Psychological predictors of disablement after acl reconstruction


Extant research on anterior cruciate ligament (ACL) injury has focused on two key outcomes of ACL rehabilitation: physical outcomes and return to play. Vela and Denegar (2010), however, propose that outcomes may include: impairment (e.g., pain), functional limitation (e.g., being unable to jump), disability (e.g., unable to play preferred sport), and negative impacts on quality of life (e.g., mood disturbance). This study explored if psychological variables at 4- and 6-months post-ACL reconstruction (ACLR; e.g., knee self-efficacy, re-injury anxiety, overall mental health) could predict perceptions of disablement in athletes at 9-months post-ACLR. Thirty-seven physically active participants (21 males, 15 females) completed measures at 4-, 6-, and 9-months post-ACLR, plus Disablement in the Physically Active Scale (Vela & Denegar, 2010) at 9-months. Backwards stepwise regression revealed the only significant predictor of perceived disablement at 9-months was knee self-efficacy at 4-months, with higher knee self-efficacy predicting lower perceived disablement F(1, 33) = 6.75, p<.05, R2 = .15. Bivariate correlations revealed a positive correlation between perceived disablement and re-injury anxiety (r = .60, p<.001) at 9-months. Participants who had (vs. not) returned to play (M = 23.95, SD = 6.73) revealed significantly lower perceived disablement at 9-months (M = 38.00, SD = 11.16) t(35)= -4.67, p<.001. Qualitative data confirmed participants who had not returned to play reported more disablement, including impairments (e.g., pain, instability), functional limitations (e.g., unable to perform skills associated with the sport) and quality of life impediments (e.g., fear of re-injury). Results extend our understanding of the outcomes of sport-related injury.