Anterior cruciate ligament rupture, reconstruction, rehabilitation and recovery: The personal experiences of competitive athletes.

Borman, Anel (2018-03)

Thesis (MScSportSc)--Stellenbosch University, 2018.

Thesis

ENGLISH ABSTRACT: Injury is an unavoidable part of sport with inevitable physical as well as psychological consequences. Anterior Cruciate Ligament (ACL) injuries is one of the most prevalent injuries in sport and although considerable research has focussed on the physical recovery, the psychological effects have been neglected. Identifying the thoughts, feelings and behaviours associated with the ACL rupture, reconstruction, rehabilitation and return-to-sport could enhance our understanding of the psychological impact of the ACL recovery process. The aims of the study were to explore and analyse the personal experiences of athletes who sustained a unilateral ACL rupture and underwent ACL reconstruction (ACLR) surgery at six time intervals during the post-injury recovery period up to and including return-to-sport. Seven competitive male athletes took part in the study. Semi-structured interviews were conducted immediately post-injury, preoperative, postoperative (phases 1, 2 & 3), as well as upon return-to-sport. The interviews elicited information about the personal and situational factors that influenced each athlete’s response to an ACL injury and undergoing ACLR surgery; their cognitive appraisal of the injury and recovery process; their emotional response to the injury and recovery process, as well as their behavioural response to the injury and recovery process. A total of 42 interviews were transcribed and analysed through the use of thematic analysis (TA). Six superordinate themes emerged; 1) establishing identity (athletic and personal), 2) cognitive appraisal, 3) responses (emotional and behavioural), 4) coping strategies (approach- and avoidance orientated), 5) types of social support (emotional, informational and tangible) and 6) advice/recommendations from injured research participants. The latter was specific to the return-to-sport phase. Each superordinate theme emerged as a result of a range of themes, sub-themes and categories of codes captured immediately post-injury, preoperatively, postoperatively (phases 1, 2 and 3) and upon return-to-sport. Direct quotes from participant transcripts were included to give meaning to each superordinate theme. All participants recovered physically from their injury and returned to sport within 12 months post-injury. This study reported thoughts, feelings and behaviours associated with athletes’ experiences of the rupture, ACLR surgery, rehabilitation and recovery process, as well as prior to and following return-to-sport. To the best of my knowledge, this is the first study of its kind conducted within a South African context and one of only a few studies to note the role of a biokineticist as a source of social support. This study provides guidelines and recommendations for medical professionals involved in the ACL rehabilitation process. Those involved in the rehabilitation process should be aware of the cognitions, emotions and behaviours associated with the rupture, reconstruction, rehabilitation and return-to-sport on the timeline to recovery. Focusing on athletes’ experiences of the five R’s associated with the ACL injury recovery process (i.e., Rupture, Reconstruction, Rehabilitation, Return-to-sport and Recovery) might help medical professionals, coaches, teammates, friends and family to have a better understanding of the injured athletes’ needs. Future research should aim to follow participants for up to two years post-surgery as it could take much longer for athletes to recover psychologically.

AFRIKAANSE OPSOMMING: n Besering is 'n onvermydelike deel van sport met onvermydelike fisiese en sielkundige nagevolge. Anterior kruisligament beserings is een van die mees algemeenste beserings in sport en alhoewel ‘n aansienlike hoeveelheid navorsing op die fisiese herstel fokus, word die sielkundige nagevolge dikwels afgeskeep. Die identifisering van die gedagtes, gevoelens en gedrag wat verband hou met ‘n anterior kruisligament skeur, rekonstruksie, rehabilitasie en terugkeer-na-sport kan moontlik ons begrip van die sielkundige impak van die anterior kruisligament herstel proses verbeter. Die doel van die studie was om die persoonlike ervaringe van atlete, wat 'n eensydige anterior kruisligament skeur opgedoen het en anterior kruisligament rekonstruksie ondergaan het, te verken en ontleed gedurende ses tydintervalle tot en met hul terugkeer-na-sport. Sewe mededingende manlike atlete het aan die studie deelgeneem. Semi-gestruktureerde onderhoude is gevoer onmiddellik ná die besering, voor die operasie, na die operasie (fases 1, 2 en 3) en met hul terugkeer-na-sport. Die onderhoude het die persoonlike faktore en omstandighede geassosieer met elke atleet se reaksie op 'n anterior kruisligament besering en rekonstruksie ontlok, asook hul kognitiewe beoordeling van die besering en herstel proses; hul emosionele reaksie na die besering en herstel proses en hul gedrag na die besering en herstel proses. 'n Totaal van 42 onderhoude is geanaliseer en ontleed deur gebruik te maak van tematiese analise. Ses superordinate is geïdentifiseer; 1) vestiging van identiteit, 2) kognitiewe beoordeling, 3) reaksies (emosionele- en gedragsverwante reaksies), 4) hanteringstrategieë, 5) tipes sosiale ondersteuning en 6) raad en aanbevelings van die deelnemers aan die studie. Tema ses is uniek aan die terugkeer-na-sport fase. Superordinate het verskyn as ‘n hoofklas waarin 'n verskeidenheid temas, sub-temas en kodes ingesluit is uniek aan elk van die ses fases (onmiddellik ná die besering, voor die operasie, drie fases na die operasie en met hul terugkeer-na-sport). Direkte aanhalings uit deelnemer transkripsies is ingesluit om betekenis aan die superordinate te gee. Alle deelnemers het fisies herstel en binne 12 maande ná hul besering teruggekeer na sport. Hierdie studie rapporteer die gedagtes, gevoelens en gedrag geassosieer met ‘n anterior kruisligament skeur, rekonstruksie, rehabilitasie en herstel asook die terugkeer-na-sport. Na die beste van my wete, is dit die eerste studie van sy soort binne 'n Suid-Afrikaanse konteks en een van slegs 'n paar studies wat die rol van 'n biokinetikus as 'n bron van sosiale ondersteuning uitlig. Hierdie studie bevat waardevolle raad en aanbevelings vir mediese personeel betrokke by die anterior kruisligament rehabilitasieproses. Diegene betrokke by die rehabilitasieproses moet bewus wees van die kognisies, emosies en gedrag wat verband hou met ‘n anterior kruisligament skeur, rekonstruksie, rehabilitasie en terugkeer-na-sport op die tydlyn tot volle herstel. Deur te fokus op die vyf belangrikste aspekte van die anterior kruisligament besering herstelproses (d.w.s., skeur, rekonstruksie, rehabilitasie, terugkeer-na-sport en herstel) kan medici, afrigters, spanmaats, vriende en familielede moontlk help om die behoeftes van die beseerde atleet beter te verstaan. Toekomstige navorsing moet poog om deelnemers vir tot en met twee jaar ná anterior kruisligament rekonstruksie te volg, omdat sielkundige herstel heelwat langer kan vat.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/103314
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