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A randomized, controlled study of a rehabilitation model to improve knee-function self-efficacy with ACL injury
Thomee P, Wahrborg P, Borjesson M, Thomee R, Eriksson BI, Karlsson J
Journal of Sport Rehabilitation 2010;19(2):200-213
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

CONTEXT: The Knee Self-Efficacy Scale (K-SES) has good reliability, validity, and responsiveness for patients' perceived knee-function self-efficacy during rehabilitation after an anterior cruciate ligament (ACL) injury. Preoperative knee-function self-efficacy has also been shown to have a predictive ability in terms of outcome 1 y after ACL reconstruction. OBJECTIVE: To evaluate a new clinical rehabilitation model containing strategies to enhance knee-function selfefficacy. DESIGN: A randomized, controlled study. SETTING: Rehabilitation clinic and laboratory. PATIENTS: 40 patients with ACL injuries. INTERVENTION: All patients followed a standardized rehabilitation protocol. Patients in the experimental group were treated by 1 of 3 physiotherapists who had received specific training in a clinical rehabilitation model. These physiotherapists were also given their patients' self-efficacy scores after the initial and 4-, 6-, and 12-mo follow-ups, whereas the 5 physiotherapists treating the patients in the control group were not given their patients' self-efficacy scores. MAIN OUTCOME MEASURES: The K-SES, the Tegner Activity Scale, the Physical Activity Scale, the Knee Injury and Osteoarthritis Outcome Score, and the Multidimensional Health Locus of Control. RESULTS: Twenty-four patients (12 in each group) completed all followups. Current knee-function self-efficacy, knee symptoms in sports, and knee quality of life improved significantly (p = 0.05) in both groups during rehabilitation. Both groups had a significantly (p = 0.05) lower physical activity level at 12 mo than preinjury. No significant differences were found between groups. CONCLUSION: In this study there was no evidence that the clinical rehabilitation model with strategies to enhance self-efficacy resulted in a better outcome than the rehabilitation protocol used for the control group.
Copyright Human Kinetics. Reprinted with permission from Human Kinetics (Champaign, IL).

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