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Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction

Year 2015, Volume: 49 Issue: 5, 492 - , 24.09.2015

Abstract

Objective: The aim of this study is to evaluate early phase depression and anxiety in the proffessional athletes who underwent anterior cruciate ligament (ACL) reconstruction and compare them with the functional improvement of knee.
Methods: Thirty-eight patients (35 males, 3 females; mean age±SD: 26.84±8.03) were included in this study. Measurements were obtained immediately following the operation and at Week 6 of postoperative rehabilitation. Depression and anxiety symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS), and knee function was evaluated by Lysholm Knee Scoring Scale (LKSS).
Results: Change in total LKSS scores from the time of admission (56.4±20.2) to the end of the sixth week (78.7±13.8) was significant (t=–8.21, p<0.001). Neither the HADS depression nor the HADS anxiety scores were above the cutoff values in the 2 assessments. Significant difference was noted in HADS anxiety scores between the time of admission (6.21±3.50) and at the sixth week (5.33±3.33) (t=2.02, p=0.05). However, HADS depression scores were not statistically different between the 2 evaluations (5.95±3.68 and 5.35±3.50 at admission and Week 6 week, respectively) (t=1.07, p=0.29). Changes between the 2 LKSS and HADS anxiety assessments were negatively correlated (r=–0.49, p=0.002), but there no correlation was detected between the total LKSS and HADS score changes.
Conclusion: The decline of the signs of anxiety and depression at the sixth week of rehabilitation indicate that proper rehabilitation positively affects the emotional status of ACL reconstruction patients.

References

  • Salahudeen AK. Free radicals in kidney disease and trans- plantation. Saudi J Kidney Dis Transpl 1999;10:137–43.
  • Özdemir H, Yıldırım A, Ürgüden M, Gür S, Aydın AT. Kemik-patellar tendon-kemik grefti ile yapılan ön çapraz bağ rekonstrüksiyonlarının orta dönem sonuçları. Artro- plasti ve Artroskopik Cerrahi 1999;10:129–36.
  • Eggerding V, Reijman M, Scholten RJ, Meuffels DE. Computer-assisted surgery for knee ligament reconstruc- tion. Cochrane Database Syst Rev 2014;8:CD007601.
  • Chmielewski TL, Zeppieri G Jr, Lentz TA, Tillman SM, Moser MW, Indelicato PA, et al. Longitudinal changes in psychosocial factors and their association with knee pain and function after anterior cruciate ligament reconstruc- tion. Phys Ther 2011;91:1355–66.
  • Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 2011;45:596–606.
  • Klenk A. Psychological response to injury, recovery, and social support: A Survey of athletes at an NCAA divi- sion I university 2006. Senior Honors Projects. Paper 9. http://digitalcommons.uri.edu/srhonorsprog/9.
  • Lee DY, Karim SA, Chang HC. Return to sports after anterior cruciate ligament reconstruction - a review of patients with minimum 5-year follow-up. Ann Acad Med Singapore 2008;37:273–8.
  • Langford JL, Webster KE, Feller JA. A prospective longi- tudinal study to assess psychological changes following an- terior cruciate ligament reconstruction surgery. Br J Sports Med 2009;43:377–81.
  • Tegner Y, Lysholm J. Rating systems in the evalua- tion of knee ligament injuries. Clin Orthop Relat Res 1985;198:43–9.
  • Zigmond AS, Snaith RP. The hospital anxiety and depres- sion scale. Acta Psychiatr Scand 1983;67:361–70.
  • Devrimci HÖ, Köker S, Canat S. Hastane-anksiyete ve depresyon ölçeğinin bir Ankara örnekleminde geçerlik ve güvenirliği. Psikiyatri Psikoloji Psikofarmakoloji Dergisi 1997;5:197–201.
  • Aydemir Ö, Güvenir T, Küey L, Kültür S. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Türk Psikiyatri Dergisi 1977;8:280– 7.
  • Podlog L, Eklund RC. The psychosocial aspects of a re- turn to sport following serious injury: A review of the lit- erature from a self-determination perspective. Psychology of Sport and Exercise 2007;8:535–66.
  • Brewer BW. Developmental Differences in Psychologi- cal Aspects of Sport-Injury Rehabilitation. J Athl Train 2003;38:152–3.
  • Cupal DD. Psychological interventions in sport injury prevention and rehabilitation. J Appl Sport Psychol 1998;10:103–23.
  • Tripp DA, Stanish WD, Reardon G, Coady C, Sullivan MJ. Comparing Postoperative Pain Experiences of the Adolescent and Adult Athlete After Anterior Cruciate Ligament Surgery. J Athl Train 2003;38:154–7.
  • Oztekin HH, Boya H, Ozcan O, Zeren B, Pinar P. Pain and affective distress before and after ACL surgery: a com- parison of amateur and professional male soccer players in the early postoperative period. Knee 2008;15:368–72.
  • Ardern CL, Österberg A, Tagesson S, Gauffin H, Web- ster KE, Kvist J. The impact of psychological readiness to return to sport and recreational activities after ante- rior cruciate ligament reconstruction. Br J Sports Med 2014;48:1613–9.

PROFESYONEL SPORCULARDA ÖN ÇAPRAZ BAĞ ONARIMI SONRASI PSİKİYATRİK VE FONKSİYONEL DEĞERLENDİRME

Year 2015, Volume: 49 Issue: 5, 492 - , 24.09.2015

Abstract

Amaç: Bu çalışmada, hamstring otogrefti ile ÖÇB onarımı sonrası erken dönemde, sporcularda anksiyete ve depresif belirti şiddeti ölçülmüş ve takipte bu belirtilerin diz fonksiyonunun yeniden kazanılmasıyla ilişkili olup olmadığı araştırılmıştır.
Hastalar ve Yöntem: Çalışmaya hamstring otogrefti ile ÖÇB onarımı yapılan ve yaş ortalaması 26,84±8,03 olan 35'i erkek 3'ü kadın olmak üzere toplam 38 profesyonel sporcu hasta alınmıştır. Ölçümler ÖÇB onarımından hemen sonra ve 6. haftalarda yapılmıştır. Anksiyete ve depresyon belirtileri Hastane Anksiyete Depresyon Ölçeği (HADO) ile ölçülmüş, fonksiyonel değerlendirme ise Lysholm Diz Skorlama Ölçeği (LDSÖ) ile yapılmıştır. Bulgular: LDSÖ toplam puanı rehabilitasyonun başlangıcında 56.4±20.2,  altıncı haftanın sonunda ise 78.7±13.8 olarak bulunmuştur. Toplam LDSÖ puanındaki değişim istatistiksel olarak anlamlıdır (t=-8.21, p<0.001). HADÖ-Depresyon ve HADÖ-Anksiyete puanları her iki değerlendirmede de eşik değerin altındadır. Öte yandan birinci ve altıncı haftadaki HADÖ-Anksiyete puanları arasındaki fark istatistiksel olarak anlamlı bulunmuştur (sırasıyla 6.21±3.50 ve 5.33±3.33 t=2.02, p=0.05). Başvuru esnasındaki ve altıncı haftadaki HADÖ-Depresyon puanları arasında ise anlamlı bir fark saptanmamıştır (sırasıyla 5.95±3.68 ve 5.35±3.50 t=1.07, p=0,29). İlk değerlendirme ve altıncı haftadaki LDSÖ toplam puanları arasındaki değişim ile HADÖ-Anksiyete ve HADÖ-Depresyon alt ölçek toplam puanlarındaki değişim arasında negatif  korelasyon vardır (sırasıyla, r=-0.49, p=0.002 ve r=-0.44, p=0.006). Çıkarımlar: ÖÇB onarımı sonrası ilk altı haftada sporcuların anksiyete ve depresyon belirtileri yaşamaları rehabilitasyonu olumsuz etkileyebilir. Altı haftalık rehabilitasyon sonrasında, anksiyete belirtilerindeki düşmenin anlamlı olması ve rehabilitasyon sürecinde fonksiyonalitenin artması ile depresyon ve anksiyete belirtileri arasında negatif korelasyon saptanması,  uygun rehabilitasyon sürecinin, profesyonel sporcularda ek psikiyatrik/psikolojik destek olmaksızın kaygı ve duygudurum belirtileri üzerinde etkili olduğunu göstermektedir.

 

References

  • Salahudeen AK. Free radicals in kidney disease and trans- plantation. Saudi J Kidney Dis Transpl 1999;10:137–43.
  • Özdemir H, Yıldırım A, Ürgüden M, Gür S, Aydın AT. Kemik-patellar tendon-kemik grefti ile yapılan ön çapraz bağ rekonstrüksiyonlarının orta dönem sonuçları. Artro- plasti ve Artroskopik Cerrahi 1999;10:129–36.
  • Eggerding V, Reijman M, Scholten RJ, Meuffels DE. Computer-assisted surgery for knee ligament reconstruc- tion. Cochrane Database Syst Rev 2014;8:CD007601.
  • Chmielewski TL, Zeppieri G Jr, Lentz TA, Tillman SM, Moser MW, Indelicato PA, et al. Longitudinal changes in psychosocial factors and their association with knee pain and function after anterior cruciate ligament reconstruc- tion. Phys Ther 2011;91:1355–66.
  • Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 2011;45:596–606.
  • Klenk A. Psychological response to injury, recovery, and social support: A Survey of athletes at an NCAA divi- sion I university 2006. Senior Honors Projects. Paper 9. http://digitalcommons.uri.edu/srhonorsprog/9.
  • Lee DY, Karim SA, Chang HC. Return to sports after anterior cruciate ligament reconstruction - a review of patients with minimum 5-year follow-up. Ann Acad Med Singapore 2008;37:273–8.
  • Langford JL, Webster KE, Feller JA. A prospective longi- tudinal study to assess psychological changes following an- terior cruciate ligament reconstruction surgery. Br J Sports Med 2009;43:377–81.
  • Tegner Y, Lysholm J. Rating systems in the evalua- tion of knee ligament injuries. Clin Orthop Relat Res 1985;198:43–9.
  • Zigmond AS, Snaith RP. The hospital anxiety and depres- sion scale. Acta Psychiatr Scand 1983;67:361–70.
  • Devrimci HÖ, Köker S, Canat S. Hastane-anksiyete ve depresyon ölçeğinin bir Ankara örnekleminde geçerlik ve güvenirliği. Psikiyatri Psikoloji Psikofarmakoloji Dergisi 1997;5:197–201.
  • Aydemir Ö, Güvenir T, Küey L, Kültür S. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Türk Psikiyatri Dergisi 1977;8:280– 7.
  • Podlog L, Eklund RC. The psychosocial aspects of a re- turn to sport following serious injury: A review of the lit- erature from a self-determination perspective. Psychology of Sport and Exercise 2007;8:535–66.
  • Brewer BW. Developmental Differences in Psychologi- cal Aspects of Sport-Injury Rehabilitation. J Athl Train 2003;38:152–3.
  • Cupal DD. Psychological interventions in sport injury prevention and rehabilitation. J Appl Sport Psychol 1998;10:103–23.
  • Tripp DA, Stanish WD, Reardon G, Coady C, Sullivan MJ. Comparing Postoperative Pain Experiences of the Adolescent and Adult Athlete After Anterior Cruciate Ligament Surgery. J Athl Train 2003;38:154–7.
  • Oztekin HH, Boya H, Ozcan O, Zeren B, Pinar P. Pain and affective distress before and after ACL surgery: a com- parison of amateur and professional male soccer players in the early postoperative period. Knee 2008;15:368–72.
  • Ardern CL, Österberg A, Tagesson S, Gauffin H, Web- ster KE, Kvist J. The impact of psychological readiness to return to sport and recreational activities after ante- rior cruciate ligament reconstruction. Br J Sports Med 2014;48:1613–9.
There are 18 citations in total.

Details

Primary Language English
Journal Section Original Article
Authors

Mehmet Celebi

Tolga Saka

Bora Baskak This is me

Halise Devrimci Ozguven This is me

Bulent Ulkar This is me

Ebru Atalar

Publication Date September 24, 2015
Published in Issue Year 2015 Volume: 49 Issue: 5

Cite

APA Celebi, M., Saka, T., Baskak, B., Devrimci Ozguven, H., et al. (2015). Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction. Acta Orthopaedica Et Traumatologica Turcica, 49(5), 492. https://doi.org/10.3944/AOTT.2015.14.0380
AMA Celebi M, Saka T, Baskak B, Devrimci Ozguven H, Ulkar B, Atalar E. Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction. Acta Orthopaedica et Traumatologica Turcica. September 2015;49(5):492. doi:10.3944/AOTT.2015.14.0380
Chicago Celebi, Mehmet, Tolga Saka, Bora Baskak, Halise Devrimci Ozguven, Bulent Ulkar, and Ebru Atalar. “Psychiatric and Functional Evaluation of Professional Athletes Following Anterior Cruciate Ligament Reconstruction”. Acta Orthopaedica Et Traumatologica Turcica 49, no. 5 (September 2015): 492. https://doi.org/10.3944/AOTT.2015.14.0380.
EndNote Celebi M, Saka T, Baskak B, Devrimci Ozguven H, Ulkar B, Atalar E (September 1, 2015) Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction. Acta Orthopaedica et Traumatologica Turcica 49 5 492.
IEEE M. Celebi, T. Saka, B. Baskak, H. Devrimci Ozguven, B. Ulkar, and E. Atalar, “Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction”, Acta Orthopaedica et Traumatologica Turcica, vol. 49, no. 5, p. 492, 2015, doi: 10.3944/AOTT.2015.14.0380.
ISNAD Celebi, Mehmet et al. “Psychiatric and Functional Evaluation of Professional Athletes Following Anterior Cruciate Ligament Reconstruction”. Acta Orthopaedica et Traumatologica Turcica 49/5 (September 2015), 492. https://doi.org/10.3944/AOTT.2015.14.0380.
JAMA Celebi M, Saka T, Baskak B, Devrimci Ozguven H, Ulkar B, Atalar E. Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction. Acta Orthopaedica et Traumatologica Turcica. 2015;49:492.
MLA Celebi, Mehmet et al. “Psychiatric and Functional Evaluation of Professional Athletes Following Anterior Cruciate Ligament Reconstruction”. Acta Orthopaedica Et Traumatologica Turcica, vol. 49, no. 5, 2015, p. 492, doi:10.3944/AOTT.2015.14.0380.
Vancouver Celebi M, Saka T, Baskak B, Devrimci Ozguven H, Ulkar B, Atalar E. Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction. Acta Orthopaedica et Traumatologica Turcica. 2015;49(5):492.