The Association of Pain and Fear of Movement/Reinjury With Function During Anterior Cruciate Ligament Reconstruction Rehabilitation.
Chmielewski, Terese L. PT, PhD, SCS 1; Jones, Debi DPT 2; Day, Tim MBA, BAppSci (Physio), BEng (Civil)(Hons) 3; Tillman, Susan M. PT, CSCS, SCS 4; Lentz, Trevor A. PT 5; George, Steven Z. PT, PhD 1
Journal of Orthopaedic & Sports Physical Therapy.
38(12):746-753, December 2008.
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* STUDY DESIGN: Cross-sectional.
* OBJECTIVES: To measure fear of movement/reinjury levels and determine the association with function at different timeframes during anterior cruciate ligament (ACL) reconstruction rehabilitation. We hypothesized that fear of movement/reinjury would decrease during rehabilitation and be inversely related with function.
* BACKGROUND: Fear of movement/reinjury can prevent return to sports after ACL reconstruction, but it has not been studied during rehabilitation.
* METHODS AND MEASURES: Demographic data and responses on the shortened version of the Tampa Scale for Kinesiophobia (TSK-11), 8-Item Short-Form Health Survey (SF-8), and International Knee Documentation Committee (IKDC) subjective form were extracted from a clinical database for 97 patients in the first year after ACL reconstruction. Three groups were formed: group 1, less than or equal to 90 days; group 2, 91 to 180 days; group 3, 181 to 372 days post-ACL reconstruction. Group differences in TSK-11 score, SF-8 bodily pain rating, and IKDC scores were determined. Hierarchical linear regression models were created for each group, with IKDC score as the dependent variable, and demographic factors, SF-8 bodily pain rating, and TSK-11 score as independent variables.
* RESULTS: TSK-11 score was higher in group 1 than in group 3 (P<.05). Across the groups, SF-8 bodily pain rating decreased (P<.001) and IKDC score increased (P<.001). SF-8 bodily pain rating was a significant factor in the regression model for all groups, whereas TSK-11 score only contributed to the regression model in group 3 (partial correlation, -0.529).
* CONCLUSIONS: Pain was consistently associated with function across the timeframes studied. Fear of movement/reinjury levels appear to decrease during ACL reconstruction rehabilitation and are associated with function in the timeframe when patients return to sports.
* LEVEL OF EVIDENCE: Prognosis, level 4.
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