Journal Article

Greater fear of reinjury is related to stiffened jump-landing biomechanics and muscle activation in women after ACL reconstruction

Bell, David R., Trigsted, Stephanie M., Cook, Dane B., Dunn, Warren R., Pickett, Kristen A., Cadmus-Bertram, Lisa

2018

Overview

Purpose Fear of reinjury is an important factor in determining who returns to sport following anterior cruciate ligament reconstruction (ACLR). Evidence from other musculoskeletal injuries indicates fear of reinjury may be related to stiffened movement patterns observed in individuals following ACLR. The relationship between fear of reinjury and performance on dynamic tasks, however, has not been investigated. Therefore, the purpose of this study was to investigate the relationship between fear of reinjury and jump-landing biomechanics. Methods Thirty-six females (height = 168.7 ± 6.5 cm, body mass = 67.2 ± 10.0 kg, age = 18.9 ± 1.5 years) with a history of ACLR (time from surgery = 26.1 ± 13.3 months) participated in the study. Each participant performed five trials of a standard jump-landing task. 3D motion capture and surface electromyography was used to record peak kinematics and lower extremity muscle activation on the injured limb during the jump landings. Spearman’s rank correlations established the relationship between TSK-11 scores and each biomechanical variable of interest. Results There was a significant, negative relationship between fear of reinjury (TSK-11: 19.9 ± 4.5) and knee ( p  = 0.006), hip ( p  = 0.003), and trunk flexion ( p  = 0.013). There was also a significant, positive relationship between hip adduction ( p  = 0.007), and gluteus maximus preparatory activation ( p  = 0.001). Conclusions The results of this study indicate that higher fear of reinjury is associated with stiffened movement patterns that are associated with increased risk of a second ACL injury. Similar movement patterns have been observed in patients with low back pain. Clinicians should evaluate psychological and emotional consequences of injury in addition to the physical consequences as they appear to be related. Level of evidence III.

• Publisher: Springer Berlin Heidelberg,John Wiley & Sons, Inc
• Subject: Activation / Adaptation, Physiological / Adaptation, Psychological / Adolescent / Adult / Anterior cruciate ligament / Anterior Cruciate Ligament Injuries - psychology / Anterior Cruciate Ligament Injuries - surgery / Anterior Cruciate Ligament Reconstruction - psychology / Back injuries / Back pain / Biomechanical Phenomena / Biomechanics / Body mass / Clinical trials / Cross-Sectional Studies / Electromyography / Exercise Test / Fear / Fear avoidance / Female / Females / Health risks / Hip / Humans / Jump landing / Kinematics / Kinesiophobia / Knee / Landing / Ligaments / Low back pain / Medicine / Medicine & Public Health / Motion capture / Muscle contraction / Muscles / Orthopedics / Pain / Recurrence / Surgery / Three dimensional motion / TSK‐11 / Young Adult