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The Physiological and Psychological Effects of Accelerated Rehabilitation, Visualization, and Virtual Reality on ACL Rehabilitation

Julian Ballestreros

Name: Julian Ballesteros
Major: Biology
Advisors: Nicholas Brandley

Anterior cruciate ligament (ACL) injuries are one of the most common knee injuries among athletes. This review investigates the differences in ACL rehabilitation programs and the use of psychological techniques. Both can potentially help athletes return to sport faster and safer than they have in the past. I have compiled 68 studies with the use of multiple search engines and key words to evaluate 3 subsections: accelerated rehabilitation, visualization (including imagery and relaxation), and virtual reality (VR). Accelerated rehabilitation has made it possible for athletes to return to sport within 4-6 months, however, research recommends waiting until after 9 months to return to sport to significantly decrease reinjury risk. How fast an athlete can return to sport is dependent on the type of ACL injury and psychological state of the athlete. When evaluating visualization, imagery, and relaxation techniques there were significant effects on the quality of rehabilitation and the mindset of athletes when going through ACL rehabilitation. Psychological techniques showed some physiological effects but did not have a significant effect on the time it takes an athlete to return to sport. I believe psychological techniques have enough significance to be implemented in ACL rehabilitation programs based on the improvement in psychological readiness within athletes returning to sport. VR has the potential to positively affect ACL rehabilitation through motivation and engagement but has yet to provide any significant impact regarding the timeline for an athlete returning to sport or other variables. This review reveals VR cannot be formally implemented into ACL rehabilitation but displays potential with more research.

Posted in Comments Enabled, Independent Study, Symposium 2022.


4 responses to “The Physiological and Psychological Effects of Accelerated Rehabilitation, Visualization, and Virtual Reality on ACL Rehabilitation”

  1. Julian Ballesteros says:

    What is an ACL?

    The ACL stands for anterior cruciate ligament which sits inside the knee joint and forms an X with the PCL. It has very poor blood supply which is why this ligament typically needs to be surgically repaired when injured.

    What is the function of an ACL?

    Its function is to prevent the tibia from sliding forward in front of the femur and provide rotational stability.

    What are the causes of an ACL injury?

    The main causes of an ACL injury occur from stopping suddenly, changing direction rapidly, landing incorrectly, or a direct collision. When the ACL is overloaded, the stress causes the ligament to overstretch resulting in structural failure.

    Who is most susceptible to an ACL injury?

    Due to the nature of ACL injuries, the athletic population is most susceptible, and we see the most injuries in agility sports like soccer, football, and basketball.

  2. melanderson says:

    Hi Julian, This research is so relevant. As someone who tore her ACL three times, two times in less than one year after 9 months of rehab I wonder how VI might have helped. I definitely had re-injury anxiety and also favored my other leg without really knowing it.

  3. Julian Ballesteros says:

    Absolutely, I’ve torn both my ACL’s so that was the reasoning behind this research. I’m sure going through your process that the psychological side and reinjury anxiety has been neglected or less focused on in the past. Hopefully with this research and future research it can be incorporated more within ACL rehabilitation.

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