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Worse knee confidence, fear of movement, psychological readiness to return-to-sport and pain are associated with worse function after ACL reconstruction

journal contribution
posted on 14.01.2021, 04:16 authored by Harvi HartHarvi Hart, Adam CulvenorAdam Culvenor, A Guermazi, Kay CrossleyKay Crossley
© 2019 Objectives: To determine whether knee confidence, fear of movement, psychological readiness to return-to-sport or pain are associated with patient-reported and performance-based function and return to pivoting sport in individuals one-year after anterior cruciate ligament reconstruction (ACLR). Design: Cross-sectional study. Setting: University-laboratory. Participants: 118 individuals one-year post-ACLR. Main outcome measures: The KOOS-sport/recreation and IKDC and three hopping tasks were used to assess patient-reported and performance-based function, respectively. Questions regarding return to pivoting sport assessed return-to-sport status. Fear of movement (Tampa Scale), knee confidence (an item from KOOS, Visual Analogue Scale-VAS confidence during hopping tasks), knee pain (KOOS-pain, VAS pain during hopping tasks) and psychological readiness to return-to-sport (ACL-RSI) were also assessed. Results: Worse fear of movement (p = 0.019), KOOS-pain (p < 0.001), ACL-RSI (p < 0.001), task-specific knee confidence and pain were associated with poorer patient-reported function. Worse task-specific knee confidence (p < 0.001) and pain (p < 0006) and ACL-RSI (p < 0.016) were associated with poorer performance-based function. Higher ACL-RSI scores were associated with higher odds of returning to pivoting sport one-year post-ACLR (p < 0.001). Conclusion: Individual's fear of movement, knee confidence, psychological readiness to return-to-sport and pain are related to function. Evaluating and considering knee confidence, fear of movement, and psychological readiness should be an important part of comprehensive post-ACLR rehabilitation.


HFH is supported in part by a Transdisciplinary Bone & Joint Training Award from the Collaborative Training Program in Musculoskeletal Health Research at The University of Western Ontario. AGC is a recipient of a National Health and Medical Research Council (NHMRC) of Australia Early Career Fellowship (Neil Hamilton Fairley Clinical Fellowship (GNT1121173)). Support for this study was provided by Arthritis Australia, the Queensland Orthopaedic Physiotherapy Network, the University of Melbourne (Research Collaboration grant), and the University of British Columbia Centre for Hip Health and Mobility (Society for Mobility and Health). The sponsors were not involved in the design and conduct of this study; in the analysis and interpretation of the data; and in the preparation, review, or approval of the article.


Publication Date



Physical Therapy in Sport




8p. (p. 1-8)





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