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Self-Reported Fear of Movement/Reinjury Is Related to Asymmetry in Knee Kinematics During Running in Individuals at 6 Months After Anterior Cruciate Ligament Reconstruction

Yasir S. Alshehri, PT, MS (University of Kansas Medical Center, Kansas City, United States); Wen Liu, PhD; Scott Mullen; Bryan Vopat; Paul Schroeppel; Jeffrey Randall; Marcio dos Santos, PT, MSc, PhD

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Friday, November 15, 2019

Session Title: Musculoskeletal and Sports Medicine Research Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 8

Disclosures: Yasir S. Alshehri, PT, MS: Nothing to disclose

Objective: To determine the relationship between self-reported fear of movement/reinjury and interlimb asymmetry in shank angular velocity (SAV) at different gait speeds in patients with anterior cruciate ligament reconstruction (ACLR) at 6 months after surgery.

Design: Cross-sectional study.

Setting: Outpatient clinic.

Participants: 17 patients with primary unilateral ACLR (females=9; age=28.06±7.07 years old; body mass index=25.89±4.04 kg/m2; pre-injury Tegner activity scale=7.35±1.58).

Interventions: Not applicable.

Main Outcome Measures: Fear of movement/reinjury was assessed using the Tampa Scale of Kinesiophobia (TSK-11). A higher TSK-11 score is indicative of a higher level of fear. Gait assessment was conducted along a 12-meter straight walkway and at different self-selected speeds: walk, walk fast, and run. Two wireless inertial sensors were attached on the shanks bilaterally to measure sagittal plane SAV. The average of SAV peaks was calculated during loading response of gait for each limb. One-tailed Pearson’s correlations were used to examine the association between the TSK-11 score and interlimb SAV peak asymmetry (involved – uninvolved) at each gait speed.

Results: No significant correlations were observed between the TSK-11 score and SAV peak during walking or walking fast (r=0.37, P =.07 and r=0.36, P =.08, respectively). However, a significant moderate positive correlation was identified between the TSK-11 score and SAV peak during running (r=0.44, P =.039). Overall, greater interlimb SAV asymmetry during running was associated with higher scores of the TSK-11.

Conclusions: At 6 months post-ACLR, patients with higher self-reported fear of movement/reinjury demonstrated greater interlimb asymmetry in SAV during loading response of running. Future studies should investigate whether addressing fear of movement/reinjury during rehabilitation would improve running SAV symmetry, or whether addressing running SAV asymmetry would reduce fear of movement/reinjury.

Level of Evidence: Level III

To cite this abstract in AMA style:

Alshehri YS, Liu W, Mullen S, Vopat B, Schroeppel P, Randall J, Santos Md. Self-Reported Fear of Movement/Reinjury Is Related to Asymmetry in Knee Kinematics During Running in Individuals at 6 Months After Anterior Cruciate Ligament Reconstruction [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/self-reported-fear-of-movement-reinjury-is-related-to-asymmetry-in-knee-kinematics-during-running-in-individuals-at-6-months-after-anterior-cruciate-ligament-reconstruction/. Accessed May 15, 2025.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/self-reported-fear-of-movement-reinjury-is-related-to-asymmetry-in-knee-kinematics-during-running-in-individuals-at-6-months-after-anterior-cruciate-ligament-reconstruction/

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