心理干预对前交叉韧带重建患者有效性的Meta分析与系统评价
简介
这项系统综述和Meta分析评估了心理干预对前交叉韧带重建（ACLR）术后康复的效果。纳入11项随机对照试验（440例患者）。关键发现：心理干预能显著减轻疼痛（大效应量）、改善恐动症（小效应量）、提高膝关节自我效能（中等效应量）和患者报告功能（IKDC，中等效应量），其中意象疗法对疼痛改善尤为突出（三项试验，大效应量）。但对KT-1000、肌力、心理幸福感及重…
英文摘要
Background: No systematic review has yet been conducted simultaneously on the effectiveness of psychological interventions across multiple outcome measures during rehabilitation following anterior cruciate ligament reconstruction (ACLR). This study aims to assess the effects of such interventions on pain, psychological outcomes, patient-reported knee function, objective knee measures, and quality of life following ACLR. Methods: We searched PubMed, Medline, Embase, PsycINFO, and the Cochrane Library from inception to 20 April 2026 (PROSPERO CRD42023483889). Eligible randomized controlled trials compared psychological interventions with usual care in ACLR patients. Two reviewers assessed eligibility, risk of bias, and extracted data. Random-effects models were used; effect sizes were interpreted using Cohen's guidelines. Results: Of 401 records screened, 11 RCTs (440 participants) were included. Psychological interventions significantly improved pain (six trials, SMD = -0.96, 95% CI -1.40 to -0.52, p < 0.001, I2 = 47%; large effect), kinesiophobia (TSK-11: five trials, SMD = -0.48, -0.74 to -0.22, I2 = 0%; small effect), knee self-efficacy (K-SES: three trials, SMD = 0.53, 0.19-0.86, I2 = 0%, moderate effect), patient-reported knee function (IKDC: two trials, SMD = 0.58, 0.26-0.90, I2 = 0%, moderate effect), and physical role function (SF-36: two trials, SMD = 0.41, 0.04-0.78, I2 = 0%, small effect). No significant effects were found for KT1000, knee strength, SF-36 mental well-being, or ACL-RSI (all p > 0.05, with substantial heterogeneity for ACL-RSI). Particularly, imagery therapy reduced pain (three trials, SMD = -1.54, I2 = 15%). Conclusions: This meta-analysis provides preliminary evidence that psychological interventions, especially imagery therapy, may improve pain, psychological outcomes, patient-reported knee function, and quality of life after ACLR. Adequately powered trials with standardized protocols are needed to confirm these findings.