The Impact of Psychological Factors on Return to Sports after Anterior Cruciate Ligament Reconstruction: A Systematic Review
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Published:2023-07-24
Issue:3
Volume:3
Page:78-93
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ISSN:2673-4036
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Container-title:Osteology
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language:en
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Short-container-title:Osteology
Author:
Longo Umile Giuseppe1ORCID, De Salvatore Sergio12ORCID, D’Orrico Federica1, Bella Matilda1, Corradini Alessandra1, Rizzello Giacomo1, De Marinis Maria Grazia3, Denaro Vincenzo1
Affiliation:
1. Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Roma, Italy 2. Department of Orthopedics, Children’s Hospital Bambino Gesù, Palidoro, 00165 Rome, Italy 3. Research Unit Nursing Science, Campus Bio-Medico University, Via Alvaro del Portillo, 00128 Rome, Italy
Abstract
The rehabilitation of those who have undergone anterior cruciate ligament reconstruction (ACL-R) is a complex process that involves many factors. Physical ability recovery is not the only factor in the return to sport; psychosocial factors such as anxiety, pain response, self-esteem, locus of control, and fear of re-injury also play an important role. A systematic search was conducted on the PubMed, Medline, Cochrane, CINAHL and Embase databases using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). No randomized controlled trials (RCTs) were identified. The Methodological Index for Non-Randomized Studies (MINOR) was used to assess the quality of the identified non-RCT studies. A total of 308 studies were identified, of which 32 met the eligibility criteria. The results of these studies were obtained using the KOOS (ADL, Sport, QoL), ACL, TSK-11, K-SES, questionnaires/interviews, and other scales as instrumental approaches. This systematic review and meta-analysis revealed that psychological factors have a significant influence on the post-anterior cruciate ligament reconstruction outcomes of athletes. Fear of re-injury and pain were the primary factors that limited return to sport, whereas self-efficacy, psychological will, and age were associated with better functional outcomes and were essential for male and young patients. Clinicians should focus on both physical and psychological components to optimize rehabilitation.
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