BACKGROUND: Decreased psychological readiness for sport may contribute to poor return-to-sport rates after anterior cruciate ligament reconstruction (ACLR). Though advanced rehabilitation is used to improve functional readiness for sport after ACLR, the effect of advanced rehabilitation on psychological readiness is unknown. OBJECTIVE: To examine changes in psychological and functional measures and readiness for sport based on these measures in patients with ACLR following advanced group training. METHODS: In this retrospective cohort study, patients with primary ACLR enrolled in a 5-week group training program after completing traditional physical therapy. Data collection pretraining and posttraining included demographic information, the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale, and single-leg hop testing (single, triple, crossover triple, and timed hops). Readiness for sport was based on criteria for the ACL-RSI scale score (low threshold, 56 points or greater; high threshold, 75 points or greater) and hop tests (90% or greater limb symmetry). RESULTS: Fifty-eight patients (21 male) participated. Mean ACL-RSI scale scores, mean hop test limb symmetry, and the proportion of patients meeting ACL-RSI and hop test readiness-for-sport criteria significantly improved from pretraining to posttraining. Posttraining ACL-RSI scale scores were correlated with single hop (r = 0.269) and triple hop (r = 0.275) limb symmetry, yet changes in the measures were not significantly correlated. After training, only 53.4% (lower ACL-RSI threshold) or 37.9% (higher ACL-RSI threshold) of the sample met both psychological and functional readiness criteria. CONCLUSION: Advanced group training following ACLR improved psychological and functional outcomes; however, further, individualized intervention may be needed to address residual deficiencies in some patients. LEVEL OF EVIDENCE: Therapy, level 2b. J Orthop Sports Phys Ther 2018;48(11):864-872. Epub 12 Jun 2018. doi:10.2519/jospt.2018.8041.
BACKGROUND: Decreased psychological readiness for sport may contribute to poor return-to-sport rates after anterior cruciate ligament reconstruction (ACLR). Though advanced rehabilitation is used to improve functional readiness for sport after ACLR, the effect of advanced rehabilitation on psychological readiness is unknown. OBJECTIVE: To examine changes in psychological and functional measures and readiness for sport based on these measures in patients with ACLR following advanced group training. METHODS: In this retrospective cohort study, patients with primary ACLR enrolled in a 5-week group training program after completing traditional physical therapy. Data collection pretraining and posttraining included demographic information, the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale, and single-leg hop testing (single, triple, crossover triple, and timed hops). Readiness for sport was based on criteria for the ACL-RSI scale score (low threshold, 56 points or greater; high threshold, 75 points or greater) and hop tests (90% or greater limb symmetry). RESULTS: Fifty-eight patients (21 male) participated. Mean ACL-RSI scale scores, mean hop test limb symmetry, and the proportion of patients meeting ACL-RSI and hop test readiness-for-sport criteria significantly improved from pretraining to posttraining. Posttraining ACL-RSI scale scores were correlated with single hop (r = 0.269) and triple hop (r = 0.275) limb symmetry, yet changes in the measures were not significantly correlated. After training, only 53.4% (lower ACL-RSI threshold) or 37.9% (higher ACL-RSI threshold) of the sample met both psychological and functional readiness criteria. CONCLUSION: Advanced group training following ACLR improved psychological and functional outcomes; however, further, individualized intervention may be needed to address residual deficiencies in some patients. LEVEL OF EVIDENCE: Therapy, level 2b. J Orthop Sports Phys Ther 2018;48(11):864-872. Epub 12 Jun 2018. doi:10.2519/jospt.2018.8041.
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