{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T19:47:29Z","timestamp":1782503249384,"version":"3.54.5"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sports Health: A Multidisciplinary Approach"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cruciate ligament (ACL) injuries are the most common knee ligament injuries and ACL reconstruction (ACLR) is often required to restore stability and facilitate return-to-sport. However, kinesiophobia\u2014fear of movement due to risk of reinjury\u2014is prevalent post-ACLR (62% to 78%) and linked to poor return-to-sport outcomes despite good physical recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Patient, injury, surgery, and rehabilitation factors can be associated with elevated kinesiophobia in patients undergoing primary ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level\u20093.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was conducted using data from a tertiary acute hospital\u2019s ACL registry between June 1, 2019 and June 1, 2023. Included were patients aged 18\u2009years to 60\u2009years undergoing primary ACLR. Exclusions were revision ACLR, multiligament injuries, and incomplete 1-year dataset. Demographics, injury\/surgery\/rehabilitation factors and patient-reported outcomes were measured preoperatively, and at 6\u2009months and 1\u2009year. Tampa Scale of Kinesiophobia-17 (TSK-17, with \u226537 indicating elevated kinesiophobia), was recorded preoperatively and 1 year postoperatively. Multivariate regression was used to identify predictors of elevated 1-year kinesiophobia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Data from 200 patients were analyzed (8 excluded due to incomplete data). Baseline TSK-17 was 38.6\u2009\u00b1\u20095.6, improving to 32.6\u2009\u00b1\u20097.6 at 1\u2009year (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001), with 59% showing elevated kinesiophobia at baseline and 29% at 1\u2009year. The average TSK-17 reduction was 6.1\u2009\u00b1\u20098.6, meeting the minimal clinically important difference (MCID) level. Prehabilitation was attended by 106 patients (55.21%), with a median of 1 session (range 0-10). Elevated 1-year kinesiophobia was associated significantly with higher baseline TSK-17 scores (odds ratio [OR], 2.004; 95% CI, 1.013-3.968;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.05) and inversely associated with attending \u22651 prehabilitation session (OR, 0.513; 95% CI, 0.264-0.997;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Prehabilitation before ACLR should be standard-of-care, to reduce risk of elevated kinesiophobia at 1-year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>High baseline kinesiophobia predicts sustained elevated 1-year kinesiophobia, hence assessment (TSK-17 scores) and early intervention targeting kinesiophobia should be included in preoperative ACLR protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19417381261453652","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T12:11:30Z","timestamp":1782303090000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prehabilitation for Patients Undergoing Anterior Cruciate Ligament Reconstruction Reduces Kinesiophobia Levels at 1-Year Postoperation"],"prefix":"10.1177","author":[{"given":"Sean Wei Loong","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0870-0939","authenticated-orcid":false,"given":"Ming Foo Kenneth","family":"Nah","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver Tze Rong","family":"Lim","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoe","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Research and Innovations Of\ufb01ce, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7460-0733","authenticated-orcid":false,"given":"Jegathesan","family":"T","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lester Teong","family":"Jin Tan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5454-1190","authenticated-orcid":false,"given":"Keng Thiam","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4314-8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4103\/sjsm.sjsm_31_20"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jfmk9020078"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.26181\/61822007b1713"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2021.03.013"},{"key":"e_1_3_2_7_2","unstructured":"Boulding G. 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