Jump Training Improves Psychological Impairments and Facilitates Greater Sports Participation in Athletes with ACL Reconstruction

Abstract

PURPOSE: About 35% of athletes with anterior cruciate ligament (ACL) reconstruction fail to return to their preinjury level of sports participation. Psychological factors, such as fear of reinjury, often prevent athletes who wish to return to their sport from achieving their goal. Limited evidence is available to direct patient care to target these psychological impairments. Most ACL injuries are non-contact in nature and typically occur during a deceleration task such as jump landing. We propose that training focused on improving jump landing performance will improve psychological factors and facilitate increased sports participation. METHODS: Forty-eight athletes completed screening tests an average of 2 years after unilateral ACLR (Wk0). Testing included the ACL-Return to Sport after Injury (ACL- RSI) scale as measure of psychological readiness for sports participation. Athletes (n = 25, 9 men, age = 23 ± 5 yr) who scored below normative ACL-RSI recovery standards (<65%) completed 8 weeks of twice-weekly jump landing training. Retesting occurred at midtraining (Wk4), posttraining (Wk8), and 2 months after training (Wk16). Athletes answered a survey measuring perceived changes in sports participation at the end of training. Changes observed during training were determined via repeated measures ANOVA. RESULTS: ACL-RSI scores improved substantially throughout treatment (mean ± SD; Wk0: 53 ± 18%, Wk4: 67 ± 15%, Wk8: 76 ± 16%; p<0.001). Treatment benefits were maintained over the retention period (Wk16: 81 ± 15%; p=0.052). Four out of 5 athletes trained report that they were more likely to participate in their sports activities after training and two thirds of the cohort described at least a moderate increase in their sports participation. CONCLUSIONS: Progressively dosed jump training that focuses on correcting aberrant landing movements is effective at addressing psychological factors in athletes who self-identified as having limited readiness for sport. The training was also effective at facilitating increased sports participation. Clinicians should consider implementing similar jump training interventions to help athletes who are struggling to return to their desired sports participation because of limited confidence or high fear of reinjury. Funded in part by the Foundation for Physical Therapy.