To examine the role of psychosocial interventions in improving patient-reported clinical outcomes, including return to sport/activity, and intermediary psychosocial factors after anterior cruciate ligament reconstruction.
Methods:
MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science were searched from each database’s inception to March 2017 for published studies in patients after anterior cruciate ligament reconstruction. Studies were included if they reported on the effects of a postoperative psychosocial intervention on a patient-reported clinical measure of disability, function, pain, quality of life, return to sport/activity, or intermediary psychosocial factor. Data were extracted using a standardized form and summary effects from each article were compiled. The methodological quality of randomized trials was assessed using the Physiotherapy Evidence Database Scale and scores greater than 5/10 were considered high quality.
Results:
A total of 893 articles were identified from the literature search. Of these, four randomized trials (N = 210) met inclusion criteria. The four articles examined guided imagery and relaxation, coping modeling, and visual imagery as postoperative psychosocial interventions. Methodological quality scores of the studies ranged from 5 to 9. There were inconsistent findings for the additive benefit of psychosocial interventions for improving postoperative function, pain, or self-efficacy and limited evidence for improving postoperative quality of life, anxiety, or fear of reinjury. No study examined the effects of psychosocial interventions on return to sport/activity.
Conclusion:
Overall, there is limited evidence on the efficacy of postoperative psychosocial interventions for improving functional recovery after anterior cruciate ligament reconstruction.
BienDPDubuqueTJ.Considerations for late stage ACL rehabilitation and return to sport to limit re-injury risk and maximize athletic performance. Int J Sports Phys Ther2015; 10: 256–271.
3.
GrantJA.Updating recommendations for rehabilitation after ACL reconstruction: a review. Clin J Sport Med2013; 23: 501–502.
4.
KruseLMGrayBWrightRW.Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am2012; 94: 1737–1748.
5.
ArdernCLWebsterKETaylorNF, et al. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med2011; 45: 596–606.
6.
KvistJ.Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation. Sports Med2004; 34: 269–280.
7.
te WierikeSCvanderSluisAvandenAkker-ScheekI, et al. Psychosocial factors influencing the recovery of athletes with anterior cruciate ligament injury: a systematic review. Scand J Med Sci Sports2013; 23: 527–540.
8.
LentzTAZeppieriGJrGeorgeSZ, et al. Comparison of physical impairment, functional, and psychosocial measures based on fear of reinjury/lack of confidence and return-to-sport status after ACL reconstruction. Am J Sports Med2015; 43: 345–353.
9.
TjongVKMurnaghanMLNyhof-YoungJM, et al. A qualitative investigation of the decision to return to sport after anterior cruciate ligament reconstruction: to play or not to play. Am J Sports Med2014; 42: 336–342.
10.
TrippDAStanishWEbel-LamA, et al. Fear of reinjury, negative affect, and catastrophizing predicting return to sport in recreational athletes with anterior cruciate ligament injuries at 1 year postsurgery. Rehabil Psychol2007; 52: 74–81.
11.
ChmielewskiTLZeppieriGJrLentzTA, et al. Longitudinal changes in psychosocial factors and their association with knee pain and function after anterior cruciate ligament reconstruction. Phys Ther2011; 91: 1355–1366.
12.
JohnsonUIvarssonAKarlssonJ, et al. Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors. BMC Sports Sci Med Rehabil2016; 8: 20.
13.
ThomeePWahrborgPBorjessonM, et al. Self-efficacy of knee function as a pre-operative predictor of outcome 1 year after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc2008; 16: 118–127.
14.
EhdeDMDillworthTMTurnerJA.Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. Am Psychol2014; 69: 153–166.
15.
KeefeFJRumbleMEScipioCD, et al. Psychological aspects of persistent pain: current state of the science. J Pain2004; 5: 195–211.
16.
RiddleDLWadeJBJiranekWA, et al. Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clin Orthop Relat Res2010; 468: 798–806.
17.
MainCJGeorgeSZ.Psychologically informed practice for management of low back pain: future directions in practice and research. Phys Ther2011; 91: 820–824.
18.
MoherDLiberatiATetzlaffJ, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med2009; 151: 264–269, W64.
19.
FurlanADPennickVBombardierC, et al. 2009updated method guidelines for systematic reviews in the Cochrane back review group. Spine2009; 34: 1929–1941.
20.
SinghJADohmMSprowsonAP, et al. Outcome domains and measures in total joint replacement clinical trials: can we harmonize them? An OMERACT collaborative initiative. J Rheumatol2015; 42: 2496–2502.
21.
WyldeVMacKichanFBruceJ, et al. Assessment of chronic post-surgical pain after knee replacement: development of a core outcome set. Eur J Pain2015; 19: 611–620.
22.
de MortonNA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother2009; 55: 129–133.
23.
MacedoLGElkinsMRMaherCG, et al. There was evidence of convergent and construct validity of physiotherapy evidence database quality scale for physiotherapy trials. J Clin Epidemiol2010; 63: 920–925.
24.
MaherCGSherringtonCHerbertRD, et al. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther2003; 83: 713–721.
25.
CostaLOMaherCGMoseleyAM, et al. da Costa and colleagues’ criticism of PEDro scores is not supported by the data. J Clin Epidemiol2013; 66: 1192–1193.
26.
MaherCG.A systematic review of workplace interventions to prevent low back pain. Aust J Physiother2000; 46: 259–269.
27.
CupalDDBrewerBW.Effects of relaxation and guided imagery on knee strength, reinjury anxiety, and pain following anterior cruciate ligament reconstruction. Rehabil Psychol2001; 46: 28–43.
28.
MaddisonRPrapavessisHClatworthyM.Modeling and rehabilitation following anterior cruciate ligament reconstruction. Ann Behav Med2006; 31: 89–98.
29.
MaddisonRPrapavessisHClatworthyM, et al. Guided imagery to improve functional outcomes post-anterior cruciate ligament repair: randomized-controlled pilot trial. Scand J Med Sci Sports2012; 22: 816–821.
30.
ZaffagniniSRussoRLMarcheggiani MuccioliGM, et al. The Videoinsight® method: improving rehabilitation following anterior cruciate ligament reconstruction—a preliminary study. Knee Surg Sports Traumatol Arthrosc2013; 21: 851–858.
31.
LangfordJLWebsterKEFellerJA.A prospective longitudinal study to assess psychological changes following anterior cruciate ligament reconstruction surgery. Br J Sports Med2009; 43: 377–381.
32.
GobbiAFranciscoR.Factors affecting return to sports after anterior cruciate ligament reconstruction with patellar tendon and hamstring graft: a prospective clinical investigation. Knee Surg Sports Traumatol Arthrosc2006; 14: 1021–1028.
33.
EverhartJSBestTMFlaniganDC.Psychological predictors of anterior cruciate ligament reconstruction outcomes: a systematic review. Knee Surg Sports Traumatol Arthrosc2015; 23: 752–762.
34.
FlaniganDCEverhartJSGlassmanAH.Psychological factors affecting rehabilitation and outcomes following elective orthopaedic surgery. J Am Acad Orthop Surg2015; 23: 563–570.
35.
KernsRDThornBEDixonKE.Psychological treatments for persistent pain: an introduction. J Clin Psychol2006; 62: 1327–1331.
36.
ButlerACChapmanJEFormanEM, et al. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev2006; 26: 17–31.
37.
MorleySEcclestonCWilliamsA.Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain1999; 80: 1–13.
38.
TurnerJAHoltzmanSManclL.Mediators, moderators, and predictors of therapeutic change in cognitive-behavioral therapy for chronic pain. Pain2007; 127: 276–286.
39.
AsmundsonGJGVlaeyenJWSCrombezG.Understanding and treating fear of pain. New York: Oxford University Press, 2004, pp. xx, 1–365.
40.
LoeserJDBonicaJJ.Bonica’s management of pain. 3rd ed.Philadelphia, PA: Lippincott Williams & Wilkins, 2001, p. xxii, 2178 p.
41.
VlaeyenJWLintonSJ.Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain2000; 85: 317–332.
42.
DeWaltDADavisTCWallaceAS, et al. Goal setting in diabetes self-management: taking the baby steps to success. Patient Educ Couns2009; 77: 218–223.
43.
ThornBE.Cognitive therapy for chronic pain: a step-by-step guide. New York: Guilford Press, 2004, pp. xxiv, 1–278.
44.
JensenMP.Psychosocial approaches to pain management: an organizational framework. Pain2011; 152: 717–725.
45.
ArcherKRDevinCJVanstonSW, et al. Cognitive-behavioral-based physical therapy for patients with chronic pain undergoing lumbar spine surgery: a randomized controlled trial. J Pain2016; 17: 76–89.
46.
RiddleDLKeefeFJNayWT, et al. Pain coping skills training for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty: a quasi-experimental study. Arch Phys Med Rehabil2011; 92: 859–865.
47.
BennellKLAhamedYJullG, et al. Physical therapist-delivered pain coping skills training and exercise for knee osteoarthritis: randomized controlled trial. Arthritis Care Res2016; 68(5): 590–602.
48.
BryantCLewisPBennellKL, et al. Can physical therapists deliver a pain coping skills program? An examination of training processes and outcomes. Phys Ther2014; 94: 1443–1454.
49.
HuntMAKeefeFJBryantC, et al. A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a pilot study. Knee2013; 20: 106–112.
50.
HurleyMVWalshNEMitchellHL, et al. Clinical effectiveness of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain: a cluster randomized trial. Arthritis Rheum2007; 57: 1211–1219.
51.
SchulzKFAltmanDGMoherD, et al. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ2010; 340: c332.
52.
DijkersMP.Reporting on interventions: issues and guidelines for rehabilitation researchers. Arch Phys Med Rehabil2015; 96: 1170–1180.
53.
GlasziouPMeatsEHeneghanC, et al. What is missing from descriptions of treatment in trials and reviews?BMJ2008; 336: 1472–1474.
54.
US Department of Health and Human Services (HHS). Physical activity fundamental to preventing disease. Washington, DC: HHS, 2002, pp. 1–19.
55.
SnyderARMartinezJCBayRC, et al. Health-related quality of life differs between adolescent athletes and adolescent nonathletes. J Sport Rehabil2010; 19: 237–248.
56.
ValoisRFZulligKJHuebnerES, et al. Physical activity behaviors and perceived life satisfaction among public high school adolescents. J Sch Health2004; 74: 59–65.
57.
PerkinsDFJocobsJEBarberBL, et al. Childhood and adolescent sports participation as predicators of participation in sports and physical fitness activities during young adulthood. Youth Soc2004; 35: 495–520.
58.
PrattHDPatelDRGreydanusDE.Behavioral aspects of children’s sports. Pediatr Clin North Am2003; 50: 879–899, ix.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
