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Implementation of in vivo exposure therapy to decrease injury-related fear in females with a history of ACL-reconstruction: a pilot study [with consumer summary]
Baez S, Cormier M, Andreatta R, Gribble P, Hoch JM
Physical Therapy in Sport 2021 Nov;52:217-223
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; 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*

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 eta2 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 eta2 = 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.

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