Self-efficacy of knee function as a pre-operative predictor of outcome 1 year after anterior cruciate ligament reconstruction

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 16; no. 2; pp. 118 - 127
• Main Authors: Thomeé, Pia, Währborg, Peter, Börjesson, Mats, Thomeé, Roland, Eriksson, B. I., Karlsson, Jon
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.02.2008; Springer Nature B.V
• Subjects: Adolescent; Adult; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament/injuries/surgery; Clinical outcomes; Exercise; Female; Follow-Up Studies; Gender; Humans; Joint and ligament injuries; Kirurgi; Knee; Knee Joint - physiology; Knee Joint - surgery; Knee Joint/physiology/surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Motor Activity - physiology; Muscle; Muscle function; Muscle, Skeletal - physiology; Orthopedics; Outcome Assessment (Health Care); Patients; Preoperative Care; Quality of life; Recovery of Function - physiology; Rehabilitation; Self Efficacy; Skeletal/physiology; Surgery; Sweden; K-SES; Predictors and outcome; Muscle function; KOOS; Physical activity
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-007-0433-6

The knee self-efficacy scale (K-SES) has been shown to have good reliability, validity and responsiveness during rehabilitation for patients’ perceived self-efficacy of knee function. Determinants of self-efficacy of knee function 1 year after ACL reconstruction have been found to be the patients’ internal locus of control and knee symptoms in sports and recreation. The predictive ability of perceived self-efficacy of knee function measured by the K-SES has not been studied in terms of patient outcome after an ACL reconstruction. The purpose of this study was to explore the potential for pre-operative self-efficacy of knee function measured by the K-SES to predict patient outcome in terms of physical activity, knee symptoms and muscle function 1 year after an ACL reconstruction. Thirty-eight patients were evaluated for outcome in terms of physical activity with the Tegner activity scale and the physical activity scale (PAS), knee symptoms with the Lysholm knee scoring scale and the knee injury and osteoarthritis outcome score (KOOS) and knee function with ability tests for muscle function 1 year after ACL reconstruction. Multiple regression and logistic multiple regression analysis were used to evaluate the K-SES as a possible predictor of outcome. The patients’ present perceived self-efficacy of knee function (K-SES Present ) pre-operatively was a significant predictor ( P  = 0.016) of the patients returning to their intensity and frequency of physical activity (PAS) 1 year after ACL reconstruction, when adjusted for age, gender and pre-injury physical activity level (Tegner Pre-injury ) (odds ratio = 2.1). The patients’ perceived future self-efficacy of knee function (K-SES Future ) pre-operatively was a significant predictor ( P  = 0.045) of their self-rated knee function in sports/recreational activities (KOOS Sports/recreation ) at the 1-year follow-up, when adjusted for age, gender and Tegner Pre-injury ( R 2  =0.25). The pre-operative K-SES Future was also a significant predictor ( P  = 0.023) of the patients’ knee-related quality of life (KOOS Qol ), at the 1-year follow-up, when adjusted for age, gender and Tegner Pre-injury ( R 2  =0.23). The pre-operative K-SES Future was furthermore a significant predictor of an acceptable outcome 1 year after surgery, on the Lysholm knee scoring scale ( P  = 0.003, odds ratio = 1.7), as well as on KOOS Sports/recreation ( P  = 0.002, odds ratio = 1.6) and knee-related quality of life (KOOS Qol ) ( P  = 0.037, odds ratio = 1.4), when adjusted for age, gender and Tegner Pre-injury . The pre-operative K-SES Future was also a significant predictor ( P  = 0.04) of an acceptable outcome 1 year after surgery, on the one-leg hop for distance (odds ratio = 2.2), when adjusted for age, gender and Tegner Pre-injury . In conclusion, this study indicates that patients’ perceived self-efficacy of knee function pre-operatively is of predictive value for their return to acceptable levels of physical activity, symptoms and muscle function 1 year after ACL reconstruction.