The relationships between kinesiophobia and clinical outcomes after ACL reconstruction differ by self-reported physical activity engagement

Objectives: To investigate whether relationships between kinesiophobia, lower extremity function, and patient-reported function differ by self-reported physical activity engagement after ACL reconstruction (ACLR). Design: Cross-sectional. Setting: Laboratory. Participants: Seventy-seven patients with a primary, unilateral ACLR. Main outcome measures: Kinesiophobia (TSK-17) was the primary outcome. Lower extremity function included quadriceps and hamstrings strength, fatigue, and hop performance. Patient-reported function included regional function (IKDC, KOOS subscales) and physical activity engagement (Godin Leisure-Time Exercise). Patients were evaluated together, then stratified by LOW and HIGH physical activity. Correlations and multiple regression analyses identified relationships between kinesiophobia and outcome measures. Results: Greater kinesiophobia was associated with lesser hamstrings strength, hop performance, and patient-reported function. Greater hamstrings fatigue and lesser KOOSADL explained greater kinesiophobia in patients reporting LOW physical activity. Lesser triple hop symmetry, crossover hop distance, and IKDC explained greater kinesiophobia in patients reporting HIGH physical activity. Conclusions: Greater kinesiophobia associated with worse outcomes after ACLR. Relationships differed by self-reported physical activity engagement. Interventions that improve the ability to perform knee-related activities of daily living may be appropriate to minimize the impact of fear in less active patients, while those targeting hop performance and knee-related sport activities may be better suited for more active patients. (C) 2019 Elsevier Ltd. All rights reserved.