The online version of this article (doi:10.1186/s12891-017-1643-9) contains supplementary material, which is available to authorized users.
Fear of harm (FoH) after Anterior Cruciate Ligament Reconstruction (ACLR) should be addressed in physical therapy as it hampers return to sports. However, there are no instruments assessing FoH specific for ACLR. The objective of this study is to describe the development and measurement properties of the Photograph Series of Sports Activities for ACLR (PHOSA-ACLR) measuring ACL injury related FoH.
Based on literature and opinion of physical therapists with extensive experience in ACLR treatment, photographs depicting FoH inducing situations in ACL injury were considered for inclusion in the instrument. For each photograph the patients is asked to report perceived harmfulness. The set of photographs was completed by two samples of patients with ACLR: 1 cross-sectional sample (n = 55), and 1 test-retest reliability sample (n = 58). Internal consistency and structural validity were assessed in 109 patients. In 58 patients criterion validity was assessed by calculating pearson correlations with the Tampa Scale of Kinesiophobia (TSK). Correlations with self-reported knee function (KOOS and Lysholm score), and Knee Self-efficacy Scale (K-SES) were computed for hypothesis testing. Test-retest reliability was determined in a group of 55 patients, assessed twice with 1 week between assessments.
Twelve photographs depicting sports related movements that are likely to invoke FoH after ACLR were selected. Two items were deleted because of lack of discrimination. The remaining 10 items were included in the PHOSA-ACLR, and the scale showed excellent internal consistency (Cronbach’s Alpha is .95). Items reflected one dimension, and was strongly correlated with TSK (r = .59). A priori formulated hypotheses are confirmed and test-retest correlation was excellent (ICC = .86).
The PHOSA-ACLR showed acceptable measurement properties. The PHOSA-ACLR gives specific information about fear invoking sports situations that are not measured by other kinesophobia measures. Therefore, the PHOSA-ACLR might be a valuable additional tool in rehabilitation of ACLR patients. Additional research is needed to determine responsiveness to change.
Additional file 1: PHOSA-ACLR: Photograph Series of Sport Activities after Anterior Cruciate Ligament- Reconstruction. (DOCX 1399 kb)12891_2017_1643_MOESM1_ESM.docx
van Melick N, van Cingel RE, Brooijmans F, Neeter C, van Tienen T, Hullegie W, Nijhuis-van der Sanden MW. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. Br J Sports Med. 2016;50(24):1506–15.
Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med. 2014;48(21):1543–52. CrossRefPubMed
Wierike S, Sluis A, Akker-Scheek I, Elferink-Gemser M, Visscher C. Psychosocial factors influencing the recovery of athletes with anterior cruciate ligament injury: a systematic review. Scand J Med Sci Sports. 2013;23(5):527–40.
Nyland J, Cottrell B, Harreld K, Caborn DN. Self-reported outcomes after anterior cruciate ligament reconstruction: an internal health locus of control score comparison. Arthrosc: J Arthroscopic Related Surgery. 2006;22(11):1225–32. CrossRef
Flanigan DC, Everhart JS, Pedroza A, Smith T, Kaeding CC. Fear of reinjury (kinesiophobia) and persistent knee symptoms are common factors for lack of return to sport after anterior cruciate ligament reconstruction. Arthrosc: J Arthroscopic Related Surgery. 2013;29(8):1322–9. CrossRef
Ardern CL, Taylor NF, Feller JA, Whitehead TS, Webster KE. Sports participation 2 years after anterior Cruciate ligament reconstruction in athletes who had not returned to sport at 1 year a prospective follow-up of physical function and psychological factors in 122 athletes. Am J Sports Med. 2015;43(4):848–56. CrossRefPubMed
Wiese-Bjornstal DM, Smith AM, Shaffer SM, Morrey MA. An integrated model of response to sport injury: psychological and sociological dynamics. J Appl Sport Psychol. 1998;10(1):46–69. CrossRef
Miller, R.- Kori, S.- Todd, D. The tampa scale for kinisophobia. Unpublished report. 1991.
Kugler K, Wijn J, Geilen M, de Jong J, Vlaeyen J. The Photograph series of Daily Activities (PHODA). CD-rom version 1.0. Institute for rehabilitation research and school for physiotherapy. Seattle: IASP Press; 1999.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, De Vet HC. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010;19(4):539–49. CrossRefPubMedPubMedCentral
De Groot IB, Favejee MM, Reijman M, Verhaar JA, Terwee CB. The Dutch version of the knee injury and osteoarthritis outcome score: a validation study. Health Qual Life Outcomes. 2008;6(1):1. CrossRef
Halfens R. Locus of control. De beheersorientatie in relatie tot ziekte en gezondheidssgedrag. (locus of control in relation to illness and health behaviour). Maastricht, The Netherlands: PhD. Rijks Universiteit Maastricht; 1985.
Williams B, Brown T, Onsman A. Exploratory factor analysis: a five-step guide for novices. Australas J Paramedicine. 2012;8(3):1.
Fleiss JL. Reliability of measurement. The design and analysis of clinical experiments. 1986;1–32.
Gignac MA, Cao X, Ramanathan S, White LM, Hurtig M, Kunz M, Marks PH. Perceived personal importance of exercise and fears of re-injury: a longitudinal study of psychological factors related to activity after anterior cruciate ligament reconstruction. BMC Sports Sci Med Rehabil. 2015;7(1):1. CrossRef
- Measuring individual hierarchy of anxiety invoking sports related activities: development and validation of the Photographic Series of Sports Activities for Anterior Cruciate Ligament Reconstruction (PHOSA-ACLR)
Wim van Lankveld
Nicky van Melick
J. Bart Staal
Robert van Cingel
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
e.Med Kampagnen-Visual, Mail Icon II