Modeling and rehabilitation following anterior cruciate ligament reconstruction

Abstract

Background/Purpose: This study sought to examine the effectiveness of a modeling video to reduce preoperative perceptions of anxiety and pain, as well as to increase postoperative self-efficacy and functional outcomes after anterior cruciate ligament reconstruction. Methods: Following baseline assessment of state anxiety, perceptions of expected pain, injury severity, and knee function (International Knee Documentation Committee [IKDC] system), patients scheduled for surgical reconstruction of the anterior cruciate ligament were randomly assigned to either a modeling intervention or a control group. Psychological assessments were repeated preoperatively for expected pain and anxiety. Actual pain was assessed preoperatively, prior to discharge, and at 2 weeks postoperatively. Rehabilitation self-efficacy was assessed prior to discharge and at 2 and 6 weeks postoperatively. IKDC functional assessments were repeated at 6 weeks postoperatively, whereas range of motion was assessed at 2 and 6 weeks postsurgery. Results: Compared with the participants in the control condition, participants assigned to the modeling intervention reported significantly lower perceptions of expected pain preoperatively and significantly greater self-efficacy at predischarge to perform rehabilitation tasks. Those who received the modeling intervention also experienced significantly better IKDC objective functional outcome scores compared with their control counterparts. No psychological variables mediated relations between the intervention and functional outcomes. Conclusions: The data suggest that watching a modeling video may be an effective prophylactic treatment to decrease perceptions of expected pain, increase rehabilitation self-efficacy, and provide an early stimulus with respect to early function. © 2006 by The Society of Behavioral Medicine.