Effectiveness Of Modeling Videos On Psychological States Of Patients Undergoing Rehabilitation Following ACL Reconstruction

Abstract

To date, much of the rehabilitation following anterior cruciate ligament reconstruction (ACLR) has centered on physical components. However, return to sports depends on not only physical recovery but also psychological readiness. According to a systematic review published in 2017, there is limited evidence on the efficacy of psychological interventions. PURPOSE: To examine the effectiveness of modeling videos to reduce preoperative kinesiophobia and fear of reinjury as well as to increase postoperative self-efficacy after ACLR. METHODS: Following baseline assessment of psychological states through ACL-Return to Sport after Injury (ACL-RSI), Knee Self Efficacy Scale (K-SES), and Tampa Scale of Kinesiophobia (TSK) and knee function (International Knee Documentation Committee [IKDC] system), patients scheduled for ACLR were randomly assigned to intervention, placebo, or control group. Six modeling intervention videos were developed by the investigators to represent six different periods: pre-operation, during hospitalization, 2 weeks, 6 weeks, 3 months, and 6 months post operations. Another six videos were developed to serve as placebo. Intervention and placebo groups watched their respective videos during their follow-up visits while control group did not. All groups completed psychological and functional assessments during their follow-up visits. RESULTS: Ten patients were assigned to intervention group, 11 to placebo group, and 11 to control group. No significant changes in ACL-RSI, K-SES, and TSK scores over six-month period were found among groups (p=0.574, p=0.808, p=0.888, respectively). Although three groups all showed improvement in ACL-RSI, K-SES, and TSK at six months, their improvements were not linear (p=0.467, 0.364, 0.274, respectively). All groups demonstrated temporary decrease in ACL-RSI and TSK scores at three months. CONCLUSIONS: Watching modeling videos compared to placebo and control did not reduce kinesiophobia or fear of reinjury as well as improve self-efficacy after ACLR. However, there may be potential room for psychological intervention at three months, and it is important to recognize psychological readiness for successful return to sports.