SELF-REPORTED FEAR PREDICTS FUNCTIONAL PERFORMANCE AND SECOND ACL INJURY AFTER ACL RECONSTRUCTION AND RETURN TO SPORT: A PILOT STUDY

Review written by Christina Le info

BACKGROUND & OBJECTIVE

A great deal of research has investigated return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction to ensure safe and successful RTS. Considering fear of reinjury is one of the most commonly reasons cited for not returning to sport, perhaps it should be included in the battery of RTS testing. The objective of this pilot study was to determine if self-reported fear at time of RTS was associated with physical activity, functional tests, and risk of second ACL injury.

METHODS

At the time of RTS, all participants completed the Tampa Scale of Kinesiophobia-11 (TSK-11) to assess fear, completed the Marx Activity Rating Scale (Marx) to assess activity level, and underwent functional tests (single leg hop for distance and isometric quadriceps strength). The TSK-11 score was dichotomized to divide participants into two groups: high fear (scoring 17) and low fear (scoring <17). All other exposure variables were also dichotomized: high vs low activity (16 vs <16 on the Marx), good vs poor single leg hop symmetry (>95% vs 95% limb symmetry index; LSI), and good vs poor quadriceps strength symmetry (>90% vs 90% LSI). Lastly, participants were monitored via phone and/or email for 24 months after RTS to determine if they had sustained a second ACL injury.

RESULTS

This pilot study consisted of forty participants (mean age 16.2 years, SD3.4) with an average RTS time from surgery of 7.6 months (SD2.4). Nineteen participants were placed in the high fear group and 21 were in the low fear group.

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