Psychological Factors Associated With Anterior Cruciate Ligament Reconstruction Recovery

被引:56
作者
Christino, Melissa A. [1 ,2 ]
Fleming, Braden C. [1 ,2 ]
Machan, Jason T. [1 ,2 ]
Shalvoy, Robert M. [1 ,2 ]
机构
[1] Brown Univ, Rhode Isl Hosp, Dept Orthopaed Surg, Providence, RI 02903 USA
[2] Brown Univ, Warren Alpert Med Sch, Providence, RI 02912 USA
基金
美国国家卫生研究院;
关键词
anterior cruciate ligament; ACL; psychological; self-esteem; return to sport; SELF-EFFICACY; PREINJURY LEVEL; HEALTH LOCUS; SPORT; OUTCOMES; INJURY; RETURN; SURGERY; SCORE; FORM;
D O I
10.1177/2325967116638341
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Psychological factors may have underappreciated effects on surgical outcomes after anterior cruciate ligament (ACL) reconstruction; however, few studies have investigated the relationship between specific psychological factors, objective clinical data, and patient-oriented outcomes. Purpose: Psychological factors are significantly associated with patient perceptions and functional outcomes after ACL reconstruction. The purpose of this study was to demonstrate relationships between self-esteem, health locus of control, and psychological distress with objective clinical outcomes, patient-oriented outcomes, and return to sport. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Twenty-seven patients who were 6 to 24 months post-computer-assisted ACL reconstruction by a single surgeon consented to participate in the study (52% response rate). Participants had a 1-time visit with a physician consisting of: a physical examination, a single-leg hop test, KT-1000 arthrometer measurements, and survey completion. Psychological measures included the Multidimensional Health Locus of Control Scale, Rosenberg Self-Esteem Scale, and Brief Profile of Mood States. Outcome measures included the Tegner activity scale, International Knee Documentation Committee (IKDC) Subjective Knee Score, Knee injury and Osteoarthritis Outcome Score-Quality of Life subscale (KOOS-QOL), and Short Form-36 (SF-36). Patient charts were also reviewed for pertinent operative details. Results: The mean age of patients (SD) was 25.7 +/- 8.4 years, and the mean duration of time since surgery was 16.5 +/- 5.9 months. The majority (89%) of the patients identified themselves as athletes, and of these, 65% reported returning to sports at a competitive level. Sport returners were found to have higher levels of self-esteem (P = .002) and higher reported KOOS-QOL scores (P = .02). Self-esteem was significantly associated with IKDC scores (r = 0.46, P < .05), KOOS-QOL scores (r = 0.45, P < .05), and SF-36 subscales of general health (r = 0.45, P < .05) and physical functioning (r = 0.42, P < .05). Internal locus of control was significantly correlated with performance on single-leg hop test (r = 0.4, P < .05). Objective knee stability measurements did not correlate with subjective outcomes. Conclusion: Self-esteem levels and locus of control had significant relationships with functional test performance and validated outcome measures after ACL reconstruction. Sport returners had significantly higher self-esteem levels than those who did not return to sports, without observable differences in knee stability or time since surgery.
引用
收藏
页数:9
相关论文
共 41 条
[1]  
[Anonymous], 1992, Measuring functioning and well-being: The medical outcomes study EApproach
[2]   A systematic review of the psychological factors associated with returning to sport following injury [J].
Ardern, Clare L. ;
Taylor, Nicholas F. ;
Feller, Julian A. ;
Webster, Kate E. .
BRITISH JOURNAL OF SPORTS MEDICINE, 2013, 47 (17) :1120-+
[3]   Psychological Responses Matter in Returning to Preinjury Level of Sport After Anterior Cruciate Ligament Reconstruction Surgery [J].
Ardern, Clare L. ;
Taylor, Nicholas F. ;
Feller, Julian A. ;
Whitehead, Timothy S. ;
Webster, Kate E. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2013, 41 (07) :1549-1558
[4]   Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play [J].
Ardern, Clare L. ;
Webster, Kate E. ;
Taylor, Nicholas F. ;
Feller, Julian A. .
BRITISH JOURNAL OF SPORTS MEDICINE, 2011, 45 (07) :596-606
[5]   Return to the Preinjury Level of Competitive Sport After Anterior Cruciate Ligament Reconstruction Surgery Two-thirds of Patients Have Not Returned by 12 Months After Surgery [J].
Ardern, Clare L. ;
Webster, Kate E. ;
Taylor, Nicholas F. ;
Feller, Julian A. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2011, 39 (03) :538-543
[6]   Patient Outcomes Following Anterior Cruciate Ligament Reconstruction: The Influence of Psychological Factors [J].
Brand, Emily ;
Nyland, John .
ORTHOPEDICS, 2009, 32 (05) :335-340
[7]   Self-protective changes in athletic identity following anterior cruciate ligament reconstruction [J].
Brewer, Britton W. ;
Cornelius, Allen E. ;
Stephan, Yannick ;
Van Raalte, Judy .
PSYCHOLOGY OF SPORT AND EXERCISE, 2010, 11 (01) :1-5
[8]   The Reliability, Validity, and Responsiveness of the Lysholm Score and Tegner Activity Scale for Anterior Cruciate Ligament Injuries of the Knee [J].
Briggs, Karen K. ;
Lysholm, Jack ;
Tegner, Yelverton ;
Rodkey, William G. ;
Kocher, Mininder S. ;
Steadman, J. Richard .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2009, 37 (05) :890-897
[9]   A BRIEF POMS MEASURE OF DISTRESS FOR CANCER-PATIENTS [J].
CELLA, DF ;
JACOBSEN, PB ;
ORAV, EJ ;
HOLLAND, JC ;
SILBERFARB, PM ;
RAFLA, S .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (10) :939-942
[10]  
CELLA DF, 1987, CANCER-AM CANCER SOC, V60, P1661, DOI 10.1002/1097-0142(19871001)60:7<1661::AID-CNCR2820600740>3.0.CO