PhD Scientific Days 2026

Health Sciences 2.

Temporal Dynamics of Psychological and Physical Recovery After Anterior Cruciate Ligament Reconstruction: A Longitudinal Study of Early Rehabilitation

Name of the presenter

Simon-Szabó, Daniella

Institute/workplace of the presenter

Semmelweis University Doctoral School, Mental Health Sciences Division, National Institute for Sports Medicine, Budapest

Authors

Daniella Simon-Szabó¹, Szilvia Ádám²
1: Semmelweis University Doctoral School, Mental Health Sciences Division, National Institute for Sports Medicine, Budapest
2: Health Services Management Training Centre, Semmelweis University, Institute of Behavioural Sciences, Semmelweis University

Text of the abstract

Introduction
Return to sport following anterior cruciate ligament (ACL) reconstruction remains inconsistent despite measurable improvements in physical parameters. Emerging evidence highlights the role of psychological factors in shaping recovery outcomes; however, the temporal interplay between physical recovery and psychological processes during early rehabilitation remains insufficiently understood. This early phase represents a critical period during which physical and psychological recovery trajectories may diverge, influencing later functional outcomes.

Aims
This study aimed to examine the longitudinal relationship between physical recovery and key psychological variables during the early rehabilitation phase following anterior cruciate ligament reconstruction, with particular focus on emotional distress, pain-related fear, return-to-sport confidence, and knee-related quality of life.

Methods
In this prospective longitudinal study, patients undergoing anterior cruciate ligament reconstruction (N=52) were assessed at 6 and 12 weeks postoperatively. Physical parameters included knee flexion, extension deficit, and thigh circumference. Psychological variables were assessed using validated self-report instruments measuring emotional distress, pain-related fear, return-to-sport confidence, and knee-related quality of life. Data were analysed using non-parametric tests, Spearman correlations, and robust linear regression models to account for potential deviations from normality and outliers.

Results
Physical parameters improved significantly between weeks 6 and 12, however, full functional restoration was not achieved within this period. Emotional distress showed significant negative associations with return-to-sport confidence and quality of life at both time points, with stronger correlations observed at week 12. Pain-related fear demonstrated small, non-significant associations with distress at week 6 but became significantly correlated by week 12, indicating an increasing psychological burden over time. Sex-stratified analyses revealed that pain-related fear significantly predicted emotional distress among female participants, whereas no significant predictive effect was observed in males.