Cognitive-behavioral-based physical therapy to enhance return to sport after anterior cruciate ligament reconstruction: An open pilot study

Rogelio A. Coronado, Emma K. Sterling, Dana E. Fenster, Mackenzie L. Bird, Allan J. Heritage, Vickie L. Woosley, Alda M. Burston, Abigail L. Henry, Laura J. Huston, Susan W. Vanston, Charles L. Cox, Jaron P. Sullivan, Stephen T. Wegener, Kurt P. Spindler, Kristin R. Archer

Research output: Contribution to journalArticle

Abstract

Objectives: To describe feasibility, adherence, acceptability, and outcomes of a cognitive-behavioral-based physical therapy (CBPT-ACLR) intervention for improving postoperative recovery after anterior cruciate ligament reconstruction (ACLR). Design: Pilot study. Setting: Academic medical center. Participants: Eight patients (mean age [SD] = 20.1 [2.6] years, 6 females) participated in a 7-session telephone-based CBPT-ACLR intervention beginning preoperatively and lasting 8 weeks after surgery. Main outcome measures: At 6 months, patients completed Knee Injury and Osteoarthritis Outcome Score (KOOS) sports/recreation and quality of life (QOL) subscales, International Knee Documentation Committee (IKDC), Tampa Scale of Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS), and Knee Self-Efficacy Scale (K-SES), return to sport (Subjective Patient Outcome for Return to Sports), and satisfaction. Minimal clinically important difference (MCID) was used for meaningful change. Results: Seven (88%) patients completed all sessions. Seven (88%) patients exceeded MCID on the TSK, 6 (75%) on the PCS, 5 (63%) on the KOOS sports/recreation subscale, 4 (50%) on the IKDC, and 3 (38%) on the KOOS QOL subscale. Three (38%) patients returned to their same sport at the same level of effort and performance. All patients were satisfied with their recovery. Conclusions: A CBPT-ACLR program is feasible and acceptable for addressing psychological risk factors after ACLR.

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Keywords

  • Anterior cruciate ligament
  • Cognitive behavioral therapy
  • Psychological adaptation
  • Rehabilitation
  • Return to sport
  • Telemedicine

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Coronado, R. A., Sterling, E. K., Fenster, D. E., Bird, M. L., Heritage, A. J., Woosley, V. L., Burston, A. M., Henry, A. L., Huston, L. J., Vanston, S. W., Cox, C. L., Sullivan, J. P., Wegener, S. T., Spindler, K. P., & Archer, K. R. (2020). Cognitive-behavioral-based physical therapy to enhance return to sport after anterior cruciate ligament reconstruction: An open pilot study. Physical Therapy in Sport, 42, 82-90. https://doi.org/10.1016/j.ptsp.2020.01.004