title: The Examination of Patient-Reported Outcomes and Postural Control Measures in Patients With and Without a History of ACL Reconstruction: A Case Control Study.
abstract: BACKGROUND
  There is a lack of literature to support the diagnostic accuracy and cut-off scores of commonly used patient-reported outcome measures (PROMs) and clinician-oriented outcomes such as postural-control assessments (PCAs) when treating post-ACL reconstruction (ACLR) patients. These scores could help tailor treatments, enhance patient-centered care and may identify individuals in need of additional rehabilitation.
  
  
  OBJECTIVE
  To determine if differences in 4-PROMs and 3-PCAs exist between post-ACLR and healthy participants, and to determine the diagnostic accuracy and cut-off scores of these outcomes.
  
  
  METHODS
  Case control.
  
  
  METHODS
  Laboratory.
  
  
  METHODS
  A total of 20 post-ACLR and 40 healthy control participants.
  
  
  METHODS
  The participants completed 4-PROMs (the Disablement in the Physically Active Scale [DPA], The Fear-Avoidance Belief Questionnaire [FABQ], the Knee Osteoarthritis Outcomes Score [KOOS] subscales, and the Tampa Scale of Kinesiophobia [TSK-11]) and 3-PCAs (the Balance Error Scoring System [BESS], the modified Star Excursion Balance Test [SEBT], and static balance on an instrumented force plate). Mann-Whitney U tests examined differences between groups. Receiver operating characteristic (ROC) curves were employed to determine sensitivity and specificity. The Area Under the Curve (AUC) was calculated to determine the diagnostic accuracy of each instrument. The Youdin Index was used to determine cut-off scores. Alpha was set a priori at P < 0.05.
  
  
  RESULTS
  There were significant differences between groups for all PROMs (P < 0.05). There were no differences in PCAs between groups. The cut-off scores should be interpreted with caution for some instruments, as the scores may not be clinically applicable.
  
  
  CONCLUSIONS
  Post-ACLR participants have decreased self-reported function and health-related quality of life. The PROMs are capable of discriminating between groups. Clinicians should consider using the cut-off scores in clinical practice. Further use of the instruments to examine detriments after completion of standard rehabilitation may be warranted.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Hoch
authors.forename: Cori W
authors.initials: CW
authors.lastname: Sinnott
authors.forename: Kendall P
authors.initials: KP
authors.lastname: Robinson
authors.forename: William O
authors.initials: WO
authors.lastname: Perkins
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Hartman
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000534:rehabilitation* / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D000071066:Patient Reported Outcome Measures; D004856:Postural Balance; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: injury management; knee joint; orthopedics; star excursion balance test