Does the Fear of Re-Injury in Athletes After an ACL Reconstruction Negatively Affect Their Return to Sport Process: A Critically Appraised Topic

Does the Fear of Re-Injury in Athletes After an ACL Reconstruction Negatively Affect Their Return to Sport Process: A Critically Appraised Topic

Date

2-14-2024

Faculty Mentor

Christopher Clark, Kinesiology; Jennifer Burgett, Kinesiology; David Kean, Kinesiology

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Submission Type

Conference Proceeding

Location

11:45-11:55am | Houston Cole Library, 11th Floor

Description

Context: A rupture of the anterior cruciate ligament (ACL) is a very prevalent injury in athletes. The ACL is the most injured ligament within the knee, ranging up to 200,000 injuries per year and approximately 100,000 ACL reconstructions occur annually. In addition to initial ACL injuries, the athletic population also has the highest risk of re-injury. Fear is a normal psychological response that can affect the decision-making process during recovery. Therefore, the purpose of this critically appraised topic is if fear of re-injury in athletes after undergoing an anterior cruciate ligament reconstruction (ACLR) negatively affect their return to sport process.

Methods: A computerized search was conducted in October 2023. The search terms used were “kinesiophobia in athletes with ACL reconstruction”, “ACL reconstruction”, “kinesiophobia”, and “fear of return to play in athletes after an ACL reconstruction”. Electronic databases used were PubMed, Google Scholar, JSU Houston Cole Library Database, and Sports Discus. Inclusion criteria: Articles in the English language and written after 2011. Exclusion criteria: Combined knee ligament injuries, other psychological injuries, and studies that did not include athletes. Validity of the selected studies was determined using the PRIMSA and STROBE checklists. One author independently reviewed the studies, scored each paper, and reviewed the completed appraisals to come to a consensus on the study quality.

Results: The literature search retrieved 2,570 total articles and 2,567 were excluded based on the exclusion criteria, resulting in three studies. The cited sources used for this article included a variety of questionnaires, interviews, and neurological assessments tools to measure the fear in athletes during their recovery process. Athletes did not return to their sport after ACLR because they had a fear of failing financially and socially, along with having the reconstruction fail. The costs associated with surgically reconstructed ACL injuries range from $5000 to $17,000 per patient; however, the estimated long-term societal costs may be as high as $38,000 per patient. In addition, 77.2% of ACLR patients reported emotional states such as anxiety, anger, confusion, depression, and worry. Furthermore, greater fear of reinjury was associated with lesser hamstrings strength, hop performance, and patient-reported function throughout the patient’s recovery process, as patients believed their reconstruction would fail them.

Conclusion: Research has shown that athletes who have ruptured their ACL and had a ACLR experience fear of re-injury when returning to their sport. This fear of re-injury can cause the athlete to have a delay in the return to play process, can create physical ailments that can put them at a higher risk of reinjuring their ACL, and can ultimately lead to them never returning to their sport. Implications for healthcare providers should address the emotion in the rehabilitation process of an injured athlete with an ACLR.

Keywords

student research, kinesiology

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Disciplines

Kinesiotherapy

Does the Fear of Re-Injury in Athletes After an ACL Reconstruction Negatively Affect Their Return to Sport Process: A Critically Appraised Topic

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