al. 2019

Journal of Athletic Training

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Carolina at Chapel Hill T he Anterior Cruciate Ligament (ACL) Research Retreat VIII was held March 14-16, 2019, in Greensboro, North Carolina. The retreat brought together clinicians and researchers to present and discuss research advances in ACL injury risk, outcomes, and prevention. Prior retreats (2001-2012) 1-6 largely focused on advances in primary injury risk-factor identification and prevention (ie, preventing the initial trauma). Despite our improved understanding of ACL injury risk and the success of primary prevention efforts, ACL injuries continue to occur and lead to short-term and long-term consequences that have substantial effects on joint health and quality of life for years to come. To address these additional challenges, the ACL Research Retreat expanded in scope to include secondary ACL injury risk and prevention in 2015 7 and the short-term and long-term sequelae of early-onset osteoarthritis that results from the initial trauma (herein, posttraumatic osteoarthritis or PTOA) in 2019. The ACL Research Retreat VIII therefore considered ACL injury risk and prevention along a continuum that includes primary, secondary, and tertiary risk identification and prevention strategies as described by Palmieri-Smith et al (Table 1). 8 To illustrate this continuum, consider a soccer team comprising 13-year-old girls. We know the ACL injury risk increases dramatically from ages 13 to 16, 9-11 such that girls have a 2 to 4 times greater risk than similarly trained males. 12,13 Thus, our first goal for this age group, especially 970 Volume 54 Number

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Self-Reported Fear Predicts Functional Performance and Second ACL Injury After ACL Reconstruction and Return to Sport: A Pilot Study

Abstract: Self-reported fear of movement/reinjury after ACLR at the time of RTS may be an important measure to incorporate into discharge criteria prior to release to return to pivoting and cutting sports after ACLR.

Cited by 212 publications

References 38 publications

Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study

Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study

Trauma Exposure and Functional Movement Characteristics of Male Tactical Athletes

Anterior Cruciate Ligament Research Retreat VIII Summary Statement: An Update on Injury Risk Identification and Prevention Across the Anterior Cruciate Ligament Injury Continuum, March 14–16, 2019, Greensboro, NC

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