Implementation of In vivo exposure therapy to decrease injury-related fear in females with a history of ACL-Reconstruction: A pilot study

Shelby Baez; Marc Cormier; Richard Andreatta; Phillip Gribble; Johanna M Hoch

doi:10.1016/j.ptsp.2021.09.009

Implementation of In vivo exposure therapy to decrease injury-related fear in females with a history of ACL-Reconstruction: A pilot study

Phys Ther Sport. 2021 Nov:52:217-223. doi: 10.1016/j.ptsp.2021.09.009. Epub 2021 Sep 27.

Authors

Shelby Baez¹, Marc Cormier², Richard Andreatta³, Phillip Gribble⁴, Johanna M Hoch⁵

Affiliations

¹ Department of Kinesiology at Michigan State University in East Lansing, Michigan, USA. Electronic address: baezshel@msu.edu.
² Department of Kinesiology and Health Promotion at the University of Kentucky in Lexington, Kentucky, USA. Electronic address: marc.cormier@uky.edu.
³ Department of Communication Sciences and Disorders at the University of Kentucky in Lexington, Kentucky, USA. Electronic address: richard.andreatta@uky.edu.
⁴ Department of Athletic Training and Clinical Nutrition at the University of Kentucky in Lexington, Kentucky, USA. Electronic address: phillip.gribble@uky.edu.
⁵ Department of Athletic Training and Clinical Nutrition at the University of Kentucky in Lexington, Kentucky, USA. Electronic address: Johanna.Hoch@uky.edu.

PMID: 34626890
DOI: 10.1016/j.ptsp.2021.09.009

Abstract

Objective: The objective of this pilot study was to examine the preliminary feasibility and efficacy of in vivo exposure therapy (IVET) to decrease injury-related fear in females with history of ACLR.

Design: Pilot Study.

Setting: Sports Medicine Research Laboratory.

Participants: 12 female participants with history of ACLR (≥ 1 year post-operative) were randomized into a 5-week IVET group (n = 6) or 5-week sham physical activity (PA) monitoring group (n = 6).

Main outcome measures: The independent variables were Group and Time. The dependent variables were the Photographic Series of Sports Activities for ACLR (PHOSA-ACLR) and the Tampa Scale of Kinesiophobia-11 (TSK-11) scores. A Group x Time repeated measures two-way analysis of variance was completed for the PHOSA-ACLR and the TSK-11. Partial η² effect sizes were used to examine clinically meaningful differences.

Results: High retention and adherence rates were observed in the intervention group. The PHOSA-ACLR exhibited a significant main effect for Time (F_1,10 = 9.92, p = 0.01, partial η² = 0.50), but not for Group. No statistically significant or clinically meaningful differences were observed for the TSK-11.

Conclusion: Both groups exhibited decreased injury-related fear for specific functional tasks. Future research should further examine the efficacy of IVET and PA monitoring to decrease injury-related fear in patients after ACLR.

Keywords: Fear; Knee; Psychological rehabilitation; Sports injury.

Publication types

Randomized Controlled Trial

MeSH terms

Anterior Cruciate Ligament Injuries* / surgery
Anterior Cruciate Ligament Reconstruction*
Fear
Female
Humans
Implosive Therapy*
Pilot Projects