Abstract
Objectives
Anterior Cruciate Ligament (ACL) injuries are common injuries within sports. While these are common injuries, they are also feared injuries due to the surgical procedure, the long period of rehabilitation and the uncertainty of returning to sport (RTS), with kinesiophobia being one of the main causes that prevent athletes from this RTS. The objective of this systematic review is to verify which strategies can be used and which are effective in reducing kinesiophobia during the rehabilitation of anterior cruciate ligament injuries. A secondary objective is to analyze whether any of these strategies can facilitate RTS.
Methods
This is a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model. The search was carried out in the databases: PubMed (MEDLINE), Web of Science, ScienceDirect (Elsevier) and PsycINFO (APA) and was closed on December 16, 2023 with the following terms: "Anterior Cruciate Ligament" AND “ACL injur *” OR kinesiophobia OR Fear OR Psychological AND Therapy OR Rehabilitation OR Treatment.
Results
Eight clinical trials were selected for data analysis. In total, 396 individuals were evaluated with a mean age of 16.0±5.0 years to 35.0±11.9 years. The most used questionnaires to assess kinesiophobia were the Tampa Scale for Kinesiophobia (TSK) and the Anterior Cruciate Ligament – Return to Sport Index (ACL-RSI). Most studies showed the effectiveness of interventions in reducing kinesiophobia. Other outcomes were also evaluated and were found to be favorable for the intervention groups (IG), compared to the control groups (CG).
Conclusion
Education about treatment, progressive physical training and variation in the post anterior cruciate ligament reconstruction rehabilitation process prove to be an effective alternative in reducing kinesiophobia and improving knee function.