The Relationship between Kinesiophobia and Return to Sport after Shoulder Surgery for Recurrent Anterior Instability

Vascellari, Alberto; Ramponi, C; Venturin, Davide; Ben, Giulia; Coletti, Nicolò

doi:10.1055/s-0041-1730975

Cited by 19 publications

(29 citation statements)

References 35 publications

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“…Anecdotally, the reasons given for failure to return to contact sport were more psychological than physical, with most soldiers giving the reason of being concerned about repeat injury for their failure to return. Kinesiophobia is recognised as a factor affecting return to sport after stabilisation surgery 15…”

Section: Discussionmentioning

confidence: 99%

Shoulder instability in military personnel: diagnosis and outcomes of arthroscopic stabilisation

et al. 2023

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IntroductionShoulder instability is a common problem for military personnel due to the highly physical demands of work and training. This study assessed the pattern of glenoid labrum tears suffered by serving UK military personnel, the reliability of preoperative diagnostic methods (magnetic resonance arthrogram (MRA) vs clinical examination) and, finally, the outcomes of arthroscopic stabilisation in terms of satisfaction, pain, and return to sport and full deployment.MethodsRetrospective demographic and clinical data were collected for all patients within our unit who underwent arthroscopic shoulder stabilisation between September 2016 and January 2019. Patients underwent clinical examination for instability and subsequent imaging with MRA. For service evaluation, patient-reported outcome measure data and occupational outcome data were gathered preoperatively and postoperatively.Results41 military patients with shoulder instability were treated with arthroscopic stabilisation. 24.4% had an isolated anterior tear, and 41.5% had complex two-zone or pan-labral tears identified on arthroscopy. Clinical examination showed higher sensitivity, accuracy and negative predictive value for all labral tear patterns compared with MRA. Mean preoperative Oxford Shoulder Instability Score score was 18.58 (SE ±1.67) and mean postoperative score was 41.5 (SE ±1.13). 82.14% of the patients returned to full deployment during the study period and 85% had returned to sports.ConclusionComplex labral tear patterns are common in military personnel with shoulder instability, and clinical examination appears to be more effective than imaging at predicting injury pattern. Patients respond well to arthroscopic stabilisation with good rates of return to work and sport, regardless of chronicity of injury.

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Section: Discussionmentioning

confidence: 99%

Shoulder instability in military personnel: diagnosis and outcomes of arthroscopic stabilisation

et al. 2023

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“…In fact, a "psychological readiness" scale may be used as a tool when assessing athletes prior to RTP [44]. Fear of reinjury, or kinesiophobia, is also commonly cited as a hindrance to successful postoperative return to pre-injury participation following both ACL reconstruction [30,31] and anterior shoulder stabilization surgery [32]. Previous research on RTP following Achilles tendon rupture has shown that psychological readiness improves and kinesiophobia decreases with greater time from the injury [48].…”

Section: Discussionmentioning

confidence: 99%

“…Athlete playing style and behavior after RTP following injury may be equally as important as medical management in safeguarding the vulnerable brain from HIE. Psychological factors and fear of reinjury may complicate athletes' RTP process as they begins sport activities again [29][30][31][32]. Whether or not athletes' RTP behavior re ects the conservative shift seen in post-concussion management has not been explored previously.…”

Section: Introductionmentioning

confidence: 99%

Change in Head Impact Exposure following Return to Play in Concussed Football Athletes

Muench

Sinson

Harezlak

et al. 2022

Preprint

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Background Following sport-related concussion, early head impact exposure and premature return to play is known to increase risk of repeat concussion in football athletes, yet athletes’ true post-injury head impact exposure profiles and biomechanical progression have not been explored. Accordingly, this study explored how American college football athletes alter playing style during their return from concussion, particularly within the same athletic season. Methods Using head impact exposure profiles of fifty-two collegiate football athletes from six NCAA Division I programs, this analysis compared daily volume of head impacts following concussion with pre-injury levels and further compared these athletes to team- and position-matched controls to minimize season- or team-related factors. Additionally, this study provided an analysis of the possible association between length of recovery time and change in head impact exposure following concussion using continuous linear regression. Results Over 40% of concussed athletes did not reach their pre-injury level of head impact exposure at any point during the remainder of the season segment that the concussion occurred. Furthermore, concussed athletes showed significantly larger decreases than non-concussed athletes over the same time period. Finally, longer recovery times after concussion were associated with larger decreases in head impact exposure over the remaining contact days within the season segment. Conclusions This study provide evidence for a shift in playing style after returning from concussion, both in the immediate days after return to play as well as over extended periods of time within the season. These findings will help to better inform the management of athletes returning from concussion.

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“…The mean follow-up was 47.8 ± 16.3 months, according to data from 11 studies [12,17,19,20,22,23,26,34,36,37,42]. In addition, eight studies [12,22,23,26,36,37,41,42] categorised athletes based on their level of sports practice, ranging from recreational to professional, with 324 athletes (48.1%) practicing at a competitive level. A total of 506 (53.8%) of the 941 athletes participated in contact or collision sports [17,19,20,22,26,34,[36][37][38]41], while 32.3% of the 674 athletes participated in overhead sports [12,17,23,26,34,37] (Table 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

Substantial influence of psychological factors on return to sports after anterior shoulder instability surgery: a systematic review and meta‐analysis

Velasquez Garcia,

Iida,

Kuroiwa

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose This systematic review and meta-analysis aimed to (1) determine the proportion of patients who underwent anterior shoulder instability surgery and did not return to sports for psychological reasons and (2) estimate differences in psychological readiness scores between patients who did and did not return to sports. Methods The EBSCOhost/SPORTDiscus, PubMed/Medline, Scopus, EMBASE and Cochrane Library databases were searched for relevant studies. The data synthesis included the proportion of patients who did not return to sports for psychological reasons and the mean differences in the psychological readiness of athletes who returned and those who did not return to sports. Non-binomial data were analysed using the inverse-variance approach and expressed as the mean difference with 95% confidence intervals. ResultsThe search yielded 700 records, of which 13 (1093 patients) were included. Fourteen psychological factors were identified as potential causes for not returning to sports. The rates of return to sports at any level or to the preinjury level were 79.3% and 61.9%, respectively. A total of 55.9% of the patients cited psychological factors as the primary reason for not returning to sports. The pooled estimate showed that patients who returned to sports had a significantly higher Shoulder Instability-Return to Sport After Injury score (P < 0.00001) than those who did not, with a mean difference of 30.24 (95% CI 24. 95-35.53; I 2 = 0%; n.s.). Conclusions Psychological factors have a substantial impact on the rate of return to sports after anterior shoulder instability surgery. Patients who returned to sports had significantly higher psychological readiness than those who did not return to sports. Based on these results, healthcare professionals should include psychological and functional measurements when assessing athletes' readiness to return to sports. Level of evidence Level IV.

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The Relationship between Kinesiophobia and Return to Sport after Shoulder Surgery for Recurrent Anterior Instability

Cited by 19 publications

References 35 publications

Shoulder instability in military personnel: diagnosis and outcomes of arthroscopic stabilisation

Shoulder instability in military personnel: diagnosis and outcomes of arthroscopic stabilisation

Change in Head Impact Exposure following Return to Play in Concussed Football Athletes

Substantial influence of psychological factors on return to sports after anterior shoulder instability surgery: a systematic review and meta‐analysis

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