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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >How Much Do Psychological Factors Affect Lack of Return to Play After Anterior Cruciate Ligament Reconstruction? A Systematic Review
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How Much Do Psychological Factors Affect Lack of Return to Play After Anterior Cruciate Ligament Reconstruction? A Systematic Review

机译：心理因素在前韧带重建后缺乏回归缺乏返回吗？系统评价

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Background: Variables affecting return to sport after anterior cruciate ligament reconstruction (ACLR) are multifactorial. The nonphysical factors germane to successful return to play (RTP) are being increasingly recognized. Purpose: To (1) evaluate the available evidence base for psychological factors relating to RTP after ACLR, (2) identify psychological factors affecting RTP after ACLR, and (3) understand currently available metrics used to assess psychological RTP readiness. Study Design: Systematic review; Level of evidence, 4. Methods: A review of the MEDLINE database was performed for studies reporting RTP after ACLR. Studies reporting on the psychological determinants of RTP were included. Demographic, methodological, and psychometric properties of the included studies were extracted. Weighted analysis was performed after patients were pooled across included studies. Results: Of 999 studies identified in the initial search, 28 (2.8%) studies, comprising 2918 patients, were included; 19 studies (n = 2175 patients) reported RTP rates. The mean time for RTP was 17.2 months. There was a 63.4% rate of RTP, and 36.6% of patients returning to sport were not able to perform at their prior level of play. Of the 795 patients who did not achieve RTP, 514 (64.7%) cited a psychological reason for not returning. Fear of reinjury was the most common reason (n = 394; 76.7%); other psychological factors included lack of confidence in the treated knee (n = 76; 14.8%), depression (n = 29; 5.6%), and lack of interest/motivation (n = 13; 2.5%). The Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, the ACL–Return to Sport after Injury scale, and the Knee Self-Efficacy Scale were reported measures for assessing the influence of psychology on RTP. Conclusion: Psychological factors play an important role in RTP after ACLR. Among studies evaluating the impact of psychology on RTP, there was a delay in returning as well as lower RTP rates compared with the previously reported normative literature. Fear of reinjury was the most commonly reported impediment to RTP. The psychosocial measures identified in this review may have a role in RTP protocols for assessing mental resiliency; however, their roles need to be further investigated and validated in patients who have undergone ACLR.
机译：背景：在前交叉韧带重建（ACLR）后，影响返回运动的变量是多因素。越来越识别出成功返回播放的非物质因素锗（RTP）。目的：至（1）评估ACLR，（2）识别ACLR后影响RTP的心理因素的心理因素的可用证据基础，（3）了解用于评估心理RTP准备的目前可用的指标。研究设计：系统评价;证据级别，4.方法：对ACLR后报告RTP的研究进行了对MEDLINE数据库的审查。包括关于RTP的心理决定因素的研究。提取包括研究的人口统计学，方法和心理测量性质。患者在纳入包括的研究后进行加权分析。结果：在初始搜索中确定的999例研究，包括2918名患者的28例（2.8％）研究; 19研究（n = 2175名患者）报告了RTP率。 RTP的平均时间为17.2个月。 RTP率为63.4％，36.6％的患者返回运动的患者无法在其现有水平上进行。在没有达到RTP的795名患者中，514（64.7％）引用了不返回的心理原因。害怕重振是最常见的原因（n = 394; 76.7％）;其他心理因素包括缺乏对治疗膝盖的信心（n = 76; 14.8％），抑郁症（n = 29; 5.6％），缺乏兴趣/动机（n = 13; 2.5％）。 Kinesiophoophobia，医院焦虑和抑郁症的坦帕规模，伤害范围后的ACL返回，膝关节自效量表均报告评估心理学对RTP的影响。结论：心理因素在ACLR后在RTP中发挥着重要作用。在研究心理学对RTP的影响中，与先前报道的规范文献相比，返回和较低的RTP率延迟。对Repjury的恐惧是RTP最常见的障碍。本综述中确定的心理社会措施可能在RTP协议中具有评估心理弹性的协议;然而，他们的角色需要进一步调查和验证，该患者受到ACLR的患者。

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