A Randomized, Controlled Study of a Rehabilitation Model to Improve Knee-Function Self-Efficacy With ACL Injury

Abstract

Context:The Knee Self-Efficacy Scale (K-SES) has good reliability, validity, and responsiveness for patients’ perceived knee-function self-efficacy during rehabilitation after an anterior cruciate ligament (ACL) injury. Preoperative knee-function self-efficacy has also been shown to have a predictive ability in terms of outcome 1 y after ACL reconstruction.Objective:To evaluate a new clinical rehabilitation model containing strategies to enhance knee-function self-efficacy.Design:A randomized, controlled study.Setting:Rehabilitation clinic and laboratory.Patients:40 patients with ACL injuries.Intervention:All patients followed a standardized rehabilitation protocol. Patients in the experimental group were treated by 1 of 3 physiotherapists who had received specific training in a clinical rehabilitation model. These physiotherapists were also given their patients’ self-efficacy scores after the initial and 4-, 6-, and 12-mo follow-ups, whereas the 5 physiotherapists treating the patients in the control group were not given their patients’ self-efficacy scores.Main Outcome Measures:The K-SES, the Tegner Activity Scale, the Physical Activity Scale, the Knee Injury and Osteoarthritis Outcome Score, and the Multidimensional Health Locus of Control.Results:Twenty-four patients (12 in each group) completed all followups. Current knee-function self-efficacy, knee symptoms in sports, and knee quality of life improved significantly (P = .05) in both groups during rehabilitation. Both groups had a significantly (P = .05) lower physical activity level at 12 mo than preinjury. No significant differences were found between groups.Conclusion:In this study there was no evidence that the clinical rehabilitation model with strategies to enhance self-efficacy resulted in a better outcome than the rehabilitation protocol used for the control group.