The roles of acceptance and catastrophizing in rehabilitation following anterior cruciate ligament reconstruction

ObjectivesThe purpose of this study was to determine if pain catastrophizing and experiential acceptance predicted depression, pain intensity, and maladaptive behaviour following anterior cruciate ligament reconstruction.DesignPatients who had undergone anterior cruciate ligament surgery completed assessment within 2 weeks of surgery (N = 44) and again 6 months post-surgery (N = 26).MethodsPredictor measures were the Pain Catastrophizing Scale and the Acceptance and Action Questionnaire. Outcome measures included the depression scale of the Depression Anxiety and Stress Scale, numerical rating scale of pain intensity, and the alcohol and substance misuse subscale of the Brief Coping Orientations to the Problem Experience inventory. Demographic variables and athletic identity were also measured.ResultsHigher pain catastrophizing scores were associated with greater pain intensity and depressive symptoms in the 2-week post-operative period. Lower acceptance scores in the 2-week post-operative period were predictive of more severe depression scores at 6 months, even after controlling for early post-operative depression and athletic identity. Lower acceptance was also associated with greater use of alcohol and other substances, reportedly to cope with the stress of being injured.ConclusionsThis study highlights the importance of acceptance in an athletic population undergoing rehabilitation after ACL reconstruction.