Background:

Psychological readiness to return to sport has emerged as an important factor associated with outcomes after anterior cruciate ligament reconstruction (ACLR). Psychological factors are potentially modifiable during the course of rehabilitation, and improving them may lead to better outcomes.

Purpose:

To determine whether athletes with a positive psychological response after participation in a neuromuscular training and second injury prevention program had better self-reported function and activity outcomes compared with athletes who did not have a meaningful change.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

After ACLR and the completion of formal rehabilitation, 66 level I/II athletes completed the following self-reported measures at enrollment (pretraining): the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale, the International Knee Documentation Committee (IKDC) subjective knee form, and the 5 subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS). Participants completed these measures after 10 sessions of agility, plyometric, and progressive strength training and at 1 and 2 years after ACLR. Participants who displayed an increase in the ACL-RSI score from pretraining to posttraining that exceeded the minimal clinically important difference (≥10 points) were defined as having a positive psychological response (responders) to training, and those who did not were defined as nonresponders. A mixed-model analysis of variance was used to determine if group differences in IKDC and KOOS scores existed over the 4 time points (pretraining, posttraining, and the 1- and 2-year follow-ups).

Results:

The responders reported better self-reported function compared with the nonresponders, regardless of time, on the IKDC form (P = .001), KOOS–Sport and Recreation (P = .014), KOOS-Pain (P = .007), and KOOS-Symptoms (P = .002) but not on the KOOS–Quality of Life (P = .078). Overall, 77% of responders and 67% of nonresponders returned to their previous level of sport by 1 year after ACLR (P = .358), and 82% of responders and 78% of nonresponders returned to their previous level of sport by 2 years after ACLR (P = .668).

Conclusion:

Ultimately, 59% of the athletes in this study displayed a meaningful improvement in their psychological outlook over the course of the training program. Responders demonstrated persistently better self-reported function at posttraining and at 1 and 2 years after ACLR, but there were no between-group differences in return-to-sport rates.

中文翻译：

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前交叉韧带重建后 2 年 ACL-SPORTS 训练计划的心理反应与自我报告功能的关联

背景：

重返运动的心理准备已成为与前交叉韧带重建 (ACLR) 后结果相关的重要因素。心理因素在康复过程中可能会改变，改善它们可能会带来更好的结果。

目的：

确定参加神经肌肉训练和二次伤害预防计划后心理反应积极的运动员与没有有意义变化的运动员相比，是否有更好的自我报告功能和活动结果。

学习规划：

队列研究；证据水平，3。

方法：

在 ACLR 和完成正式康复后，66 名 I/II 级运动员在入学时（训练前）完成了以下自我报告的措施：前交叉韧带 - 受伤后恢复运动 (ACL-RSI) 量表、国际膝关节文献委员会(IKDC) 主观膝关节形态，以及膝关节损伤和骨关节炎结果评分 (KOOS) 的 5 个分量表。参与者在 10 次敏捷性、增强式和渐进式力量训练后以及 ACLR 后 1 年和 2 年完成了这些测量。从训练前到训练后 ACL-RSI 评分增加超过最小临床重要差异（≥10 分）的参与者被定义为对训练有积极的心理反应（响应者），而那些没有被定义为无响应者.

结果：

在 IKDC 表格 ( P = .001)、KOOS-运动和娱乐 ( P = .014)、KOOS-Pain ( P = .007)上，与无反应者相比，响应者报告了更好的自我报告功能，无论时间长短，和 KOOS-Symptoms ( P = .002)，但不适用于 KOOS-生活质量 ( P = .078)。总体而言，77% 的反应者和 67% 的无反应者在 ACLR 后 1 年恢复到以前的运动水平（P = .358），82% 的反应者和 78% 的无反应者在 2 年内恢复到以前的运动水平在 ACLR ( P = .668) 之后。

结论：

最终，在这项研究中，59% 的运动员在训练计划过程中表现出他们的心理前景显着改善。响应者在训练后和 ACLR 后 1 年和 2 年表现出持续更好的自我报告功能，但在恢复运动率方面没有组间差异。