Relationship between Kinesiophobia and Dynamic Postural Stability after Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Study

Introduction: Anterior cruciate ligament (ACL) injuries in young, active patients generally require ACL reconstruction (ACLR) in order to restore mechanical and postural stability. The fear of movement or reinjury (kinesiophobia) has become increasingly recognized in the post-ACLR population, however the association between restoration of postural stability and kinesiophobia remains largely unknown. The purpose of this study was to investigate changes in mean TSK-11, DMA scores and time on the testing platform, as well as any correlation between TSK-11 and mean overall and individual translational and rotational DMA scores during the first 12 months following ACLR. Design: Cohort study Methods: Patients undergoing ACLR were prospectively enrolled and dynamic postural stability and kinesiophobia based on the Tampa Scale of Kinesiophobia-11 (TSK-11) were collected within 2 days prior to surgery and at 6- and 12-months following ACLR. Dynamic postural stability was quantified by calculating a dynamic motion analysis (DMA) score, with score calculated in three translational (anterior/posterior [AP], up/down [UD], medial/lateral [ML]) and three rotational (left/right [LR], flexion/extension [FE], and internal/external rotation [Rot]) independent planes of motions. Correlations between DMA and TSK-11 scores at each timepoint were analyzed. Results: A total of 25 patients meeting inclusion criteria were analyzed. Mean overall DMA and TSK-11 scores increased with each successive testing interval. At 6-month follow up, a weakly positive association between TSK-11 and DMA scores was appreciated based on overall DMA, AP, UD, ML and LR. At 12-months, a moderately positive correlation was appreciated between TSK-11 and the translational, but not rotational, planes of motion. Conclusions: Following ACLR, lower level of kinesiophobia were found to be moderately associated with improved dynamic stability, especially in the translation planes of motion.