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Janet E. Simon, Dustin R. Grooms and Carrie L. Docherty

surgery may further impact HRQOL due to injury severity or the nature of surgery itself increasing risk of OA development and decreasing knee-related QOL and function. 5 , 6 , 22 There have been several investigations illustrating the long-term impact that knee injury or knee surgery has on HRQOL. 19

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Abbey C. Thomas, Janet E. Simon, Rachel Evans, Michael J. Turner, Luzita I. Vela and Phillip A. Gribble

individuals who underwent knee surgery would be more likely to be diagnosed with OA than individuals who sustained a knee injury that was not treated surgically. Methods Design This study was a cross-sectional survey. Patients or Participants An online survey regarding knee injury history, treatment, and

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Joanne M. Daly, Britton W. Brewer, Judy L. Van Raalte, Albert J. Petitpas and Joseph H. Sklar

Cognitive appraisal models of adjustment to sport injury hold that cognitive appraisals of the injury determine emotional responses to the injury, which in turn influence behavioral responses (e.g., adherence to rehabilitation). To test this model, recreational and competitive athletes undergoing rehabilitation following knee surgery (N = 31) appraised their ability to cope with their injury and completed a measure of mood disturbance. Adherence to rehabilitation was measured in terms of attendance at rehabilitation sessions and physical therapist/athletic trainer ratings of patient behavior during rehabilitation sessions. As predicted, cognitive appraisal was associated with emotional disturbance. Emotional disturbance was inversely related to one measure of adherence (attendance) but was unrelated to the other measure of adherence (physical therapist/athletic trainer ratings). The results of this study provide support for cognitive appraisal models and suggest that emotional disturbance may be a marker for poor adherence to sport injury rehabilitation regimens.

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Nicolas Olivier, Renaud Legrand, Jacques Rogez, FX Gamelin, Serge Berthoin and Thierry Weissland

Objective:

To analyze the consequences on heart rate variability (HRV) of a hospitalization period due to surgery of the knee in sportsmen.

Patients:

Ten soccer players who had undergone knee surgery took part in this study.

Design:

HRV was measured before and after hospitalization within a 7-day interval.

Results:

After the hospitalization phase, heart rate at rest increased significantly (3 beats/minute). A significant decrease of 7% in the cardiac inter beat interval (R-R interval), P < 0.05 and a 66% decrease in total power spectral density: −66%, P < 0.05 were observed. The disturbance of the autonomic nervous system could be due to a variation in cardiac vagal activity resulting in a 64% decrease in the high frequencies (P < 0.05). This variation was not associated with a modification in normalized markers (LFn.u., HFn.u.) and LF/HF ratio (P > 0.05).

Conclusion:

In sportsmen, a hospitalization period led to an increase in resting heart rate and was associated with a disturbance of the autonomic nervous system.

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Jay R. Ebert, Kate E. Webster, Peter K. Edwards, Brendan K. Joss, Peter D’Alessandro, Greg Janes and Peter Annear

reflection of the wider Australian (and international) orthopedic community, though it was encouraging to capture 86% of AKS members with a specialty in knee surgery. Ongoing education of orthopedic surgeons on the importance of rehabilitation and better targeted referral pathways for rehabilitation and RTS

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Matthew D. Pepe and Christopher D. Harner

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Carrie B. Scherzer, Britton W. Brewer, Allen E. Cornelius, Judy L. Van Raalte, Albert J. Petitpas, Joseph H. Sklar, Mark H. Pohlman, Robert J. Krushell and Terry D. Ditmar

Objective:

To examine the relationship between self-reported use of psychological skills and rehabilitation adherence.

Design:

Prospective correlational design.

Setting:

Outpatient physical-therapy clinic specializing in sports medicine.

Patients:

Fifty-four patients (17 women and 37 men) undergoing rehabilitation after anterior-cruciate-ligament reconstruction.

Main Outcome Measures:

An abbreviated version of the Sports Injury Survey (Ievleva & Orlick, 1991) was administered approximately 5 weeks after surgery to assess use of goal setting, imagery, and positive self-talk. Four adherence measures were obtained during the remainder of rehabilitation: attendance at rehabilitation sessions, practitioner ratings of patient adherence at rehabilitation sessions, patient self-reports of home exercise completion, and patient self-reports of home cryotherapy completion.

Results:

Goal setting was positively associated with home exercise completion and practitioner adherence ratings. Positive self-talk was positively correlated with home exercise completion.

Conclusions:

Use of certain psychological skills might contribute to better adherence to sport-injury rehabilitation protocols.

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Luke M. Mueller, Ben A. Bloomer and Chris J. Durall

Clinical Scenario:

Anterior cruciate ligament (ACL) injuries are associated with a lengthy recovery time, decreased performance, and an increased rate of reinjury. To improve performance of the injured knee, affected athletes often undergo surgical reconstruction and rehabilitation. Determining when an athlete is ready to safely return to play (RTP), however, can be challenging for clinicians. Although various outcome measures have been recommended, their ability to predict a safe RTP is questionable.

Focused Clinical Question:

Which outcome measures should be used to determine readiness to return to play after ACL reconstruction?

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Michael J. Axe, Kirk H. Swigart and Lynn Snyder-Mackler