Psychological factors, rehabilitation adherence, and rehabilitation outcome after anterior cruciate ligament reconstruction

Objective: To examine prospectively the relationships among psychological f actors, rehabilitation adherence, and short-term rehabilitation outcome aft er knee surgery. Study Design and Participants: Individuals with acute ante rior cruciate ligament (ACL) tears (N = 95) completed measures of self-moti vation, social support, athletic identity, and psychological distress befor e reconstructive surgery. After surgery, participants(n = 93) reported on t heir completion of home rehabilitation exercises and cryotherapy, and their rehabilitation practitioners indicated the patients' attendance at, and ad herence during, rehabilitation sessions. Rehabilitation outcome measures we re taken from participants (n = 69) approximately 6 months postsurgery. Mai n Outcome Measures: Knee laxity, functional ability, and subjective symptom s were the primary outcomes assessed. Results: Self-motivation was a signif icant predictor of home exercise completion; athletic identity and psycholo gical distress were significant predictors of knee laxity; and attendance a t rehabilitation sessions and home cryotherapy completion were significant predictors of functional ability. Rehabilitation adherence did not mediate the relationship between psychological factors and rehabilitation outcome. Conclusions: The prospective associations obtained among psychological fact ors, rehabilitation adherence, and short-term rehabilitation outcome after ACL reconstruction may inform the development of interventions designed to enhance the rehabilitation of individuals with sport-related orthopedic inj uries.