Cognitive-behavioral-based physical therapy to enhance return to sport after anterior cruciate ligament reconstruction: An open pilot study. (March 2020)

• Record Type: Journal Article
• Authors: Coronado, Rogelio A.; Sterling, Emma K.; Fenster, Dana E.; Bird, Mackenzie L.; Heritage, Allan J.; Woosley, Vickie L.; Burston, Alda M.; Henry, Abigail L.; Huston, Laura J.; Vanston, Susan W.; Cox, Charles L.; Sullivan, Jaron P.; Wegener, Stephen T.; Spindler, Kurt P.; Archer, Kristin R.
• Is Part Of: Physical therapy in sport. Volume 42(2020)
• Page Start: 82
• Page End: 90
• Publication Date: 2020-03
• Subjects: Anterior cruciate ligament -- Cognitive behavioral therapy -- Psychological adaptation -- Rehabilitation -- Return to sport -- Telemedicine; Sports physical therapy -- Periodicals; Sports injuries -- Patients -- Rehabilitation -- Periodicals; Athletic Injuries -- diagnosis -- Periodicals; Athletic Injuries -- therapy -- Periodicals; Physical Therapy -- Periodicals; Sports Medicine -- Periodicals; 615.82088796
• DOI: 10.1016/j.ptsp.2020.01.004
• Languages: English
• ISSNs: 1466-853X

Abstract

Abstract: Objectives: To describe feasibility, adherence, acceptability, and outcomes of a cognitive-behavioral-based physical therapy (CBPT-ACLR) intervention for improving postoperative recovery after anterior cruciate ligament reconstruction (ACLR). Design: Pilot study. Setting: Academic medical center. Participants: Eight patients (mean age [SD] = 20.1 [2.6] years, 6 females) participated in a 7-session telephone-based CBPT-ACLR intervention beginning preoperatively and lasting 8 weeks after surgery. Main outcome measures: At 6 months, patients completed Knee Injury and Osteoarthritis Outcome Score (KOOS) sports/recreation and quality of life (QOL) subscales, International Knee Documentation Committee (IKDC), Tampa Scale of Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS), and Knee Self-Efficacy Scale (K-SES), return to sport (Subjective Patient Outcome for Return to Sports), and satisfaction. Minimal clinically important difference (MCID) was used for meaningful change. Results: Seven (88%) patients completed all sessions. Seven (88%) patients exceeded MCID on the TSK, 6 (75%) on the PCS, 5 (63%) on the KOOS sports/recreation subscale, 4 (50%) on the IKDC, and 3 (38%) on the KOOS QOL subscale. Three (38%) patients returned to their same sport at the same level of effort and performance. All patients were satisfied with their recovery. Conclusions: A CBPT-ACLR program is feasible and acceptable for addressing psychological risk factors after ACLR. Highlights: Limited evidence exists on psychologically-informed rehabilitation after anterior cruciate ligament reconstruction (ACLR). A cognitive-behavioral based physical therapy (CBPT-ACLR) intervention may be a beneficial approach for return to sport. The CBPT-ACLR intervention is feasible to implement prior to and after ACLR. The CBPT-ACLR intervention is acceptable to patients based on adherence and positive feedback on intervention components.