Research Progress on Intervention Strategies for Anterior Cruciate Ligament Reconstruction Surgery-induced Fear of Movement
DOI:
https://doi.org/10.54097/bfbkpf06Keywords:
Anterior cruciate ligament reconstruction, Kinesiophobia, Intervention strategies.Abstract
Kinesiophobia is an impediment to functional recovery and return to previous level of activity following anterior cruciate ligament reconstruction (ACL-R), is estimated at 30-50%, and this paper explores the factors in uencing it (biomechanical, pain perception, psychological), and the main three lines of action regarding ACL-R induced kinesiophobia. CBT and GET, that correct irrational cognition and step by step exercise adaptation, are able to alleviate kinesiophobia. However, no long-term follow-up is given. The utilization of physical therapy including isokinetic, proprioceptive and BFR training and/or preoperative pre-rehabilitation, can increase the muscular power and joint stability but cannot offer an individualization and psychological integration. Smart interventions like VR training, AI-based rehabilitation systems and the APP were proven to reduce kinesiophobia and improve compliance with the rehab; however, they are limited to the inconsistency of equipment parameters and uncertainty of long-term effects. Further studies are needed to explore the relationship between kinesiophobia’s determinants, as well as largesample, multi-center long-term randomized trials to fill in gaps with current interventions.
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[1] Zheng, X., Chang, M., Tian, W., Liu, X., Liao, D., Yuan, H., & Cui, L. (2025). Influencing factors of kinesiophobia in patients after anterior cruciate ligament reconstruction: A scoping review. Medicine, 104(41), e45138. https://doi.org/10.1097/MD.0000000000045138
[2] Vlaeyen, J. W. S., Kole-Snijders, A. M. J., Boeren, R. G. B., & van Eek, H. (1995). Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain, 62(3), 363–372. https://doi.org/10.1016/0304-3959(94)00279-N
[3] Yang Yang, Sheng Xiaomin, Wang Jiao & Zeng Cong (2025). Research progress on sports phobia in patients undergoing anterior cruciate ligament reconstruction. Contemporary Nurses (Late Edition), 32(02), 8-14. https://doi.org/10.19793/j.cnki.1006-6411.2025.06.003
[4] Dudley, R. I., Lohman, E. B., Gharibvand, L., & Patterson, C. S. (2025). Pain-related fear induces aberrant drop jump landing biomechanics in healthy and anterior cruciate ligament reconstructed females. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 33(10), 3553–3561. https://doi.org/10.1002/ksa.12604
[5] Erhart-Hledik, J. C., Chu, C. R., Asay, J. L., B Mahtani, G., & Andriacchi, T. P. (2022). Vertical ground reaction force 2 years after anterior cruciate ligament reconstruction predicts 10-year patient-reported outcomes. Journal of orthopaedic research: official publication of the Orthopaedic Research Society, 40(1), 129–137. https://doi.org/10.1002/jor.25025
[6] Xiao, M., van Niekerk, M., Trivedi, N. N., Hwang, C. E., Sherman, S. L., Safran, M. R., & Abrams, G. D. (2023). Patients Who Return to Sport After Primary Anterior Cruciate Ligament Reconstruction Have Significantly Higher Psychological Readiness: A Systematic Review and Meta-analysis of 3744 Patients. The American journal of sports medicine, 51(10), 2774–2783. https://doi.org/10.1177/03635465221102420
[7] Brewer, B. W., Van Raalte, J. L., & Cornelius, A. E. (2022). An Interactive Cognitive-Behavioural Multimedia Program Favourably Affects Pain and Kinesiophobia During Rehabilitation After Anterior Cruciate Ligament Surgery: An Effectiveness Trial. International journal of sport and exercise psychology, 20(4), 1133–1155. https://doi.org/10.1080/1612197x.2021.1934712
[8] Sun, J. N., Wang, R. S., Zheng, Q. Y., Ma, Y. R., & Chen, P. (2025). Cognitive-behavioural physical therapy improves psychological readiness for return to sport, knee function, and resilience in patients after anterior cruciate ligament reconstruction: A randomised controlled trial. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 10.1002/ksa.12687. Advance online publication. https://doi.org/10.1002/ksa.12687
[9] Baez, S., Cormier, M., Andreatta, R., Gribble, P., & Hoch, J. M. (2021). Implementation of In vivo exposure therapy to decrease injury-related fear in females with a history of ACL-Reconstruction: A pilot study. Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine, 52, 217–223. https://doi.org/10.1016/j.ptsp.2021.09.009
[10] Kumar, R., Singh, A., & Singh, V. (2025). Evidence-Based Interventions and Functional Outcomes for Return to Sport After ACL Reconstruction: A Systematic Review and Meta-analysis. Indian journal of orthopaedics, 60(2), 272–299. https://doi.org/10.1007/s43465-025-01615-y
[11] Zheng, Q. Y., Sun, J. N., Wang, R. S., Ma, Y. R., & Chen, P. (2025). Does proprioceptive training improve joint function and psychological readiness in patients after anterior cruciate ligament reconstruction? A randomized controlled trial. BMC musculoskeletal disorders, 26(1), 364. https://doi.org/10.1186/s12891-025-08621-z
[12] Li, X., Li, J., Qing, L., Wang, H., Ma, H., & Huang, P. (2023). Effect of quadriceps training at different levels of blood flow restriction on quadriceps strength and thickness in the mid-term postoperative period after anterior cruciate ligament reconstruction: a randomized controlled external pilot study. BMC musculoskeletal disorders, 24(1), 360. https://doi.org/10.1186/s12891-023-06483-x
[13] Cortés-Pérez, I., Desdentado-Guillem, J. M., Camacho-Delgado, M. S., Del Rocío Ibancos-Losada, M., Obrero-Gaitán, E., & Lomas-Vega, R. (2025). Virtual reality-based therapy after anterior cruciate ligament injury effectively reduces pain and improves knee function, movement patterns, and dynamic balance: A systematic review and meta-analysis. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 33(5), 1736–1753. https://doi.org/10.1002/ksa.12477
[14] Guo, Y., Li, D., Wu, Y. B., Sun, X., Sun, X. Y., & Yang, Y. P. (2023). Mobile health-based home rehabilitation education improving early outcomes after anterior cruciate ligament reconstruction: A randomized controlled clinical trial. Frontiers in public health, 10, 1042167. https://doi.org/10.3389/fpubh.2022.1042167
[15] Zhu, T., Huang, Y., Pu, J., Wang, C., Ruan, M., Lu, P., Yang, X., Bao, N., Chen, Y., & Zhang, A. (2026). Evaluation of the Efficacy of an Artificial Intelligence-Based Assessment and Correction System in the Rehabilitation of Patients Following Anterior Cruciate Ligament Reconstruction Surgery. Journal of clinical medicine, 15(2), 575. https://doi.org/10.3390/jcm15020575
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