Abstract
Aim: To investigate the relationship between patient psychological characteristics, adherence to rehabilitation physiotherapy and outcome at one year following anterior cruciate ligament reconstruction.
Methods: 75 consecutive patients undergoing ACL reconstruction by a single experienced surgeon received a pre-operative psychological assessment comprising of five questionnaires; Athletic Identity Measurement Scale (AIMS), Recovery Locus of Control Scale (RLCS), Self-Motivation Inventory (SMI), Hospital Anxiety and Depression Scale (HADS), and Short Form Social Support Questionnaire (SSQ6). Four functional questionnaires were completed pre-operatively by the patient; Subjective Knee Evaluation Form (IKDC 2000), Tegner Activity Scale (TAS), Lysholm Score (LS), and Lower Extremity Functional Score (LEFS). LEFS is a simple, sensitive subjective assessment tool which is sensitive to change. Final outcome was assessed by repeating the functional questionnaires at 1-year post-operatively following rehabilitation. Rehabilitation adherence was measured using the Sport Injury Rehabilitation Adherence Scale (SIRAS) and physiotherapy appointment attendance.
Results: The data were analysed using regression analysis (n=57). Self motivation score (R2= 0.142), a higher athletic identity (R2= 0.067), good social support (R2=0.170) and an internal locus of control or high self efficacy (R2=0.111) were all found to be positive predictors of final outcome. Poor self motivation and an external locus of control are associated with less successful final outcome.
Discussion and Conclusion: Self motivation and self efficacy are positive predictors of final outcome after ACL reconstruction. These aspects may be reinforced during rehabilitation. Patients with an external locus of control and poor self-motivation can be identified and their pre- and post-operative management may be adapted to achieve optimal outcome.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
