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Study tracks psychological intervention for ACL rehab

Jun. 28, 2018, 8:55 AM

A new study is testing whether psychologically-informed rehabilitation would help athletes with anterior cruciate ligament injuries return to play. (iStock image)

Professional athletes like Tom Brady, Derrick Rose and Megan Rapinoe had the grit to stay in the game after suffering anterior cruciate ligament (ACL) tears, but the knee injury is often a career-ender for others.

A Vanderbilt University Medical Center researcher is assessing whether psychologically-informed rehabilitation would help more athletes with ACL injuries return to play.

Kristin Archer, PhD, DPT, associate professor of Orthopaedics and Rehabilitation, received support from the American Orthopaedic Society for Sports Medicine (AOSSM) and Aircast Foundation for the research. She’s the first recipient of the AOSSM/Aircast Foundation Return to Play Clinical Research Grant.

The randomized clinical trial, conducted at Vanderbilt and Cleveland Clinic, will focus on athletes between the ages of 14 and 35 who have undergone ACL reconstruction. The research also received support from the Vanderbilt Institute for Clinical and Translational Research (VICTR).

“We have developed an intervention that focuses specifically on the fear about returning to sports,” Archer said.

She worked closely with Vickie Woosley, PsyD, a Vanderbilt University sports psychologist, in designing the study.

Half of the randomized participants will receive a psychological intervention delivered by a physical therapist, while the other half will be given educational information by a physical therapist that highlights the physical challenges of returning to play.

“Some athletes are physically able to go back to sport, but why aren’t they going back?” Archer said. “We are honing in on this issue of people who don’t want to go back because they are fearful. There has been a lot in the popular press about athletes being afraid, that they just don’t trust their knee.”

The recovery time following surgery, which takes six months or even longer, sets the stage for fear and doubt, Archer said.

“With the interventions, we do one session before they have surgery to set expectations about what is going to happen and what they can and can’t do during their recovery and how long it will take them, because these athletes think they can get back sooner when they really can’t,” Archer said.

“That really affects them. Then we talk to them weekly for a month after surgery and then every two weeks for a total of six sessions after surgery. The whole idea is to get them ready and prepared for when they can go back to sports.”

Embedded within the study is a validation project to determine the best assessment tool for return to sport in patients following ACL reconstruction.

There’s a scarcity of research on the efficacy of psychosocial interventions after ACL surgery, according to review of medical literature published March 2018 in Clinical Rehabilitation. Archer is the senior author of that article.


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