Masters Degrees (Physiotherapy)

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Browsing Masters Degrees (Physiotherapy) by Subject "Anterior cruciate ligament"

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    Fear of re-injury and other intrinsic factors are associated with return to sport after anterior cruciate ligament reconstruction
    (Stellenbosch : Stellenbosch University, 2015-04) Ross, Cheryl Anne; Louw, Quinette; Clifford, Amanda; Stellenbosch University. Faculty of Health Sciences. Interdisciplinary Health Sciences. Physiotherapy.
    ENGLISH ABSTRACT: The anterior cruciate ligament is the most commonly injured ligament in the knee, with only one third of athletes returning to their pre-injury level of sport. Identifying intrinsic factors associated with an increased likelihood of return to sport may improve the surgical outcome. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. The objective was to systematically appraise publications describing intrinsic factors which may be associated with return to sport, after anterior cruciate ligament reconstruction. A comprehensive eligibility checklist was composed. Methodological quality appraisal of cohort studies revealed that high quality studies were included in the review. A descriptive synthesis of the findings associating intrinsic factors with return to sport was performed. Ten studies were included. The most important finding was the association of fear of re-injury preventing return to sports participation. Knee function did not always correspond with the likelihood of returning to sport. Younger athletes and competitive, male athletes appeared more likely to return. Across these studies, the 141 athletes not returning to pre-injury sport were questioned as to the reason for non return. An average of 35% (49 athletes) cited fear of re-injury as the reason. Fear of re-injury was thus investigated further as it could be considered in the post-operative management of anterior cruciate ligament reconstruction. In a qualitative study with supplemental cross-sectional analysis, factors informing fear of re-injury were explored. Male and female athletes, aged 17-50 years were included (n=59). Reconstruction procedures using any graft type were included; however revision and multi-ligament reconstruction was excluded. Twenty-four participants (41%) did not return to the pre-injury sport. Those citing fear of re-injury as the only reason for not-retuning to sport were interviewed (n=12). Thus, those who did not return to pre-injury type and level of sport despite good knee function. Athletes’ experiences informing fear of re-injury were explored by semi-structured interviews. Data analysis was performed by content analysis. Codes were allocated and categorised and these categories were synthesised into themes. The Qualitative review guidelines – RATS were followed. From the participant interviews, four themes emerged: undergoing the surgery and recovery again, nature of the pre-injury sport imposing risk of re-injury, personality traits, and social priorities. An accelerated rehabilitation programme was suggested to improve the post–operative experience. The supplementary analysis revealed athletes younger than 20 years of age were more likely to return to sport. Modifiable fears include pain, length of rehabilitation, mechanism of injury and psychological aspects. Pain management, motivation and education are important considerations post-operatively and during rehabilitation. Clinicians should be aware of factors informing fear of re-injury on an individual basis to develop a tailored management plan.