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Retrospective experiences of individuals two decades after anterior cruciate ligament injury: a process of re-orientation towards acceptance
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).ORCID iD: 0000-0002-3334-1376
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.ORCID iD: 0000-0002-0366-4609
2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 21, p. 6267-6276Article in journal (Refereed) Published
Abstract [en]

Purpose: Individual perspectives of long-term consequences decades after anterior cruciate ligament (ACL) injury are unexplored. We addressed experiences and the impact on life of former athletes >20 years post-ACL injury.

Methods: Individual interviews, analysed using Grounded Theory, were conducted with 18 persons injured mainly during soccer 20–29 years ago.

Results: A theoretical model was developed with the core category Re-orientation towards acceptance, overarching three categories illustrating the long-term process post-injury. Initially the persons felt like disaster had struck; their main recall was strong pain followed by reduced physical ability and fear of movement and re-injury. In the aftermaths of injury, no participant reached the pre-injury level of physical activity. Over the years, they struggled with difficult decisions, such as whether to partake or refrain from different physical activities, often ending-up being less physically active and thereby gaining body weight. Fear of pain and re-injury was however perceived mainly as psychological rather than resulting from physical limitations. Despite negative consequences and adjustments over the years, participants still found their present life situation manageable or even satisfying.

Conclusion: ACL injury rehabilitation should support coping strategies e.g., also related to fear of re-injury and desirable physical activity levels, also with increasing age.

IMPLICATIONS FOR REHABILITATION

More than 20 years after the ACL injury, the individuals despite re-orientation towards acceptance and a settlement with their life situation, still had fear of both pain and re-injury of the knee, with concerns about physical activity and gaining of body weight. Patients with ACL injury may need better individual guidance and health advice on how to remain physically active, to find suitable exercises and to maintain a healthy body weight. Education related to pain, treatment choices, physical activity, injury mechanisms in participatory discussions with the patient about the ACL injury may be beneficial early in the rehabilitation process to avoid catastrophizing and avoidance behaviour. ACL injury rehabilitation needs to address coping strategies incorporating the psychological aspects of suffering an ACL injury, including fear of movement/secondary injury, in order to support return-to-sport and/or re-orientation over time.

Place, publisher, year, edition, pages
Taylor & Francis, 2022. Vol. 44, no 21, p. 6267-6276
Keywords [en]
fear of movement, fear of re-injury, knee injury, long-term consequences, qualitative design, rehabilitation
National Category
Physiotherapy Sport and Fitness Sciences
Research subject
Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-186916DOI: 10.1080/09638288.2021.1962415ISI: 000684732300001PubMedID: 34388952Scopus ID: 2-s2.0-85112472778OAI: oai:DiVA.org:umu-186916DiVA, id: diva2:1588014
Available from: 2021-08-26 Created: 2021-08-26 Last updated: 2022-12-06Bibliographically approved

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Fjellman-Wiklund, AnncristineSöderman, KerstinHäger, Charlotte

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