Cognitive-behavioural physical therapy improves psychological readiness for return to sport, knee function, and resilience in patients after anterior cruciate ligament reconstruction: A randomised controlled trial.
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引用次数: 0
Abstract
Purpose: Psychological preparation prior to the return to sport (RTS) has a significant impact on knee function following anterior cruciate ligament reconstruction (ACLR). The objective of this study was to evaluate the efficacy of a cognitive-behavioural-based physical therapy (CBPT) program in enhancing patients' psychological well-being, psychological preparation for RTS and knee function.
Methods: A randomised parallel-group controlled trial was conducted. Seventy-two patients awaiting ACLR were randomly assigned to the CBPT or control group. The evaluation comprised the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI), Lysholm score, Knee Self-Efficacy Scale (K-SES), Tampa Scale for Kinesiophobia (TSK), Brief Resilience Scale (BRS) and locus of control (LOC). These were measured preoperatively and at 6, 12 and 24 weeks postoperatively.
Results: Sixty-one subjects were finally included, 29 in the CBPT and 32 in the control group. At the 6th, 12th, and 24th postoperative weeks, the CBPT group had significantly higher ACL-RSI scores (66.4 vs. 62.2, 73.7 vs. 67.8, 85.1 vs. 80.1; p = 0.035, 0.012, 0.032, respectively), K-SES future scores (7.1 vs. 5.6, 7.9 vs. 6.8, 8.2 vs. 7.3; p = 0.002, 0.028, 0.047, respectively), and BRS scores (3.6 vs. 3.2, 4.1 vs. 3.7, 5.0 vs. 4.3; p = 0.025, 0.029, <0.001, respectively) compared to the control group. Lysholm scores were better in the CBPT group at Weeks 12 and 24 (73.7 vs. 65.3, 83.2 vs. 72.2; p = 0.038, <0.001, respectively), and the Week 24 mean difference exceeded the minimal clinically important difference (MCID) (10.0). No significant differences were found in TSK, K-SES present and LOC scores.
Conclusion: CBPT-based psychological interventions facilitate enhanced psychological preparation for RTS, improved knee function and elevated confidence and resilience for future rehabilitation in patients who have undergone ACLR.
Level of evidence: Level I, randomised controlled trial.
目的：恢复运动前的心理准备（RTS）对前交叉韧带重建（ACLR）后的膝关节功能有显著影响。本研究的目的是评估基于认知行为的物理治疗（CBPT）项目在增强患者心理健康、RTS心理准备和膝关节功能方面的疗效。方法：采用随机平行组对照试验。72例等待ACLR的患者被随机分配到CBPT组或对照组。评估包括前交叉韧带损伤后运动恢复（ACL-RSI）、Lysholm评分、膝关节自我效能量表（K-SES）、坦帕运动恐惧症量表（TSK）、短暂恢复量表（BRS）和控制点（LOC）。分别于术前、术后6周、12周和24周进行测量。结果：最终纳入61例受试者，其中CBPT组29例，对照组32例。在术后第6、12、24周，CBPT组的ACL-RSI评分明显高于对照组(66.4 vs. 62.2, 73.7 vs. 67.8, 85.1 vs. 80.1；p = 0.035, 0.012, 0.032)， K-SES未来评分(7.1 vs. 5.6, 7.9 vs. 6.8, 8.2 vs. 7.3；p = 0.002, 0.028, 0.047)， BRS评分(3.6 vs. 3.2, 4.1 vs. 3.7, 5.0 vs. 4.3；结论：基于cbpt的心理干预有助于增强ACLR患者对RTS的心理准备，改善膝关节功能，提高对未来康复的信心和弹性。证据等级：一级，随机对照试验。临床试验注册：ChiCTR2400087631。
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