PTOtherInternational journal of sports physical therapy2026

Knee-Related Function and Psychological Aspects After ACL Reconstruction Among Individuals With and Without Kinesiophobia: A Mixed-Methods Study.

Mandeep Kaur, Luzita Vela, Teres Chmielewski and 3 others

PMID 41488375

WHAT IT FOUND

Patients with high fear of movement reported significantly worse knee-related quality of life than those with low fear, despite similar physical function scores.

Both groups experienced fear and activity avoidance, but those with high fear showed less confidence and fewer coping strategies.

Key findings

01The only statistically significant difference in patient-reported outcomes was in the KOOS quality of life subscale, where the high kinesiophobia group scored 56.3 and the low group scored 71.9.

02Qualitative interviews revealed three main themes: fear of re-injury, activity avoidance linked to interlimb asymmetry, and coping mechanisms, with high-fear patients showing more avoidance and fewer coping resources.

03While ACL-RSI scores for psychological readiness showed a large effect size difference, the result was not statistically significant due to the small sample size.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

Read the rest of this summary

You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.

Already have one?

What it does not show

The sample size was very small (n=15), which limited statistical power for quantitative comparisons. Interviewers were not blinded to the participants' kinesiophobia status. The wide range of time since surgery (5-11 months) means participants were at different rehabilitation stages. The study was conducted in a single US center, limiting generalizability.

Declared interests

The study was funded by the Curry School of Education and Human Development at the University of Virginia. The authors reported no conflicts of interest.

The easy way to misread this

Do not conclude that physical function is identical between groups. While most physical outcome measures were not statistically different, the study was underpowered to detect smaller differences, and qualitative data suggested high-fear patients actively avoided loading the injured limb.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →