Investigation of activity and kinesiophobia in anterior cruciate ligament reconstructed patients

Öz

Aim: To investigate the kinesiophobia and activity score in anterior cruciate ligament reconstructed patients and healthy males. Materials and Methods: 27 healthy males and 19 anterior cruciate ligament reconstructed male patients who had ‘Lysholm Knee Score’ above 84 at final controls participated in the study. Their sociodemographic and physical characteristics were recorded. Patients’ activity score was evaluated by ‘Tegner Activity Score’ and kinesiophobia was evaluated by ‘Tampa Kinesiophobia Scala’. Results: Patients’ age were 29,4 years, healthy males’ age were 28,1 years (p>0.05). The follow-up was 14,7 months. ‘Tegner Activity Score’ was lower for anterior cruciate ligament reconstructed patients (p=0.03), whereas ‘Tampa Kinesiophobia Scala’ was higher (p=0.004). Conclusion: Patients with ACL reconstruction may not return to preinjury levels of sports participation for a variety of reasons. Several researches reported fear of reinjury was the most commonly cited reason for not returning to preinjury levels of sports participation. Determine of the kinesophobia at post op early period in ACL reconstructions could make a significant contribution to return to preinjury levels of sports

Anahtar Kelimeler

• Anterior cruciate ligament reconstruction
• kinesiophobia
• return to sport

ÖN ÇAPRAZ BAĞ REKONSTRÜKSİYONU GEÇİREN HASTALARDA VE SAĞLIKLI ERKEKLERDE KİNEZYOFOBİNİN VE AKTİVİTE SKORUNUN KARŞILAŞTIRILMASI

Öz

AMAÇ: Ön çapraz bağ rekonstrüksiyonu yapılan hastalar ile sağlıklı erkeklerdeki kinezyofobinin ve aktivite skorunun incelenmesi amaçlanmıştır. GEREÇ VE YÖNTEM: 27 sağlıklı erkek ile en az postoperatif 6.ayının dolduran son takibinde Lysholm diz skoru 84'ün üstünde olan 19 erkek hasta çalışmaya dahil edildi. Katılımcıların sosyodemografik ve fiziksel özellikleri kaydedildi. Aktivite düzeyi Tegner Aktivite Skoru ile, kinezyofobi değerleri Tampa Kinezyofobi Ölçeği ile değerlendirildi. BULGULAR: Hastaların ortalama takip süresi 14.8±7.5 aydı. Tegner Aktivite Skoru opere grupta sağlıklı bireylere göre düşük bulunurken (p=0.04), Tampa Kinezyofobi Ölçeği değerleri yüksek bulundu (p=0.009). SONUÇ: Ön çapraz bağ rekonstrüksiyonu geçiren hastaların, farklı sebeplerden dolayı yaralanma öncesindeki sportif aktivite düzeyine dönemedikleri bilinmektedir. Birçok çalışmada yaralanma öncesi sportif aktivite seviyesine dönmeyi engelleyen en sık sebebin tekrar yaralanma korkusu olduğunu belirtmiştir. Ön çapraz bağ rekonstrüksiyonu erken rehabilitasyon sürecinde kinezyofobinin saptanması, hastaların rüptür öncesi aktivite düzeylerine ulaşmaları için katkı sağlayabilir. 

Anahtar Kelimeler

• Ön çapraz bağ rekonstrüksiyonu
• hareket korkusu
• spora geri dönüş

Kaynakça

1. Wilk KE, Simoneau GG. Managing knee injuries: keeping up with changes. J Orthop Sports Phys Ther 2012;42:150- 2.
2. Kvist J, Ek A, Sporrstedt K, Good L. Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2005;13:393-7.
3. Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F. Anterior cruciate ligament reconstruction: bone-patellar tendon- bone compared with double semitendinosus and gracilis tendon grafts. A prospective, randomized clinical trial. J Bone Joint Surg Am 2004;86-A:2143-55.
4. Gobbi A, Francisco R. Factors affecting return to sports after anterior cruciate ligament reconstruction with patellar tendon and hamstring graft: a prospective clinical investigation. Knee Surg Sports Traumatol Arthrosc 2006;14:1021-8.
5. 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.
6. Mikkelsen C, Werner S, Eriksson E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports:a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc 2000;8:337-42.
7. Ross MD, Irrgang JJ, Denegar CR, McCloy CM, Unangst ET. The relationship between participation restrictions and selected clinical measures following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2002;10:10-9.
8. Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries, part I. Am J Sports Med 2005;33:1579-602.

9. Kvist J. Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation. Sports Med 2004;34:269-80.
10. Tunca Yılmaz Ö, Yakut Y, Uygur F, Uluğ N. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fizyoter Rehabil 2011;22(1):44-9.
11. Karasel S, Akpınar B, Gülbahar S, Baydar M, El Ö, Pınar H, ve ark. Patellar tendon otogrefti ile ön çapraz bağ rekonstrüksiyonu ve modifiye hızlandırılmış rehabilitasyon programı sonrasında klinik ve fonksiyonel sonuçlar ve propriyosepsiyon. Acta Orthop Traumatol Turc 2010;44(3):220-8.
12. Saka T. Principles of postoperative anterior cruciate ligament rehabilitation. World Journal of Orthopedics 2014;5(4):450-9.
13. Briggs KK, Kocher MS, Rodkey WG, Steadman JR. Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg 2006;88:698-705.
14. Çelik D, Coşkunsu D, Kılıçoğlu Ö. Translation and cultural adaptation of the Turkish Lysholm Knee Scale: ease of use, validity and reliability. Clin Orthop Relat Res 2013; 471(8): 2602-10.
15. Murphy DF, Connolly DAJ, Beynnon BD. Risk factors for lower extremity injury: a review of the literature. Br J Sports Med 2003;37:13–29.
16. 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(7):596-606.
17. Swirtun LR, Eriksson K, Renstrom P. Who chooses anterior cruciate ligament reconstruction and why? A 2-year prospective study. Scand J Med Sci Sports 2006;16(6):441- 6.
18. Wiger P, Brandsson S, Kartus J, Eriksson BI, Karlsson J. A comparison of results after arthroscopic anterior cruciate ligament reconstruction in female and male competitive athletes. A two- to five-year follow-up of 429 patients. Scand J Med Sci Sports 1999;9(5):290-5.
19. Webster KE, Feller JA, Lambros C. Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery. Phys Ther Sport 2008; 9(1):9–15.
20. Chmielewski TL, Jones D, Day T, Tillman SM, Lentz TA, George SZ. The association of pain and fear of movement/ re-injury with functionduring anterior cruciate ligament reconstruction rehabilitation. J Orthop Sports Phys Ther 2008;38(12):746-53.
21. 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 reconstruction. Phys Ther 2011;91(9):1355-66.
22. Baltacı G, Yılmaz G, Atay AÖ. The outcomes of anterior cruciate ligament reconstructed and rehabilitated knees versus healthy knees: a functional comparison. Acta Orthop Traumatol Turc 2012;46(3):186-95.
23. Ardern CL, Taylor NF, Feller JA, Whitehead TS, Webster KE. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. Am J Sports Med 2013;41(7):1549-58.
24. Flanigan DC, Everhart JS, Pedroza A, Smith T, Kaeding CC. Fear of reinjury (kinesiophobia) and persistent knee symptoms are common factors for lack of return to sport after anterior cruciate ligament reconstruction. Arthroscopy 2013;29(8):1322-9.
25. Lentz TA, Zeppieri G, George SZ, Tillman SM, Moser MW, Farmer KW, et al. Comparison of physical impairment, functional, and psychosocial measures based on fear of reinjury/lack of confidence and return-to-sport status after ACL reconstruction. Am J Sports Med 2015;43(2):345-53.
26. Morrey MA, Stuart MJ, Smith AM, Weise-Bjornstal D. A longitudinal examination of athletes’ emotional and cognitive responses to anterior cruciate ligament injury. Clin J Sport Med 1999;9:63-9.
27. Langford JL, Webster KE, Feller JA. A prospective longitudinal study to assess psychological changes following anterior cruciate ligament reconstruction surgery. Br J Sports Med 2009;43:377-88.
28. Lentz TA, Zeppieri G, Tillman SM, Indelicato PA, Moser MW, George SZ, et al. Return to pre-injury sports participation following anterior cruciate ligament reconstruction: contributions of demographic, knee impairment and self-report measures. J Orthop Sports Phys Ther 2012;42(11):839-901.
29. Johnson U. A three-year follow-up of long-term injured competitive athletes: influence of psychological risk factors on rehabilitation. J Sport Rehabil 1997;6:256-71.
30. Ardern CL, Webster KE, Taylor NF, Feller JA. Return to the preinjury level of competitive sport after anterior cruciate ligament reconstruction surgery: two-thirds of patients have not returned by 12 months after surgery. Am J Sports Med 2011;39:538-43.