| 1. |
- Beischer, Susanne, et al.
(författare)
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How Is Psychological Outcome Related to Knee Function and Return to Sport Among Adolescent Athletes After Anterior Cruciate Ligament Reconstruction?
- 2019
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 47:7, s. 1567-1575
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adult patients who succeed in returning to their preinjury levels of sport after anterior cruciate ligament (ACL) reconstruction have been characterized by a more positive psychological response. It is not known whether this relationship is valid for adolescent athletes. Purpose: To investigate psychological readiness to return to sport, knee-related self-efficacy, and motivation among adolescent (15-20 years old) and adult (21-30 years old) athletes after ACL reconstruction. A further aim was to compare athletes (15-30 years old) who had recovered their muscle function and returned to sport with athletes who had not. Study Design: Case-control study; Level of evidence, 3. Methods: Data were extracted from a rehabilitation-specific register 8 and 12 months after ACL reconstruction. Athletes previously involved in knee-strenuous sport who had undergone primary ACL reconstruction were included. Data comprised psychological patient-reported outcomes and results from 5 tests of muscle function. Comparisons were performed between age groups, between athletes who had and had not recovered their muscle function, and between patients who had returned to sport and not. Results: In all, 384 (50% females) and 271 athletes (52% females) were included at the 8- and 12- month follow-ups, respectively. Enhanced self-efficacy was reported at both follow-ups by adolescents and by athletes who had recovered their muscle function. Athletes who had recovered their muscle function reported higher (P = .0007) motivation to achieve their goals. Subgroup analyses on patient sex revealed findings similar to those in the main analyses for females but not for males. Moreover, adolescent and adult athletes who had returned to sport reported significantly higher levels on the Knee Self-Efficacy Scale and the ACL-Return to Sport After Injury scale at both follow-ups. Conclusion: Adolescent athletes, especially females, perceived enhanced self-efficacy, had a higher return-to-sport rate, and were more motivated to reach their goals after ACL reconstruction compared with adults. Regardless of age, athletes who had returned to sport and athletes with more symmetrical muscle function had a stronger psychological profile.
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| 2. |
- Beischer, Susanne, et al.
(författare)
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Knee strength, hop performance and self-efficacy at 4 months are associated with symmetrical knee muscle function in young athletes 1 year after an anterior cruciate ligament reconstruction.
- 2019
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Ingår i: BMJ open sport & exercise medicine. - : BMJ. - 2055-7647. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- We investigated whether patient demographics, 4-month patient-reported outcomes (PRO) and muscle function predicted young athletes regaining symmetrical muscle function in five tests of muscle function 1 year after ACL reconstruction.We extracted data on patient demographics, PROs and the results of five tests of muscle function from a rehabilitation-specific register. Athletes were 15-30 years of age, involved in knee-strenuous sport and had undergone a primary ACL reconstruction. The primary outcome was achieving a Limb Symmetry Index of ≥90% for the battery of tests 1 year after ACL reconstruction. Patient demographics, muscle-function data and results for PROs at the 4-month follow-up were analysed.In all, 237 athletes (59% female; mean age 22±4 years) were included in the study. One year after ACL reconstruction, 26% (62/237) of the included athletes had achieved symmetrical muscle function. Univariable analysis showed that symmetrical muscle function was associated with present self-efficacy, OR 1.28 (95% CI 1.04 to 1.58, p=0.011), knee-extension strength, OR 1.73 (95% CI 1.28 to 2.34), knee-flexion strength, OR 1.39 (95% CI 1.07 to 1.81), vertical hop, OR 1.77 (95% CI 1.27 to 2.45), single-leg hop for distance, OR 1.98 (95% CI 1.24 to 3.17) and side hop, OR 1.64 (95% CI 1.15 to 2.33).Symmetrical knee-extension and knee-flexion strength, a more symmetrical hop performance and higher present self-efficacy at an early stage all increased the odds of achieving symmetrical muscle function in young athletes 1 year after ACL reconstruction.
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| 3. |
- Beischer, Susanne, et al.
(författare)
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Validation of an 18-item version of the Swedish Knee Self-Efficacy Scale for patients after ACL injury and ACL reconstruction
- 2021
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Ingår i: Journal of Experimental Orthopaedics. - : Springer Science and Business Media LLC. - 2197-1153. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To evaluate the measurement properties of a new version of the Swedish Knee Self-Efficacy Scale (K-SES) in samples of individuals with an anterior cruciate ligament (ACL) injury and after ACL reconstruction. A secondary aim was to translate the new version of K-SES into English in order to prepare for future complete cross-cultural adaptation. Methods The reliability, structural validity, internal consistency and construct validity of the new, 18-item version of the K-SES (K-SES18) were assessed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for evaluating methodological quality. The Swedish version of the K-SES18 was translated to English using recommended guidelines. Results The test-retest reliability for the K-SES18 subscale present and the K-SES18 subscale future showed an Interclass Correlation Coefficient (ICC) = 0.92. In addition, the K-SES18 had a Cronbach's alpha ranging from 0.93 to 0.96 for the K-SES18 subscale present and from 0.81 to 0.91 for the K-SES18 subscale future. No floor and ceiling effects were identified for the subscale present or the subscale future of the K-SES18. A factor analysis produced 2 factors of importance; K-SES(18)present and K-SES(18)future. Seven predefined hypotheses were confirmed. Conclusion The K-SES18 has acceptable reliability and validity to assess knee self-efficacy in patients up to 18 months after ACL injury and reconstruction.
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| 4. |
- Beischer, Susanne, et al.
(författare)
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Young athletes return too early to knee-strenuous sport, without acceptable knee function after anterior cruciate ligament reconstruction
- 2018
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 The Author(s) Purpose: The purpose of this study was to evaluate the return to knee-strenuous sport rate, muscle function and subjective knee function among adolescent patients (15–20 years of age) and adult patients (21–30 years of age) 8 and 12 months, respectively, after anterior cruciate ligament (ACL) reconstruction. It was hypothesised that no differences in outcome would be found between age groups at 8 or 12 months after ACL reconstruction. Methods: Cross-sectional data from five tests of muscle function, from the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Tegner Activity Scale (Tegner), performed at 8 and 12 months after a primary ACL reconstruction, were extracted from a rehabilitation outcome register. A total of 270 (51% women) athletes, aged 15–30 years, who were all involved in knee-strenuous sport prior the injury, were included at 8 months after ACL reconstruction. At 12 months 203 (51% women) were included. The return to knee-strenuous-sport rates and the rate of achieving a limb symmetry index of ≥ 90% in all five tests of muscle function, defined as recovery of muscle function, and subjective knee function scores, as measured with the KOOS, were compared between age groups. Results: The adolescent patients had a higher (50%) return to knee-strenuous sport rate compared with the adult patients (38%) 8 months after ACL reconstruction (p = 0.04). At the 12-month follow-up, no difference was found between the age groups; 74 and 63%, respectively. At the 8-month follow-up, 29% of the patients, in both age groups, who had returned to sport had recovered their muscle function in all five tests of muscle function. At the 12-month follow-up, the corresponding results were 20% for the adolescents and 28% for the adult patients. No difference in mean KOOS scores was found between the age groups at 8 or at 12 months after ACL reconstruction. Conclusion: The majority of young athletes make an early return to knee-strenuous sport after a primary ACL reconstruction, without recovering their muscle function. To set realistic expectations, clinicians are recommended to ensure that young athletes receive information about not to return before muscle function is recovered and that this may take longer time than 12 months. Level of evidence: II.
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| 5. |
- Beischer, Susanne, et al.
(författare)
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Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return
- 2020
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Ingår i: Journal of Orthopaedic & Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 50:2, s. 83-90
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the association between sustaining a second anterior cruciate ligament (ACL) injury and (1) time to return to sport, (2) symmetrical muscle function, and (3) symmetrical quadriceps strength at the time of return to sport in young athletes after primary ACL reconstruction. DESIGN: Prospective cohort study. METHODS: Patient demographics and results from 5 tests of muscle function (2 strength tests and 3 hop tests) were extracted from a rehabilitation registry. A questionnaire was sent to athletes (1530 years old) who were involved in knee-strenuous sport before the injury and had undergone primary ACL reconstruction to determine time of return to knee-strenuous sport (preinjury Tegner Activity Scale score of 6 or greater). We used the Cox proportional hazard regression model to analyze time to event. RESULTS: One hundred fifty-nine (32% of initial sample) athletes (mean +/- SD age, 21.5 +/- 4.4 years; 64% female) were included. Athletes with a higher preinjury Tegner Activity Scale score had a higher rate of second ACL injury (hazard ratio = 2.1; 95% confidence interval: 1.2, 3.6; P<.01). Athletes who returned to knee-strenuous sport before 9 months after reconstruction had a higher rate of second ACL injury (hazard ratio = 6.7; 95% confidence interval: 2.6,16.7; P<.001). There was no association between symmetrical muscle function or quadriceps strength and second ACL injury. CONCLUSION: Returning to knee-strenuous sport before 9 months after ACL reconstruction was associated with an approximately 7-fold increased rate of sustaining a second ACL injury. Achieving symmetrical muscle function or quadriceps strength was not associated with new ACL injury in young athletes.
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| 6. |
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| 7. |
- Gustavsson, Alexander, et al.
(författare)
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A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:8, s. 778-88
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to develop a test battery of hop tests with high ability to discriminate (i.e. high test-retest reliability, sensitivity, specificity and accuracy) between the hop performance of the injured and the uninjured side in patients with an ACL injury and in patients who have undergone ACL reconstruction. Five hop tests were analysed: three maximum single hop tests and two hop tests while developing fatigue. Fifteen healthy subjects performed the five hop tests on three separate occasions in a test-retest design. Thirty patients, mean 11 months after an ACL injury and 35 patients, mean 6 months after ACL reconstruction were tested. ICC values ranged from 0.85 to 0.97 for the five hop tests, indicating that all the tests had high test-retest reliability. Sixty-seven percent to 100% of the healthy subjects had normal symmetry (i.e. <10% side-to-side difference) in the five hop tests. Abnormal symmetry in the five hop tests ranged from 43 to 77% for patients with an ACL injury and from 51 to 86% for patients who had undergone ACL reconstruction respectively. The three tests with the highest ability to discriminate hop performance were chosen for the test battery; they were the vertical jump, the hop for distance and the side hop. The test battery revealed a high level of sensitivity and accuracy in patients with an ACL injury (87 and 84%) and in patients who had undergone ACL reconstruction (91 and 88%), when at least one of the three tests was classified as abnormal. To summarise, the test battery consisting of both maximum single hop performances: the vertical jump and the hop for distance and hop performance while developing fatigue: the side hop, produced high test-retest reliability, sensitivity and accuracy. Further, the test battery produced higher values compared with any of the three hop tests individually revealing that only one out of ten patients had restored hop performance 11 months after an ACL injury and 6 months after ACL reconstruction. It is concluded that this test battery showed a high ability to discriminate between the hop performance of the injured and the uninjured side both in patients with an ACL injury and in patients who have undergone ACL reconstruction.
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| 8. |
- Hamrin Senorski, Eric, 1989, et al.
(författare)
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Concomitant injuries may not reduce the likelihood of achieving symmetrical muscle function one year after anterior cruciate ligament reconstruction: a prospective observational study based on 263 patients.
- 2018
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 26:10, s. 2966-2977
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Tidskriftsartikel (refereegranskat)abstract
- A better understanding of patient characteristics and the way common concomitant injuries affect the recovery of muscle function after surgery should help providers to treat patients with anterior cruciate ligament (ACL) injuries. The aim of this study was to determine whether patient characteristics, concomitant injuries and graft choice at ACL reconstruction were associated with symmetrical knee muscle function at one year. The hypothesis was that the presence of concomitant injuries would negatively influence the opportunity to achieve symmetrical knee function at the one-year follow-up.Data was extracted from the Swedish National Knee Ligament Register and a rehabilitation outcome register between August 2012 and December 2016. The patients had been evaluated with a battery of tests comprising knee extension and flexion strength, vertical jump, hop for distance and the side-hop test one year after ACL reconstruction. Univariable and multivariable logistic regression analyses were performed with achieving a limb symmetry index (LSI) of ≥ 90% in all tests of muscle function as primary outcome.A total of 263 patients with a mean age of 26.7 ± 10.3 years were included in the study (47% females). No patient demographic or intra-operative predictors were found to be significant when attempting to predict the achievement of a symmetrical muscle function. Lateral meniscus injury and a patellar tendon autograft reduced the odds of achieving an LSI of ≥ 90% in knee extension strength, OR = 0.49 [(95% CI 0.25-0.97), p = 0.039] and OR = 0.30 [(95% CI 0.14-0.67), p = 0.0033] respectively. In addition, reduced odds of recovering knee extension strength were found in older patients, OR = 0.76 [(95% CI 0.60-0.98), p = 0.034]. A higher pre-injury level of physical activity increased the odds of recovering knee flexion strength, OR = 1.14 [(95% CI 1.01-1.29), p = 0.037].Intra-operatively identified concomitant injuries or graft choice did not affect the likelihood of recovering symmetrical performance in five different tests of muscle function one year after ACL reconstruction. However, fewer than one in four patients achieved an LSI of ≥ 90% in all tests.Prospective observational study: Level 2.
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| 9. |
- Hamrin Senorski, Eric, 1989, et al.
(författare)
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Low 1-Year Return-to-Sport Rate After Anterior Cruciate Ligament Reconstruction Regardless of Patient and Surgical Factors A Prospective Cohort Study of 272 Patients
- 2018
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 46:7, s. 1551-1558
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is insufficient knowledge about the way that concomitant injuries affect the short-term likelihood of a return to a knee-strenuous sport after anterior cruciate ligament (ACL) reconstruction. Hypotheses/Purpose: The purpose was to study whether patient characteristics, concomitant injuries, and graft choice at primary ACL reconstruction can predict return to sport (RTS) 1 year after surgery. The hypotheses were that younger age at the time of ACL reconstruction would positively affect RTS, while the presence of concomitant injuries would negatively affect RTS 1 year after surgery. Methods: Data were extracted from a rehabilitation-specific register and the Swedish National Knee Ligament Register. Twelve months after surgery, all patients were evaluated for RTS via the Tegner Activity Scale. The primary outcome was a return to kneestrenuous sport, defined as a Tegner Activity Scale >= 6. Univariable and multivariable logistic regression analyses were performed with patient characteristics, concomitant knee injuries, and graft choice as independent variables. Results: A total of 272 patients (51% female) with a mean +/- SD age of 25.0 +/- 6 9.2 years were included. In the multivariable analysis, a favorable odds ratio (OR) for returning to sport was found for patients of male sex (OR, 2.58; 95% CI, 1.43-4.65; P = .0016), younger age at the time of ACL reconstruction (OR, 2.32; 95% CI, 1.59-3.33; P < 0001), a higher preinjury score on the Tegner Activity Scale (OR, 1.45; 95% CI, 1.13-1.87; P = .0038), and an absence of injury to the meniscus (OR, 1.92; 95% CI, 1.10-3.36; P = .023) and medial collateral ligament (OR, 7.61; 95% CI, 1.42-40.87; P = .018). In addition, the absence of cartilage injury was favorable in terms of RTS in the univariable analysis (OR, 2.48; 95% CI, 1.40-4.39; P = .0018). Conclusion: Positive predictors of a return to knee-strenuous sport 1 year after ACL reconstruction were male sex, younger age, a high preinjury level of physical activity, and the absence of concomitant injuries to the medial collateral ligament and meniscus.
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| 10. |
- Hamrin Senorski, Eric, 1989, et al.
(författare)
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Return to knee-strenuous sport after anterior cruciate ligament reconstruction: a report from a rehabilitation outcome registry of patient characteristics.
- 2017
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 25:5
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Tidskriftsartikel (refereegranskat)abstract
- To characterise patients who returned to knee-strenuous sports after an anterior cruciate ligament (ACL) reconstruction.Data from isotonic tests of muscle function and patient-reported outcome measures, Tegner activity scale (Tegner and Lysholm in Clin Orthop Relat Res 198:43-49, 1985), physical activity scale, knee injury and osteoarthritis scale and knee self-efficacy scale were extracted from a registry. The 157 included patients, 15-30 years of age, had undergone primary ACL reconstruction and were all involved in knee-strenuous sports, i.e. pre-injury Tegner of 6 or higher. Return to sport was studied in two different ways: return to pre-injury Tegner and return to knee-strenuous sport (Tegner 6).Fifty-two patients (33 %), who returned to pre-injury Tegner, 10 months after surgery, were characterised by better subjective knee function measured with the knee injury and osteoarthritis outcome score (p < 0.05), compared with patients who did not. These patients also had higher perceived self-efficacy of knee function (p < 0.01), measured with knee self-efficacy scale. Eighty-four patients (54 %) who returned to knee-strenuous sports, i.e. Tegner 6 or higher, were characterised by higher goals for physical activity (p < 0.01) and higher self-efficacy of future knee function (p < 0.05). Strength measurements showed that women who returned to sports were stronger in leg extension than women who did not. No differences were found in Limb Symmetry Index for knee strength or jumping ability.Patients who returned to sports after ACL reconstruction had better subjective knee function and higher self-efficacy of knee function. Results highlight that further emphasis should be placed at psychological factors during rehabilitation of patients after ACLR.II.
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