Knee performance and self-efficacy trajectory curves after ACL reconstruction: A longitudinal study.
OBJECTIVES
To examine knee flexion range-of-motion, quadriceps strength, and knee self-efficacy trajectory curves over 6 months after anterior cruciate ligament reconstruction (ACLR), stratified by patients' Month-6 sports activity level.


DESIGN
Prospective longitudinal study.


SETTING
Hospital outpatient physiotherapy department.


PARTICIPANTS
595 individuals after unilateral ACLR (mean age, 27 years).


MAIN OUTCOME MEASURES
At 2-, 3-, and 6-months post-surgery, knee flexion range-of-motion, quadriceps strength, and self-efficacy were quantified. Flexion range-of-motion was additionally measured at 2- and 4-weeks post-surgery. Sports activity levels were assessed using the Tegner Activity Score at 6-months post ACLR.


RESULTS
The various measures improved nonlinearly over time, with substantial improvements observed in the first 2-4 months post-surgery. In multivariable generalized least squares models, greater knee flexion range-of-motion, quadriceps strength, and self-efficacy over time were significantly associated with higher Month-6 Tegner levels (all P values < 0.01). Additionally, receiving a bone-patellar-tendon-bone graft or meniscal repair was associated with lower quadriceps strength trajectories (P-values<0.001) while female sex was associated with lower knee self-efficacy trajectories (P = 0.02).


CONCLUSIONS
Greater knee flexion range-of-motion, quadriceps strength, and self-efficacy were associated with higher Month-6 Tegner levels. The derived trajectory curves may be useful for effective management decision making and adequate results interpretation during the rehabilitation process.
['Pua|Yong-Hao|YH|', 'Low|Juanita|J|', 'Woon|Ee-Lin|EL|', 'Tay|Olivia Shi-Min|OS|', 'Cheong|Philip|P|', 'Thumboo|Julian|J|', 'Clark|Ross Allan|RA|', 'Chang|Paul|P|', 'Tan|Andrew|A|', 'Ho|Jia-Ying|JY|']
D000328:Adult D000070598:Anterior Cruciate Ligament Injuries D059549:Anterior Cruciate Ligament Reconstruction D005260:Female D006801:Humans D007717:Knee D008137:Longitudinal Studies D008297:Male D053580:Muscle Strength D011446:Prospective Studies D052097:Quadriceps Muscle D016059:Range of Motion, Articular D020377:Self Efficacy D055815:Young Adult
knee ACL Quadriceps Psychosocial factors