The Examination of Patient-Reported Outcomes and Postural Control Measures in Patients With and Without a History of ACL Reconstruction: A Case Control Study.

TitleThe Examination of Patient-Reported Outcomes and Postural Control Measures in Patients With and Without a History of ACL Reconstruction: A Case Control Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsHoch JM, Sinnott CW, Robinson KP, Perkins WO, Hartman JW
JournalJ Sport Rehabil
Volume27
Issue2
Pagination170-176
Date Published2018 Mar 01
ISSN1543-3072
KeywordsAdult, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Reconstruction, Case-Control Studies, Female, Humans, Male, Patient Reported Outcome Measures, Postural Balance, Quality of Life, Surveys and Questionnaires, Young Adult
Abstract

CONTEXT: There is a lack of literature to support the diagnostic accuracy and cut-off scores of commonly used patient-reported outcome measures (PROMs) and clinician-oriented outcomes such as postural-control assessments (PCAs) when treating post-ACL reconstruction (ACLR) patients. These scores could help tailor treatments, enhance patient-centered care and may identify individuals in need of additional rehabilitation.

OBJECTIVE: To determine if differences in 4-PROMs and 3-PCAs exist between post-ACLR and healthy participants, and to determine the diagnostic accuracy and cut-off scores of these outcomes.

DESIGN: Case control.

SETTING: Laboratory.

PARTICIPANTS: A total of 20 post-ACLR and 40 healthy control participants.

MAIN OUTCOME MEASURES: The participants completed 4-PROMs (the Disablement in the Physically Active Scale [DPA], The Fear-Avoidance Belief Questionnaire [FABQ], the Knee Osteoarthritis Outcomes Score [KOOS] subscales, and the Tampa Scale of Kinesiophobia [TSK-11]) and 3-PCAs (the Balance Error Scoring System [BESS], the modified Star Excursion Balance Test [SEBT], and static balance on an instrumented force plate). Mann-Whitney U tests examined differences between groups. Receiver operating characteristic (ROC) curves were employed to determine sensitivity and specificity. The Area Under the Curve (AUC) was calculated to determine the diagnostic accuracy of each instrument. The Youdin Index was used to determine cut-off scores. Alpha was set a priori at P < 0.05.

RESULTS: There were significant differences between groups for all PROMs (P < 0.05). There were no differences in PCAs between groups. The cut-off scores should be interpreted with caution for some instruments, as the scores may not be clinically applicable.

CONCLUSIONS: Post-ACLR participants have decreased self-reported function and health-related quality of life. The PROMs are capable of discriminating between groups. Clinicians should consider using the cut-off scores in clinical practice. Further use of the instruments to examine detriments after completion of standard rehabilitation may be warranted.

DOI10.1123/jsr.2016-0105
Alternate JournalJ Sport Rehabil
PubMed ID28253055