title: The association of pain and fear of movement/reinjury with function during anterior cruciate ligament reconstruction rehabilitation.
abstract: METHODS
  Cross-sectional.
  
  
  OBJECTIVE
  To measure fear of movement/reinjury levels and determine the association with function at different timeframes during anterior cruciate ligament (ACL) reconstruction rehabilitation. We hypothesized that fear of movement/reinjury would decrease during rehabilitation and be inversely related with function.
  
  
  BACKGROUND
  Fear of movement/reinjury can prevent return to sports after ACL reconstruction, but it has not been studied during rehabilitation.
  
  
  METHODS
  Demographic data and responses on the shortened version of Tampa Scale for Kinesiophobia (TSK-11), 8-Item Short-Form Health Survey (SF-8), and International Knee Documentation Committee (IKDC) subjective form were extracted from a clinical database for 97 patients in the first year after ACL reconstruction. Three groups were formed: group 1, less than or equal to 90 days; group 2, 91 to 180 days; group 3: 181 to 372 days post-ACL reconstruction. Group differences in TSK-11 score, SF-8 bodily pain rating, and IKDC scores were determined. Hierarchical linear regression models were created for each group, with IKDC score as the dependent variable and demographic factors, SF-8 bodily pain rating, and TSK-11 score as independent variables.
  
  
  RESULTS
  TSK-11 score was higher in group 1 than in group 3 (P < .05). Across the groups, SF-8 bodily pain rating decreased (P < .001) and IKDC score increased (P < .001). SF-8 bodily pain rating was a significant factor in the regression model for all groups, whereas TSK-11 score only contributed to the regression model in group 3 (partial correlation, -0.529).
  
  
  CONCLUSIONS
  Pain was consistently associated with function across the timeframes studied. Fear of movement/reinjury levels appear to decrease during ACL reconstruction rehabilitation and are associated with function in the timeframe when patients return to sports.
  
  
  METHODS
  Prognosis, level 4.
authors.affiliation: Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA. tchm@ufl.edu
authors.forename: Terese L
authors.initials: TL
authors.lastname: Chmielewski
authors.forename: Debi
authors.initials: D
authors.lastname: Jones
authors.forename: Tim
authors.initials: T
authors.lastname: Day
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tillman
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Lentz
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D006306:Health Surveys; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation*; D007719:Knee Joint; D016014:Linear Models; D008297:Male; D009068:Movement; D011379:Prognosis; D019651:Plastic Surgery Procedures; D012047:Rehabilitation Centers; D011795:Surveys and Questionnaires; D016896:Treatment Outcome