The Influence of Resilience and Grit on Post-Operative Outcomes After ACL Reconstruction

ABSTRACT Individuals who participate in physical activity often sustain lower extremity musculoskeletal injuries, including anterior cruciate ligament (ACL) injury. After ACL injury, most individuals undergo ACL reconstruction (ACLR) followed by extensive rehabilitation to restore knee joint function and return to physical activity. However, many individuals after index ACLR fail to return to previous levels of sport participation. Psychological impairments, such as injury-related fear and fear avoidance, are emerging as critical factors to physical activity outcomes in the adult post-ACLR population. However, our work in post-ACLR individuals has revealed those who participate in more physical activity have higher levels of injury-related fear. Other psychological factors, such as resilience and grit may be positively contributing to physical activity outcomes after ACLR. The overall objective of this longitudinal cohort study is to examine psychological factors associated with optimal physical activity, patient-reported, and clinician-based outcomes in patients after ACLR. Our central hypothesis is that resilience and grit will be positively correlated with physical activity, clinical measures of knee function, and patient-reported outcomes in this population. This study will elucidate the natural progression of the deleterious outcomes commonly identified in post-ACLR patients. The expected outcome of this work is an in-depth understanding of the relationship between self-reported resilience and grit with clinician and patient-based outcomes and physical activity participation. These findings will serve as the foundation for future psychologically-informed interventions to improve re-integration in to physical activity after ACLR.