The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction

Ardern, Clare L; Österberg, Annika; Sonesson, Sofi; Gauffin, Håkan; Webster, Kate E.; Kvist, Joanna

doi:10.1136/bjsports-2014-093842

Cited by 355 publications

(379 citation statements)

References 44 publications

(54 reference statements)

Supporting

Mentioning

355

Contrasting

Unclassified

Order By: Relevance

“…32 People choose to participate or cease participating for many reasons that may have nothing to do with their knee. 37 People may also change their sports participation following surgery on the advice of their treating clinician. These reasons may help to explain relationships between sports participation and satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity

Ardern

Österberg

Sonesson

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Self Cite

View full text Add to dashboard Cite

Purpose: To assess whether patient-reported outcomes (psychological factors, appraisals of knee function, and physical activity participation) were associated with satisfaction with knee function after anterior cruciate ligament (ACL) reconstruction. Methods: Participants who were aged 18 to 45 years and a minimum 12 months post primary ACL reconstruction completed a questionnaire battery evaluating knee self-efficacy, knee-related quality of life, self-reported function, and physical activity participation. Participants responses to the question "If you were to spend the rest of your life with your knee just the way it has been in the last week, would you feel.... (7-point ordinal scale; 1 = happy, 7 = unhappy)" were categorized as satisfied, mostly satisfied, or dissatisfied and used as the primary outcome. Ordinal regression was used to examine associations between independent variables and the primary outcome. Results: A total of 177 participants were included at an average of 3 years after primary ACL reconstruction. At follow-up, 44% reported they would be satisfied, 28% mostly satisfied, and 28% dissatisfied with the outcome of ACL reconstruction. There were significant differences in psychological responses and appraisal of knee function between the 3 groups (P = .001), and significantly more people in the satisfied group had returned to their preinjury activity (58%) than in the mostly satisfied (28%) and dissatisfied (26%) groups (P = .001). Multivariable analysis demonstrated that the odds of being satisfied increased by a factor of 3 with higher self-efficacy, greater knee-related quality of life, and returning to the preinjury activity. Conclusions: People who had returned to their preinjury physical activity and who reported higher knee-related self-efficacy and quality of life were more likely to be satisfied with the outcome of ACL reconstruction

show abstract

Section: Discussionmentioning

confidence: 99%

Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity

Ardern

Österberg

Sonesson

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…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 Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

Toole

Ithurburn

Rauh

et al. 2017

Journal of Orthopaedic & Sports Physical Therapy

128

165

View full text Add to dashboard Cite

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.

show abstract

“…Of concern is that more than 50% of non-elite sports participants do not return to pre-injury sport after ACLR (Ardern et al, 2014b), which was a critical determinant of longer-term QOL 5 to 20 years after ACLR in people with knee difficulties (Chapter 6). Prior to this research, only two studies had explored the relationship between return to sport and QOL outcomes (Ardern et al, 2014a;McCullough et al, 2012). One study reported lower KOOS-QOL scores in high school and college athletes who did not return to sport compared to those who returned to their pre-injury level of sport two years after ACLR (McCullough et al, 2012).…”

Section: Return To Sportmentioning

confidence: 99%

“…Furthermore, emotional disturbances were reported by individuals who had not returned to sport at 6 and 12 months after ACLR, compared to those who had returned to sport, despite no differences in knee function and symptoms (Langford et al, 2009). Fear of re-injury is a very common psychological manifestation experienced by individuals after ACLR (Ardern et al, 2014a;Gignac et al, 2015;Kvist et al, 2005;Tripp et al, 2007) and higher levels of fear of re-injury have been associated with worse knee-related QOL (Kvist et al, 2005). Additionally, psychological factors assessed prior to undergoing ACLR are predictive of postoperative outcomes (Everhart, Best, & Flanigan, 2015).…”

Section: Psychological Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Long-term quality of life following anterior cruciate ligament injury and reconstruction

Filbay¹

View full text Add to dashboard Cite

The anterior cruciate ligament (ACL) serves to stabilise the knee complex and prevent intraarticular knee structures from sustaining damage during multiaxial, high impact movement. An ACL rupture most commonly occurs in adolescents and young adults taking part in competitive sports and causes substantial disruption to the knee joint. Anterior cruciate ligament reconstruction (ACLR) is the most common treatment offered to ACL-ruptured individuals worldwide. Individuals undergoing this surgery often have high expectations that rarely match surgical outcomes. Return to sport rates are low, re-injury fears are widespread and many individuals develop knee osteoarthritis within ten years of ACLR. This mismatch between expectations and actual outcomes has great potential to impact longer-term quality of life (QOL). The primary aims of this thesis were to: (i) generate a detailed picture of longer-term QOL following ACLR, and (ii) identify factors related to longer-term QOL in people with knee pain, symptoms or functional limitations following ACLR.The first study in this thesis is a systematic review that revealed impaired knee-related QOL at 5 to 20 years after ACLR. However, it became evident that research into factors impacting upon QOL in this population was scarce. The systematic review found that having a subsequent knee injury, an additional knee surgery after ACLR, and developing severe radiographic osteoarthritis were associated with worse QOL outcomes. The second study in this thesis is a systematic review that investigated QOL more than five years after ACL rupture in individuals who remained ACL-deficient (did not undergo ACLR) and compared QOL between ACLdeficient and ACL-reconstructed groups. This systematic review found that ACL-deficient individuals reported comparable QOL outcomes to those who underwent ACLR 5 to 25 years previously. All studies that reported QOL after ACLR included asymptomatic participants without knee difficulties, which may underestimate the degree of QOL impairment experienced by people with ongoing knee difficulties.The third study in this thesis used a cross-sectional design to describe QOL outcomes in 162 individuals with knee pain, symptoms or functional limitations 5 to 20 years following ACLR.It showed that individuals who did not return to sport after ACLR reported poorer knee-related and health-related QOL, compared to people who returned to pre-injury levels of sport. Higher body mass index (BMI) and subsequent surgery were also related to worse QOL after ACLR.This was the first study to show that return to sport was associated with QOL impairment more than five years after ACLR. However, quantitative assessment of QOL may overlook important considerations with regard to an individual's life priorities, expectations, values and concerns.To provide a detailed understanding of QOL following ACLR, qualitative interviews were performed with 17 individuals with knee difficulties 5 to 20 years following ACLR. This was the first qualitative study to explore QOL following...

show abstract

The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction

Cited by 355 publications

References 44 publications

Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity

Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity

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

Long-term quality of life following anterior cruciate ligament injury and reconstruction

Contact Info

Product

Resources

About