前交叉韧带重建术后患者运动恐惧的研究进展及护理启示

doi:10.3761/j.issn.0254-1769.2024.24.016

摘要/Abstract

摘要：

运动恐惧在前交叉韧带重建术后患者中普遍存在，严重的运动恐惧会影响患者的康复结局和预后，不利于其身心健康。该文围绕前交叉韧带重建术后患者运动恐惧的概述、测量工具、影响因素和干预方法4个方面进行综述，分析现存的问题，并提出对未来的展望，旨在加强骨科医护人员对前交叉韧带重建术后患者运动恐惧的重视，为进一步构建科学、合理的前交叉韧带重建术后患者运动恐惧的管理方案提供参考。

关键词: 前交叉韧带重建, 运动恐惧, 综述, 护理, 康复

Abstract:

Kinesiophobia commonly exists among patients after anterior cruciate ligament reconstruction （ACLR），and severe kinesiophobia can affect the patients’ rehabilitation outcomes and prognosis，which is not conducive to their physical and mental health. This paper reviews the overview，assessment tools，influencing factors，and interventions methods of kinesiophobia in patients after ACLR，analyzes the existing problems，and puts forward the outlook for future research. It aims to strengthen the attention of orthopedic nursing staff to the kinesiophobia in patients after ACLR，and provides references for further proposing a scientific and reasonable management plan.

Key words: Anterior Cruciate Ligament Reconstruction, Kinesiophobia, Review, Nursing Care, Rehabilita-tion

梁琪, 胡三莲, 韦小梅, 陈唐瑜, 杨一琴. 前交叉韧带重建术后患者运动恐惧的研究进展及护理启示[J]. 中华护理杂志, 2024, 59(24): 3049-3054.

LIANG Qi, HU Sanlian, WEI Xiaomei, CHEN Tangyu, YANG Yiqin. Research progress on kinesiophobia in patients after anterior cruciate ligament reconstruction and nursing enlightenment[J]. Chinese Journal of Nursing, 2024, 59(24): 3049-3054.

参考文献 46

[1]	Kaeding CC, Léger-St-Jean B, Magnussen RA. Epidemiology and diagnosis of anterior cruciate ligament injuries[J]. Clin Sports Med, 2017, 36(1):1-8.
[2]	徐仁杰, 葛向阳, 郭雨亭, 等. 渐进性离心收缩训练在前交叉韧带重建术后早期康复中的临床应用[J]. 中国康复医学杂志, 2023, 38(9):1280-1283.
	Xu RJ, Ge XY, Guo YT, et al. Clinical application of progres-sive eccentric contraction training in early rehabilitation after anterior cruciate ligament reconstruction[J]. Chin J Rehabil Med, 2023, 38(9):1280-1283.
[3]	Kotsifaki R, Korakakis V, King E, et al. Aspetar clinical prac-tice guideline on rehabilitation after anterior cruciate ligament reconstruction[J]. Br J Sports Med, 2023, 57(9):500-514.
[4]	Everhart JS, Best TM, Flanigan DC. Psychological predictors of anterior cruciate ligament reconstruction outcomes:a systematic review[J]. Knee Surg Sports Traumatol Arthrosc, 2015, 23(3):752-762.
[5]	Ashton ML, Kraeutler MJ, Brown SM, et al. Psychological readi-ness to return to sport following anterior cruciate ligament reconstruction[J]. JBJS Rev, 2020, 8(3):e0110.
[6]	Rhim HC, Lee SJ, Jeon JS, et al. Effectiveness of modeling videos on psychological responses of patients following anterior cruciate ligament reconstruction:a pilot randomized trial[J]. Me-dicine, 2020, 99(45):e23158.
[7]	Zaffagnini S, Russo RL, Marcheggiani Muccioli GM, et al. The video insight method:improving rehabilitation following anterior cruciate ligament reconstruction:a preliminary study[J]. Knee Surg Sports Traumatol Arthrosc, 2013, 21(4):851-858.
[8]	Kuenze C, Bell DR, Grindstaff TL, et al. A comparison of psy-chological readiness and patient-reported function between sexes after anterior cruciate ligament reconstruction[J]. J Athl Train, 2021, 56(2):164-169.
[9]	Lethem J, Slade PD, Troup JD, et al. Outline of a fear-avoi-dance model of exaggerated pain perception:I[J]. Behav Res Ther, 1983, 21(4):401-408. DOI PMID
[10]	Kori SH. Kinesiophobia:a new view of chronic pain behaviour[J]. Pain Manag, 1990, 3:35-43.
[11]	Norte GE, Solaas H, Saliba SA, et al. The relationships bet-ween kinesiophobia and clinical outcomes after ACL recon-struction differ by self-reported physical activity engagement[J]. Phys Ther Sport, 2019, 40:1-9.
[12]	蔡立柏, 刘延锦, 崔妙然, 等. 全膝关节置换术恐动症患者术后早期功能锻炼体验的质性研究[J]. 中华护理杂志, 2019, 54(11):1663-1668. DOI
	Cai LB, Liu YJ, Cui MR, et al. Early rehabilitation exercise in total knee arthroplasty patients with kinesiophobia:a qualita-tive study[J]. Chin J Nurs, 2019, 54(11):1663-1668.
[13]	Flanigan DC, Everhart JS, Pedroza A, et al. Fear of reinjury (kinesiophobia) and persistent knee symptoms are common factors for lack of return to sport after anterior cruciate ligament reconstruction[J]. Arthroscopy, 2013, 29(8):1322-1329. DOI PMID
[14]	Theunissen WWES, van der Steen MC, Liu WY, et al. Timing of anterior cruciate ligament reconstruction and preoperative pain are important predictors for postoperative kinesiophobia[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(8):2502-2510.
[15]	Longo UG, Marino M, Rizzello G, et al. Preoperative and pos-toperative kinesiophobia influences postoperative outcome measures following anterior cruciate ligament reconstruction:a prospective study[J]. J Clin Med, 2023, 12(14):4858.
[16]	Raizah A, Alhefzi A, Alshubruqi AAM, et al. Perceived kine-siophobia and its association with return to sports activity following anterior cruciate ligament reconstruction surgery:a cross-sectional study[J]. Int J Environ Res Public Health, 2022, 19(17):10776.
[17]	陈琰琰, 吕畅, 刘晓莉, 等. 影响前交叉韧带重建术后运动恐惧心理的危险因素分析及相关干预措施[J]. 中华全科医学, 2022, 20(12):2147-2150.
	Chen YY, Lü C, Liu XL, et al. Analysis of risk factors affec-ting fear of exercise after anterior cruciate ligament recons-truction and related intervention measures[J]. Chin J Gen Pract, 2022, 20(12):2147-2150.
[18]	Miller RP, Kori SH, Todd DD. The Tample Scale:a measure of kinesiophobia[J]. Clin J Pain, 1991, 7(1):51-52.
[19]	徐榕璟, 贺旭妍, 贾守梅. 骨科老年患者术后运动恐惧的范围综述[J]. 中华护理杂志, 2024, 59(5):626-633. DOI
	Xu RJ, He XY, Jia SM. A scoping review of kinesiophobia research in elderly orthopedic postoperative patients[J]. Chin J Nurs, 2024, 59(5):626-633. DOI
[20]	胡文. 简体中文版TSK和FABQ量表的文化调适及其在退行性腰腿痛中的应用研究[D]. 上海: 第二军医大学, 2012.
	Hu W. Cultural adjustment of simplified Chinese TSK and FABQ scale and its application in degenerative lumbago and leg pain[D]. Shanghai: Second Military Medical University, 2012.
[21]	Huang H, Nagao M, Arita H, et al. Reproducibility,responsive-ness and validation of the Tampa Scale for Kinesiophobia in patients with ACL injuries[J]. Health Qual Life Outcomes, 2019, 17(1):150.
[22]	Woby SR, Roach NK, Urmston M, et al. Psychometric proper-ties of the TSK-11:a shortened version of the Tampa Scale for Kinesiophobia[J]. Pain, 2005, 117(1/2):137-144.
[23]	Cai LB, Liu YJ, Woby SR, et al. Cross-cultural adaptation,reliability,and validity of the Chinese version of the Tampa Scale for Kinesiophobia-11 among patients who have under-gone total knee arthroplasty[J]. J Arthroplasty, 2019, 34(6):1116-1121.
[24]	Waddell G, Newton M, Henderson I, et al. A Fear-Avoidance Beliefs Questionnaire(FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability[J]. Pain, 1993, 52(2):157-168. DOI PMID
[25]	汪敏, 陈惠德, 高晓平. 恐惧-逃避信念问卷评估颈椎病患者的信度及效度研究[J]. 安徽医学, 2014, 35(2):213-214,215.
	Wang M, Chen HD, Gao XP. Reliability and validity of Fear-escape Belief Questionnaire in evaluating patients with cervical spondylosis[J]. Anhui Med J, 2014, 35(2):213-214, 215.
[26]	Barchek AR, Dlugonski D, Baez SE, et al. The relationship between injury-related fear and physical activity in people with a history of anterior cruciate ligament reconstruction[J]. Phys Ther Sport, 2021, 50:201-205. DOI PMID
[27]	Webster KE, Feller JA, Lambros C. Development and prelimi-nary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate liga-ment reconstruction surgery[J]. Phys Ther Sport, 2008, 9(1):9-15. DOI PMID
[28]	Chen TW, Zhang P, Li YX, et al. Translation,cultural adapta-tion and validation of simplified Chinese version of the Anterior Cruciate Ligament Return to Sport After Injury(ACL-RSI) Scale[J]. PLoS One, 2017, 12(8):e0183095.
[29]	Mir B, Vivekanantha P, Dhillon S, et al. Fear of reinjury fo-llowing primary anterior cruciate ligament reconstruction:a systematic review[J]. Knee Surg Sports Traumatol Arthrosc, 2023, 31(6):2299-2314.
[30]	Ardern CL, Taylor NF, Feller JA, et al. Fear of reinjury in people who have returned to sport following anterior cruciate ligament reconstruction surgery[J]. J Sci Med Sport, 2012, 15(6):488-495. DOI PMID
[31]	Tjong VK, Murnaghan ML, Nyhof-Young JM, et al. A qualita-tive investigation of the decision to return to sport after anterior cruciate ligament reconstruction:to play or not to play[J]. Am J Sports Med, 2014, 42(2):336-342.
[32]	Chmielewski TL, Jones D, Day T, et al. The association of pain and fear of movement/reinjury with function during anterior cruciate ligament reconstruction rehabilitation[J]. J Orthop Sports Phys Ther, 2008, 38(12):746-753.
[33]	Hart HF, Collins NJ, Ackland DC, et al. Is impaired knee con-fidence related to worse kinesiophobia,symptoms,and physical function in people with knee osteoarthritis after anterior cruciate ligament reconstruction?[J]. J Sci Med Sport, 2015, 18(5):512-517.
[34]	何静, 汪伍, 黄春萌, 等. 前交叉韧带重建术后患者运动恐惧心理与膝关节功能的相关性研究[J]. 中医康复, 2021, 12(23):22-26.
	He J, Wang W, Huang CM, et al. Observing the relationships between kinesiophobia and knee function after ACL recons-truction[J]. Tradit Chin Med Rehabil, 2021, 12(23):22-26.
[35]	Burland JP, Toonstra JL, Howard JS. Psychosocial barriers after anterior cruciate ligament reconstruction:a clinical review of factors influencing postoperative success[J]. Sports Health, 2019, 11(6):528-534. DOI PMID
[36]	Filbay S, Kvist J. Fear of reinjury following surgical and nonsurgical management of anterior cruciate ligament injury:an exploratory analysis of the NACOX multicenter longitu-dinal cohort study[J]. Phys Ther, 2022, 102(2):pzab273.
[37]	Coronado RA, Sterling EK, Fenster DE, et al. Cognitive-beha-vioral-based physical therapy to enhance return to sport after anterior cruciate ligament reconstruction:an open pilot study[J]. Phys Ther Sport, 2020, 42:82-90. DOI PMID
[38]	Brewer BW, Van Raalte JL, Cornelius AE. An interactive cog-nitive-behavioural multimedia program favourably affects pain and kinesiophobia during rehabilitation after anterior cruciate ligament surgery:an effectiveness trial[J]. Int J Sport Exerc Psychol, 2022, 20(4):1133-1155.
[39]	崔莉莉, 李真, 真启云. 腰椎间盘突出症恐动症患者围术期分级暴露运动实施效果[J]. 护理学杂志, 2023, 38(16):96-99.
	Cui LL, Li Z, Zhen QY. Effect of perioperative graded expo-sure exercise in lumbar disc herniation patients with kinesio-phobia[J]. J Nurs Sci, 2023, 38(16):96-99.
[40]	Baez S, Cormier M, Andreatta R, et al. Implementation of in vivo exposure therapy to decrease injury-related fear in females with a history of ACL-reconstruction:a pilot study[J]. Phys Ther Sport, 2021, 52:217-223.
[41]	金天福, 李彦林. 虚拟现实平衡训练联合运动训练对前交叉韧带重建术后的影响[J]. 实用骨科杂志, 2022, 28(7):659-663.
	Jin TF, Li YL. The effects of virtual reality balance training combined with physical exercise training on patients after anterior cruciate ligament reconstruction[J]. J Pract Orthop, 2022, 28(7):659-663.
[42]	Clausen JD, Nahen N, Horstmann H, et al. Improving maximal strength in the initial postoperative phase after anterior cruciate ligament reconstruction surgery:randomized controlled trial of an app-based serious gaming approach[J]. JMIR Se-rious Games, 2020, 8(1):e14282.
[43]	Ringberg M, Eldh AC, Ardern CL, et al. Athletes’ experiences of using a self-directed psychological support,the BAck iN the Game(BANG) smartphone application,during rehabilita-tion for return to sports following anterior cruciate ligament reconstruction[J]. BMC Sports Sci Med Rehabil, 2023, 15(1):113. DOI PMID
[44]	Levinger P, Hallam K, Fraser D, et al. A novel web-support intervention to promote recovery following anterior cruciate ligament reconstruction:a pilot randomised controlled trial[J]. Phys Ther Sport, 2017, 27:29-37. DOI PMID
[45]	蔡立柏, 刘延锦, 李英, 等. 多学科协作干预方案在全膝关节置换术后恐动症患者中的应用研究[J]. 中华护理杂志, 2020, 55(4):494-499. DOI
	Cai LB, Liu YJ, Li Y, et al. The effects of multidisciplinary teamwork intervention for total knee arthroplasty patients with kinesiophobia[J]. Chin J Nurs, 2020, 55(4):494-499. DOI
[46]	张亚琴, 李艳婷, 单丹丹, 等. 协同护理模式在全髋关节置换术后恐动症患者中的应用[J]. 中华护理杂志, 2021, 56(4):515-520. DOI
	Zhang YQ, Li YT, Shan DD, et al. The effect of a collaborative nursing model on patients with kinesiophobia after total hip replacement[J]. Chin J Nurs, 2021, 56(4):515-520. DOI