Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey, UK.
Michael DeGroote School of Medicine, McMaster, Hamilton, ON, Canada.
Knee Surg Sports Traumatol Arthrosc. 2023 Jun;31(6):2299-2314. doi: 10.1007/s00167-022-07296-6. Epub 2022 Dec 23.
This review aims to elucidate the most commonly reported method to quantify fear of reinjury or kinesiophobia and to identify key variables that influence the degree of kinesiophobia following primary anterior cruciate ligament reconstruction (ACLR).
A systematic search across three databases (Pubmed, Ovid (MEDLINE), and EMBASE) was conducted from database inception to August 7th, 2022. The authors adhered to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Quality assessment of the included studies was conducted according to the Methodological Index for Non-Randomized Studies (MINORS) criteria.
Twenty-six studies satisfied the inclusion criteria and resulted in 2,213 total patients with a mean age of 27.6 years and a mean follow-up time of 36.7 months post-surgery. The mean MINORS score of the included studies was 11 out of 16 for non-comparative studies and 18 out of 24 for comparative studies. Eighty-eight percent of included studies used variations of the Tampa Scale of Kinesiophobia (TSK) to quantify kinesiophobia and 27.0% used Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI). The results of this study shows a common association between higher kinesiophobia and poor patient-reported functional status measured using International Knee Documentation Committee (IKDC) Scores, Activity of Daily Living (ADL), Quality of Life (QOL), and Sports/Recreation (S/R) subscales of Knee Osteoarthritis and Outcome Score (KOOS) and Lysholm scores. Postoperative symptoms and pain catastrophizing measured using the KOOS pain and symptom subscales and Pain Catastrophizing Score (PCS) also influenced the degree of kinesiophobia following ACLR. Patients with an increased injury to surgery time and being closer to the date of surgery postoperatively demonstrated higher levels of kinesiophobia. Less common variables included being a female patient, low preoperative and postoperative activity status and low self-efficacy.
The most common methods used to report kinesiophobia following primary ACLR were variations of the TSK scale followed by ACL-RSI. The most commonly reported factors influencing higher kinesiophobia in this patient population include lower patient-reported functional status, more severe postoperative symptoms such as pain, increased injury to surgery time, and being closer to the date of surgery postoperatively. Kinesiophobia following primary ACLR is a critical element affecting post-surgical outcomes, and screening should be implemented postoperatively to potentially treat in rehabilitation and recovery.
IV.
本综述旨在阐明最常报道的量化恐惧再损伤或运动恐惧的方法，并确定影响初次前交叉韧带重建（ACLR）后运动恐惧程度的关键变量。
从数据库建立到 2022 年 8 月 7 日，通过三个数据库（PubMed、Ovid（MEDLINE）和 EMBASE）进行系统检索。作者遵循 PRISMA 指南和 Cochrane 干预系统评价手册。根据非随机研究方法学指数（MINORS）标准对纳入研究进行质量评估。
26 项研究符合纳入标准，共纳入 2213 例患者，平均年龄 27.6 岁，术后平均随访时间 36.7 个月。纳入研究的 MINORS 平均得分为非对照研究 11 分（满分 16 分），对照研究 18 分（满分 24 分）。88%的纳入研究使用坦帕运动恐惧量表（TSK）的变体来量化运动恐惧，27.0%使用前交叉韧带损伤后重返运动量表（ACL-RSI）。本研究的结果表明，运动恐惧程度与国际膝关节文献委员会（IKDC）评分、日常生活活动（ADL）、生活质量（QOL）和膝关节骨关节炎和结局评分（KOOS）和 Lysholm 评分的患者报告功能状态较差之间存在常见关联。术后症状和疼痛灾难化，使用 KOOS 疼痛和症状子量表和疼痛灾难化量表（PCS）测量，也影响 ACLR 后运动恐惧的程度。受伤至手术时间延长和术后接近手术日期的患者表现出更高水平的运动恐惧。不太常见的变量包括女性患者、术前和术后活动状态较低以及自我效能较低。
最常报道的用于报告初次 ACLR 后运动恐惧的方法是 TSK 量表的变体，其次是 ACL-RSI。在该患者群体中，影响更高运动恐惧的最常见因素包括患者报告的功能状态较差、更严重的术后症状（如疼痛）、受伤至手术时间延长以及术后接近手术日期。初次 ACLR 后运动恐惧是影响术后结局的关键因素，应在术后实施筛查，以便在康复和恢复中进行潜在治疗。
IV。
