Abstract
Introduction: Injury to the Anterior Cruciate Ligament is a common injury among athletes. Surgery is generally required followed by a lengthy rehabilitation process and gradual reintroduction to sport. Due to the severity of the injury, many athletes are unable to return to sport following surgery and rehabilitation or are unable to return to preinjury levels for various reasons. Purpose: The purpose of this study was to identify current assessment and treatment models dealing with fear avoidance behavior and its relationship in return to sport outcomes following Anterior Cruciate Ligament Repair (ACLR). Hypothesis: It is hypothesized that there is no standards for evaluation or intervention for fear avoidance behaviors following ACLR. Methods: A literature review was performed utilizing the Boise State University online database and the PubMed database utilizing the key terms of fear, sport and rehabilitation. Peer-reviewed articles focusing on fear avoidance and ACLR were chosen. Results: Fear avoidance behavior is a substantial contributor in failure to return to sport. No consistent assessment or treatment methods were identified. Current measurements in use tend to be modified questionnaires which initially addressed fear avoidance behavior relating to chronic back pain or back surgery. Steps have been recently taken to create knee and sport specific questionnaires however they are not in consistent use. Although no common intervention strategies were found, early patient education seems to be the most commonly utilized action. Self-efficacy beliefs also prove to be a helpful indicator for both success or failure. Conclusion: There are no current standards for evaluating and treating fear avoidance behavior following ACLR. Assessment and prediction for fear avoidance behavior should be conducted at the beginning of medical treatment. Early education intervention is shown to be helpful in reducing the likelihood of developing fear avoidance behavior and increasing the possibility for positive outcomes. Improved methods of identification and measurement as well as intervention are currently needed. [Read more…] about Detrimental effects of fear avoidance behavior on return to sport outcomes following ACLR