A Summary of the Evidence for Managing Exercise Phobia in Patients After Anterior Cruciate Ligament Reconstruction Surgery.

BACKGROUND

In recent years, the incidence of anterior cruciate ligament (ACL) injuries has risen persistently. Notably, some patients develop movement fear after ACL reconstruction surgery. This psychological issue significantly reduces patients' exercise rehabilitation adherence and active participation willingness. It also exacerbates family caregiving pressures and healthcare systems' socioeconomic burden. Thus, it has become a critical factor affecting postoperative rehabilitation outcomes and public health resource allocation.

METHODS

Using the "6S" evidence resource pyramid model, we systematically searched domestic and international guideline websites, professional society or association websites, and Chinese and English databases to obtain relevant literature on the management of exercise phobia after Anterior Cruciate Ligament Reconstruction (ACLR). The types of literature included clinical decision-making, evidence summaries, guidelines, etc. The search period was from the establishment of the database to June 30, 2025. Two researchers independently conducted literature screening and quality assessment, extracted, and integrated the evidence.

RESULTS

A total of 18 documents were included, including one clinical decision, four guidelines, six meta-analyses, four systematic reviews, two evidence summaries, and one randomized controlled trial. These were summarized into 20 pieces of evidence and categorized into six aspects: management principles for patients with exercise phobia after ACLR, health education, pain management, rehabilitation exercises, intervention methods, and follow-up management.

CONCLUSION

This study summarized the best evidence for the management of exercise phobia in patients after ACLR. It is recommended that clinical healthcare providers select intervention strategies appropriately based on clinical practice and individual patient conditions to reduce the severity of exercise phobia in patients.