Psychological Skills and Adherence to Rehabilitation after Reconstruction of the Anterior Cruciate Ligament

2001 ◽  
Vol 10 (3) ◽  
pp. 165-172 ◽  
Author(s):  
Carrie B. Scherzer ◽  
Britton W. Brewer ◽  
Allen E. Cornelius ◽  
Judy L. Van Raalte ◽  
Albert J. Petitpas ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Outcome Measures ◽  
Goal Setting ◽  
Patient Adherence ◽  
Cruciate Ligament ◽  
Home Exercise ◽  
Psychological Skills ◽  
Self Talk ◽  
Self Reports ◽  
Anterior Cruciate

Objective:To examine the relationship between self-reported use of psychological skills and rehabilitation adherence.Design:Prospective correlational design.Setting:Outpatient physical-therapy clinic specializing in sports medicine.Patients:Fifty-four patients (17 women and 37 men) undergoing rehabilitation after anterior-cruciate-ligament reconstruction.Main Outcome Measures:An abbreviated version of the Sports Injury Survey (Ievleva & Orlick, 1991) was administered approximately 5 weeks after surgery to assess use of goal setting, imagery, and positive self-talk. Four adherence measures were obtained during the remainder of rehabilitation: attendance at rehabilitation sessions, practitioner ratings of patient adherence at rehabilitation sessions, patient self-reports of home exercise completion, and patient self-reports of home cryotherapy completion.Results:Goal setting was positively associated with home exercise completion and practitioner adherence ratings. Positive self-talk was positively correlated with home exercise completion.Conclusions:Use of certain psychological skills might contribute to better adherence to sport-injury rehabilitation protocols.

Adherence to Rehabilitation after Anterior Cruciate Ligament Reconstructive Surgery: Implications for Outcome

2005 ◽  
Vol 14 (3) ◽  
pp. 202-214 ◽  
Author(s):  
Tania Pizzari ◽  
Nicholas F. Taylor ◽  
Helen McBurney ◽  
Julian A. Feller
Keyword(s):  
Anterior Cruciate Ligament ◽  
Outcome Measures ◽  
Reconstructive Surgery ◽  
Cruciate Ligament ◽  
Negative Relationship ◽  
Exercise Adherence ◽  
Self Report ◽  
Home Exercise ◽  
Exercise Regimen ◽  
Anterior Cruciate

Objective:To investigate the relationship between adherence to rehabilitation and outcome after reconstructive surgery of the anterior cruciate ligament (ACL).Design:A prospective cohort study with adherence to rehabilitation evaluated over 8 weeks correlated with outcomes at 9 and 12 months postsurgery.Participants:68 patients who had undergone ACL-reconstructive surgery.Main Outcome Measures:Adherence was measured to and during appointments and by a self-report diary of home exercise. Outcomes were measured by 6 knee-function scales and 2 hop tests.Results:There was a significant relationship between home-exercise adherence and many outcomes for participants under 30 years of age (rs= .33-.44). For participants age 30 and over there was a negative relationship between home-exercise adherence and outcome. There were no significant relationships between adherence to and during physical therapy appointments and outcome after ACL-reconstructive surgery.Conclusion:Participants under 30 years of age who adhered to their home-exercise regimen had better functional outcome, whereas adherent participants age 30 and over experienced worse outcome with better home-exercise adherence.

scholarly journals Fatigue’s Lack of Effect on Thigh-Muscle Activity in Anterior Cruciate Ligament–Reconstructed Patients During a Dynamic-Landing Task

2013 ◽  
Vol 22 (2) ◽  
pp. 83-92 ◽  
Author(s):  
Lindsey K. Lepley ◽  
Abbey C. Thomas ◽  
Scott G. McLean ◽  
Riann M. Palmieri-Smith
Keyword(s):  
Anterior Cruciate Ligament ◽  
Outcome Measures ◽  
Muscle Activity ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Activation Patterns ◽  
Female Age ◽  
Muscle Activation Patterns ◽  
Anterior Cruciate ◽  
Knee Muscle

Context:As individuals returning to activity after anterior cruciate ligament reconstruction (ACLr) likely experience fatigue, understanding how fatigue affects knee-muscle activation patterns during sport-like maneuvers is of clinical importance. Fatigue has been suggested to impair neuromuscular control strategies. As a result, fatigue may place ACLr patients at increased risk of developing posttraumatic osteoarthritis (OA).Objective:To determine the effects of fatigue on knee-muscle activity post-ACLr.Design:Case control.Setting:University laboratory.Participants:12 individuals 7–10 mo post-ACLr (7 male, 5 female; age 22.1 ± 4.7 y; 1.8 ± 0.1 m; mass 77.7 ± 11.9 kg) and 13 controls (4 male, 9 female; age 22.9 ± 4.3 y; 1.7 ± 0.1 m; mass 66.9 ± 9.8 kg).Interventions:Fatigue was induced via repetitive sets of double-leg squats (n = 8), which were interspersed with sets of single-leg landings (n = 3), until squats were no longer possible.Main Outcome Measures:2 × 2 repeated-measures ANOVA was used to detect the main effects of group (ACLr, control) and fatigue state (prefatigue, postfatigue) on quadriceps:hamstring cocontraction index (Q:H CCI).Results:All subjects demonstrated higher Q:H CCI at prefatigue compared with postfatigue (F1,23 = 66.949, P ≤ .001). Q:H CCI did not differ between groups (F1,23 = 0.599, P = .447).Conclusions:The results indicate that regardless of fatigue state, ACLr individuals are capable of restoring muscle-activation patterns similar to those in healthy subjects. As a result, excessive muscle cocontraction, which has been hypothesized as a potential mechanism of posttraumatic OA, may not contribute to joint degeneration after ACLr.

scholarly journals Clinical Outcomes After Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of Autograft Versus Allograft Tissue

2009 ◽  
Vol 2 (1) ◽  
pp. 56-72 ◽  
Author(s):  
Lisa M. Tibor ◽  
Joy L. Long ◽  
Peter L. Schilling ◽  
Ryan J. Lilly ◽  
James E. Carpenter ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Anterior Cruciate Ligament ◽  
Sample Size ◽  
Randomized Clinical Trial ◽  
Acl Reconstruction ◽  
Outcome Measures ◽  
Cruciate Ligament ◽  
Allograft Reconstruction ◽  
Kt 1000 ◽  
Anterior Cruciate

Background: Clinical outcomes of autograft and allograft anterior cruciate ligament (ACL) reconstructions are mixed, with some reports of excellent to good outcomes and other reports of early graft failure or significant donor site morbidity. Objective: To determine if there is a difference in functional outcomes, failure rates, and stability between autograft and allograft ACL reconstructions. Data Sources: Medline, Cochrane Central Register of Controlled Trials (Evidence Based Medicine Reviews Collection), Cochrane Database of Systematic Reviews, Web of Science, CINAHL, and SPORTDiscus were searched for articles on ACL reconstruction. Abstracts from annual meetings of the American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America were searched for relevant studies. Study Selection: Inclusion criteria for studies were as follows: primary unilateral ACL injuries, mean patient age less than 41 years, and follow-up for at least 24 months postreconstruction. Exclusion criteria for studies included the following: skeletally immature patients, multiligament injuries, and publication dates before 1990. Data Extraction: Joint stability measures included Lachman test, pivot-shift test, KT-1000 arthrometer assessment, and frequency of graft failures. Functional outcome measures included Tegner activity scores, Cincinnati knee scores, Lysholm scores, and IKDC (International Knee Documentation Committee) total scores. Results: More than 5000 studies were identified. After full text review of 576 studies, 56 were included, of which only 1 directly compared autograft and allograft reconstruction. Allograft ACL reconstructions were more lax when assessed by the KT-1000 arthrometer. For all other outcome measures, there was no statistically significant difference between autograft and allograft ACL reconstruction. For all outcome measures, there was strong evidence of statistical heterogeneity between studies. The sample size necessary for a randomized clinical trial to detect a difference between autograft and allograft reconstruction varied, depending on the outcome. Conclusions: With the current literature, only KT-1000 arthrometer assessment demonstrated more laxity with allograft reconstruction. A randomized clinical trial directly comparing allograft to autograft ACL reconstruction is warranted, but a multicenter study would be required to obtain an adequate sample size.

scholarly journals Baseline Analysis of Patients Presenting for Surgical Review of Anterior Cruciate Ligament Rupture Reveals Heterogeneity in Patient-Reported Outcome Measures

2020 ◽  
Author(s):  
Chee Han Ting ◽  
Corey Scholes ◽  
David Zbrojkiewicz ◽  
Christopher Bell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Outcome Measures ◽  
Cruciate Ligament ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cluster Membership ◽  
Patient Reported ◽  
Rehabilitation Protocols ◽  
Anterior Cruciate

AbstractDespite the establishment of successful surgical techniques and rehabilitation protocols for anterior cruciate ligament (ACL) reconstruction, published return to sport rates are less than satisfactory. This has led orthopaedic surgeons and researchers to develop more robust patient selection methods, and investigate prognostic patient characteristics. No previous studies have integrated baseline characteristics and responses to patient-reported outcome measures (PROMs) of patients with ACL rupture presenting for surgical review. Patients electing to undergo ACL reconstruction under the care of a single orthopaedic surgeon at a metropolitan public hospital were enrolled in a clinical quality registry. Patients completed Veterans RAND 12-item Health Survey (VR-12) Physical Component Summary and Mental Component Summary scores, Tegner activity scale, and International Knee Documentation Committee (IKDC) questionnaires at presentation. Total scores were extracted from the electronic registry, and a machine learning approach (k-means) was used to identify subgroups based on similarity of questionnaire responses. The average scores in each cluster were compared using analysis of variance (ANOVA; Kruskal–Wallis) and nominal logistic regression was performed to determine relationships between cluster membership and patient age, gender, body mass index (BMI), and injury-to-examination delay. A sample of 107 patients with primary ACL rupture were extracted, with 97 (91%) available for analysis with complete datasets. Four clusters were identified with distinct patterns of PROMs responses. These ranged from lowest (Cluster 1) to highest scores for VR-12 and IKDC (Cluster 4). In particular, Cluster 4 returned median scores within 6 points of the patient acceptable symptom state for the IKDC score for ACL reconstruction (70.1, interquartile range: 59–78). Significant (p < 0.05) differences in PROMs between clusters were observed using ANOVA, with variance explained ranging from 40 to 69%. However, cluster membership was not significantly associated with patient age, gender, BMI, or injury-to-examination delay. Patients electing to undergo ACL reconstruction do not conform to a homogenous group but represent a spectrum of knee function, general physical and mental health, and preinjury activity levels, which may not lend itself to uniform treatment and rehabilitation protocols. The factors driving these distinct responses to PROMs remain unknown but are unrelated to common demographic variables.

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