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

Objective: To examine prospectively the relationships among psychological factors, rehabilitation adherence, and short-term rehabilitation outcome after knee surgery. Study Design and Participants: Individuals with acute anterior cruciate ligament (ACL) tears (N = 95) completed measures of self-motivation, social support, athletic identity, and psychological distress before reconstructive surgery. After surgery, participants(n = 93) reported on their completion of home rehabilitation exercises and cryotherapy, and their rehabilitation practitioners indicated the patients' attendance at, and adherence during, rehabilitation sessions. Rehabilitation outcome measures were taken from participants (n = 69) approximately 6 months postsurgery. Main Outcome Measures: Knee laxity, functional ability, and subjective symptoms were the primary outcomes assessed. Results: Self-motivation was a significant predictor of home exercise completion; athletic identity and psychological distress were significant predictors of knee laxity; and attendance at 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 factors, 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 injuries.