Naderi Aynollah, Fallah Mohammadi Mohammad, Dehghan Azizallah, Baker Julien S
Corrective Exercise and Sport Rehabilitation Lab, School of Sport Science, Shahrood University of Technology, Shahrood, Semnan, Iran.
Department of Sports Sciences, Faculty of Humanities, Higher Education Institute of Shafagh, Tonekabon, Iran.
Knee Surg Sports Traumatol Arthrosc. 2023 Dec;31(12):5848-5855. doi: 10.1007/s00167-023-07630-6. Epub 2023 Nov 16.
Psychosocial interventions have shown potential in reducing the fear of re-injury after anterior cruciate ligament reconstruction (ACLR), but this has not been systematically reviewed. The aim of this study was to assess the available evidence on the effect of psychosocial interventions on kinesiophobia after ACLR.
Two independent researchers conducted a systematic search in the electronic databases including Scopus, PubMed, Web of Science (WOS), SPORTDiscus, PsycINFO, and CINAHL from their inception until May 2022. They included studies that utilised a randomised controlled study design with a control group, and measured kinesiophobia using the Tampa Scale for kinesiophobia in patients who underwent primary ACLR. The outcome of interest was the mean and standard deviation of kinesiophobia. Extracted data were analysed using Comprehensive Meta-Analysis software, version 3.0 (CMA.V2), employing a random-effects model to calculate the overall effect estimates of psychosocial interventions on Kinesiophobia. The standardised mean difference with 95% confidence intervals (CIs) was computed based on the mean and standard deviation in each group.
This systematic review and meta-analysis included 5 randomised controlled trials with a total of 213 patients who underwent ACLR. The results of the meta-analysis showed that psychosocial intervention was more effective than non-psychosocial comparators in reducing kinesiophobia among patients who underwent a primary ACLR (5 trials, MD 0.56, 95% CI 0.28-0.83, p < 0.001). The heterogeneity score was zero (I = 0%; n.s. for Cochran's Q test), indicating no significant variation among the studies.
Psychosocial interventions can alleviate kinesiophobia in patients with primary ACLR. Although the limited number of reviewed studies and their methodological limitations precludes drawing a definitive conclusion regarding the effectiveness of psychosocial interventions on kinesiophobia, these promising findings can serve as a basis for developing psychological strategies to manage kinesiophobia in patients with primary ACLR and can also guide future research this issue.
II.
This trial is registered in PROSPERO on December 2021 (CRD42021282413).
心理社会干预已显示出在减轻前交叉韧带重建（ACLR）后再次受伤恐惧方面的潜力，但尚未进行系统评价。本研究的目的是评估心理社会干预对ACLR后运动恐惧影响的现有证据。
两名独立研究人员对电子数据库进行了系统检索，包括Scopus、PubMed、科学引文索引（WOS）、体育数据库、心理学文摘数据库和护理学与健康领域数据库，检索时间从各数据库建库至2022年5月。他们纳入了采用随机对照研究设计且设有对照组的研究，并使用坦帕运动恐惧量表对接受初次ACLR的患者的运动恐惧进行测量。感兴趣的结果是运动恐惧的均值和标准差。使用综合荟萃分析软件3.0版（CMA.V2）对提取的数据进行分析，采用随机效应模型计算心理社会干预对运动恐惧的总体效应估计值。根据每组的均值和标准差计算95%置信区间（CI）的标准化均值差。
本系统评价和荟萃分析纳入了5项随机对照试验，共213例接受ACLR的患者。荟萃分析结果表明，在减轻初次ACLR患者的运动恐惧方面，心理社会干预比非心理社会对照措施更有效（5项试验，MD 0.56，95%CI 0.28 - 0.83，p < 0.001）。异质性得分是零（I = 0%；Cochran's Q检验无统计学意义），表明各研究之间无显著差异。
心理社会干预可减轻初次ACLR患者的运动恐惧。尽管纳入综述的研究数量有限及其方法学局限性妨碍就心理社会干预对运动恐惧的有效性得出明确结论，但这些有前景的发现可为制定管理初次ACLR患者运动恐惧的心理策略提供依据，也可为该问题的未来研究提供指导。
II级。
本试验于2021年12月在国际前瞻性系统评价注册库（PROSPERO）注册（CRD42021282413）。
