J Orthop Sports Phys Ther. 2018 Dec;48(12):951-959. doi: 10.2519/jospt.2018.8277. Epub 2018 Jun 22.
Adolescent athletes struggle to return to sport following anterior cruciate ligament reconstruction (ACLR) for physical and psychosocial reasons. The ability to integrate contextual evidence obtained directly from patients with the growing body of quantitative rehabilitation research may aid clinicians in taking an evidence-based approach to rehabilitation and return to sport within the adolescent population.
To assess perceived barriers to return to sport, as well as positive and negative factors influencing recovery, among high school athletes with recent history of ACLR.
This phenomenographic cross-sectional study included a sample of 10 high school-aged individuals (7 female, 3 male; mean ± SD age, 16.8 ± 1.1 years; time since surgery, 5.5 ± 1.4 months) who underwent ACLR and had not returned to sports. Participants completed a semi-structured interview focused on attitudes related to return to sport, perceived physical or psychosocial barriers to physical activity and return to sport, and rehabilitation characteristics that may facilitate or hinder return to sport.
Participants reported psychosocial barriers to return to sport with greater consistency than physical barriers. Consistently reported barriers included the feeling that sport-based activities were now associated with injury, a persistent sense of uncertainty regarding full recovery, and the sense that comparison to others with ACLR by parents or coaches hindered their ability to make progress in rehabilitation.
Early identification of athletes at risk for persistent psychosocial barriers, such as fear of reinjury and uncertainty regarding full recovery, and establishment of peer mentoring groups to facilitate psychosocial support throughout the rehabilitation process may be key components of a gradual, patient-centered approach to improving mental and physical readiness for return to sport. J Orthop Sports Phys Ther 2018;48(12):951-959. Epub 22 Jun 2018. doi:10.2519/jospt.2018.8277.
青少年运动员由于身体和心理社会原因，在前交叉韧带重建（ACLR）后难以重返运动。将直接从患者获得的上下文证据与不断增加的定量康复研究相结合的能力，可能有助于临床医生在青少年人群中采用基于证据的康复和重返运动方法。
评估近期接受 ACLR 的高中生运动员重返运动的感知障碍，以及影响康复的积极和消极因素。
本现象学横断面研究纳入了 10 名高中生（7 名女性，3 名男性；平均年龄±标准差，16.8±1.1 岁；术后时间，5.5±1.4 个月），他们均接受过 ACLR 且尚未重返运动。参与者完成了一项半结构化访谈，重点关注与重返运动相关的态度、对身体活动和重返运动的感知物理或心理社会障碍，以及可能促进或阻碍重返运动的康复特征。
与身体障碍相比，参与者报告的重返运动心理社会障碍更一致。一致报告的障碍包括运动相关活动现在与受伤有关的感觉、对完全康复的持续不确定性，以及父母或教练认为与 ACLR 患者比较阻碍了他们在康复中取得进步的能力。
早期识别有持续心理社会障碍风险的运动员，例如对再次受伤的恐惧和对完全康复的不确定性，并建立同伴指导小组，在康复过程中为他们提供心理支持，可能是改善重返运动的身心准备的逐步、以患者为中心的方法的关键组成部分。
美国骨科运动物理治疗杂志 2018 年；48（12）：951-959. 2018 年 6 月 22 日在线发表。doi：10.2519/jospt.2018.8277.
