Implementation of In Vivo Exposure Therapy to Decrease Fear in Females after ACL-Reconstruction: A Pilot Study

It is estimated one out of three individuals will not return to competitive levels of sport after ACL reconstruction due to biopsychosocial impairments such as fear of re-injury. Furthermore, these individuals often exhibit changes in neurocognitive functioning, and a relationship between biopsychosocial impairments and neurocognitive function has been previously identified. Interventions to treat these impairments need to be identified so ATs can further implement patient-centered care during the rehabilitation process. The aims of this proposal are to determine the effectiveness of In Vivo Exposure Therapy (IVET) on 1) self-reported fear avoidance beliefs and fear of re-injury and 2) neurocognitive functioning in females post-ACLR reconstruction. IVET is a type of cognitive behavioral therapy that gradually exposes patients to patient-specific fear-eliciting situations (i.e. hopping, jumping, or cutting). Participants will be randomized in to the IVET or control group. Participants will complete self-reported assessments of fear/fear of re-injury and neurocognitive assessments at baseline and postintervention. Dependent variables will include scores on patient-reported outcome measures and neurocognitive testing and independent variables will include group and time. Two-way ANOVAs will be used to examine group and time differences. We hypothesize that participants enrolled in IVET will exhibit decreases in fear and improvements in neurocognitive functioning.