Department of Physical Therapy, College of Public Health and Health Professions, University of Florida Health Sciences Center, PO Box 100154, Gainesville, FL 32610-0154, USA.
Phys Ther. 2011 Sep;91(9):1355-66. doi: 10.2522/ptj.20100277. Epub 2011 Jun 23.
Evidence in the musculoskeletal rehabilitation literature suggests that psychosocial factors can influence pain levels and functional outcome.
The purpose of this study was to examine changes in select psychosocial factors and their association with knee pain and function over 12 weeks after anterior cruciate ligament (ACL) reconstruction.
This was a prospective, longitudinal, observational study.
Patients with ACL reconstruction completed self-report questionnaires for average knee pain intensity (numeric rating scale [NRS]), knee function (International Knee Documentation Committee Subjective Knee Form [IKDC-SKF]), and psychosocial factors (pain catastrophizing [Pain Catastrophizing Scale], fear of movement or reinjury [shortened version of the Tampa Scale for Kinesiophobia (TSK-11)], and self-efficacy for rehabilitation tasks [modified Self-Efficacy for Rehabilitation Outcome Scale (SER)]). Data were collected at 4 time points after surgery (baseline and 4, 8, and 12 weeks). Repeated-measures analyses of variance determined changes in questionnaire scores across time. Hierarchical linear regression models were used to examine the association of psychosocial factors with knee pain and function.
Seventy-seven participants completed the study. All questionnaire scores changed across 12 weeks. Baseline psychosocial factors did not predict the 12-week NRS or IKDC-SKF score. The 12-week change in modified SER score predicted the 12-week change in NRS score (r(2)=.061), and the 12-week change in modified SER and TSK-11 scores predicted the 12-week change in IKDC-SKF score (r(2)=.120).
The psychometric properties of the psychosocial factor questionnaires are unknown in people with ACL reconstruction. The study focused on short-term outcomes using only self-report measures.
Psychosocial factors are potentially modifiable early after ACL reconstruction. Baseline psychosocial factor levels did not predict knee pain or function 12 weeks postoperatively. Interventions that increase self-efficacy for rehabilitation tasks or decrease fear of movement or reinjury may have potential to improve short-term outcomes for knee pain and function.
肌肉骨骼康复文献中的证据表明，心理社会因素会影响疼痛程度和功能结果。
本研究旨在探讨前交叉韧带（ACL）重建后 12 周内，选择的心理社会因素的变化及其与膝关节疼痛和功能的关系。
这是一项前瞻性、纵向、观察性研究。
ACL 重建患者完成自我报告问卷，评估平均膝关节疼痛强度（数字评分量表 [NRS]）、膝关节功能（国际膝关节文献委员会主观膝关节评分 [IKDC-SKF]）和心理社会因素（疼痛灾难化 [疼痛灾难化量表]）、运动恐惧或再损伤 [简化版坦帕运动恐惧量表（TSK-11）]）和康复任务自我效能感 [改良康复结果自我效能感量表（SER）]）。数据在手术后 4 个时间点（基线和 4、8 和 12 周）收集。重复测量方差分析确定问卷评分随时间的变化。分层线性回归模型用于检查心理社会因素与膝关节疼痛和功能的关系。
77 名参与者完成了研究。所有问卷评分在 12 周内均发生变化。基线心理社会因素不能预测 12 周时的 NRS 或 IKDC-SKF 评分。改良 SER 评分在 12 周的变化预测了 NRS 评分在 12 周的变化（r²=.061），而改良 SER 和 TSK-11 评分在 12 周的变化预测了 IKDC-SKF 评分在 12 周的变化（r²=.120）。
ACL 重建患者的心理社会因素问卷的心理测量特性尚不清楚。该研究仅使用自我报告措施，重点关注短期结果。
心理社会因素在 ACL 重建后早期是潜在可改变的。基线心理社会因素水平不能预测术后 12 周膝关节疼痛或功能。增加康复任务自我效能感或降低运动恐惧或再损伤恐惧的干预措施可能有潜力改善膝关节疼痛和功能的短期结果。
