Psychological predictors of anterior cruciate ligament reconstruction outcomes: a systematic review
Psychological predictors of anterior cruciate ligament reconstruction outcomes: a systematic review
复制标题
DOI：
10.1007/s00167-013-2699-1
复制
发表时间：
2015-03-01
影响因子：
3.8
通讯作者：
Flanigan, David C.
中科院分区：
文献类型：
--
作者：
Everhart, Joshua S.;Best, Thomas M.;Flanigan, David C.
尽管膝关节功能得到充分恢复，但前交叉韧带（ACL）重建后经常发生缺乏运动的情况，越来越多的证据表明，患者之间的心理差异可能在这种差异中发挥重要作用。本综述的目的是确定预测临床相关ACL重建结果的基线心理因素，包括恢复运动、康复依从性、膝关节疼痛和膝关节功能。在PubMed、Google Scholar、CINAHL、UptoDate、科克伦综述和SportDiscus中进行了系统检索，确定了1，633项潜在纳入的研究。入选标准包括（1）前瞻性设计，（2）接受ACL重建的受试者，（3）基线时评估的心理特征，以及（4）结局指标，如恢复运动、康复依从性和评估的膝关节症状。方法学质量采用改良科尔曼评分进行评价，该评分包括几个特定项目的修订，以提高与运动医学损伤风险评估研究的相关性。平均研究规模为83 +/- A 42例患者，中位随访时间为9个月（范围3-60个月）。自我效能，自我激励和乐观的措施是预测康复的依从性，恢复运动，和自评膝关节症状。术前压力是负预测，社会支持的措施是积极的预测膝关节症状和康复的依从性。第一次康复预约时的运动恐惧症和疼痛灾难化并不能预测整个早期康复阶段的膝关节症状。患者心理因素可预测ACL重建结果。自信、乐观和自我激励对结果具有预测作用，这与自我效能理论相一致。压力、社会支持和运动自我认同可以预测结果，这与压力、健康和社会支持缓冲假设之间的全球关系是一致的。前瞻性预后研究的系统回顾，II级。
Lack of return to sport following anterior cruciate ligament (ACL) reconstruction often occurs despite adequate restoration of knee function, and there is growing evidence that psychological difference among patients may play an important role in this discrepancy. The purpose of this review is to identify baseline psychological factors that are predictive of clinically relevant ACL reconstruction outcomes, including return to sport, rehab compliance, knee pain, and knee function.A systematic search was performed in PubMed, Google Scholar, CINAHL, UptoDate, Cochrane Reviews, and SportDiscus, which identified 1,633 studies for potential inclusion. Inclusion criteria included (1) prospective design, (2) participants underwent ACL reconstruction, (3) psychological traits assessed at baseline, and (4) outcome measures such as return to sport, rehabilitation compliance, and knee symptoms assessed. Methodological quality was evaluated with a modified Coleman score with several item-specific revisions to improve relevance to injury risk assessment studies in sports medicine.Eight prospective studies were included (modified Coleman score 63 +/- A 4.9/90, range 55-72). Average study size was 83 +/- A 42 patients with median 9-month follow-up (range 3-60 months). Measures of self-efficacy, self-motivation, and optimism were predictive of rehabilitation compliance, return to sport, and self-rated knee symptoms. Pre-operative stress was negatively predictive, and measures of social support were positively predictive of knee symptoms and rehabilitation compliance. Kinesiophobia and pain catastrophizing at the first rehabilitation appointment did not predict knee symptoms throughout the early rehabilitation phase (n.s.).Patient psychological factors are predictive of ACL reconstruction outcomes. Self-confidence, optimism, and self-motivation are predictive of outcomes, which is consistent with the theory of self-efficacy. Stress, social support, and athletic self-identity are predictive of outcomes, which is consistent with the global relationship between stress, health, and the buffering hypothesis of social support.Systematic review of prospective prognostic studies, Level II.