A randomized, controlled study of a rehabilitation model to improve knee-function self-efficacy with ACL injury

J Sport Rehabil. 2010 May;19(2):200-13. doi: 10.1123/jsr.19.2.200.


Context: The Knee Self-Efficacy Scale (K-SES) has good reliability, validity, and responsiveness for patients' perceived knee-function self-efficacy during rehabilitation after an anterior cruciate ligament (ACL) injury. Preoperative knee-function self-efficacy has also been shown to have a predictive ability in terms of outcome 1 y after ACL reconstruction.

Objective: To evaluate a new clinical rehabilitation model containing strategies to enhance knee-function self-efficacy.

Design: A randomized, controlled study.

Setting: Rehabilitation clinic and laboratory.

Patients: 40 patients with ACL injuries.

Intervention: All patients followed a standardized rehabilitation protocol. Patients in the experimental group were treated by 1 of 3 physiotherapists who had received specific training in a clinical rehabilitation model. These physiotherapists were also given their patients' self-efficacy scores after the initial and 4-, 6-, and 12-mo follow-ups, whereas the 5 physiotherapists treating the patients in the control group were not given their patients' self-efficacy scores.

Main outcome measures: The K-SES, the Tegner Activity Scale, the Physical Activity Scale, the Knee Injury and Osteoarthritis Outcome Score, and the Multidimensional Health Locus of Control.

Results: Twenty-four patients (12 in each group) completed all follow-ups. Current knee-function self-efficacy, knee symptoms in sports, and knee quality of life improved significantly (P = .05) in both groups during rehabilitation. Both groups had a significantly (P = .05) lower physical activity level at 12 mo than preinjury. No significant differences were found between groups.

Conclusion: In this study there was no evidence that the clinical rehabilitation model with strategies to enhance self-efficacy resulted in a better outcome than the rehabilitation protocol used for the control group.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Injuries*
  • Female
  • Health Status Indicators
  • Humans
  • Internal-External Control
  • Knee Injuries / rehabilitation*
  • Knee Joint* / physiology
  • Male
  • Middle Aged
  • Motor Activity
  • Patient Acceptance of Health Care
  • Patient Satisfaction
  • Physical Therapy Modalities
  • Psychometrics
  • Quality of Life
  • Self Efficacy*
  • Sweden
  • Treatment Outcome
  • Young Adult