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Health-related quality of life (HRQL) includes physical, emotional, and social well-being.1 Although the literature has reported increased physical HRQL in athletes compared to their peers, sports participation has recently been associated with poor emotional and social HRQL.2,3 Increased life pressures, such as separation from family or worries of public perception in the media, have contributed to these detriments.2 Unfortunately, increased life stressors can negatively affect athletes' ability to successfully and safely perform their respective sport, and may lead to musculoskeletal injury.4 Athletic injuries can affect all aspects of HRQL, including emotional and social well-being.3 However, the emphasis of musculoskeletal rehabilitation is to improve the physical impairments, often neglecting the influence of the injury on other dimensions of HRQL. Addressing all aspects of HRQL during musculoskeletal rehabilitation is necessary for athletic trainers to successfully implement patient-centered care. Patient-centered care is care that is responsive to the patient's preferences, needs, and values, in contrast to just identifying and addressing physical impairments.5
Patients who have undergone anterior cruciate ligament reconstruction (ACLR) often exhibit deficits in emotional and social HRQL.6 These deficits have been cited as the primary reason for reduction or cessation of sports participation in this population.7 Therefore, treatment algorithms that include the assessment and treatment of emotional and social detriments are warranted. After ACLR, 1 of 3 patients fail to return to competitive levels of sports, and psychological readiness has been cited as the primary barrier.8 It has been demonstrated that patients who exhibit increased levels of injury-related fear after ACLR are 13 times more likely to sustain a secondary injury to the ACL limb within 24 months of reconstruction.9 Thus, rehabilitation that addresses not only the physical impairments often identified after ACLR, but also HRQL detriments could help to mitigate these negative responses. This in turn should enhance the provision of patient-centered care delivered and improve overall health outcomes.
Psychosocial factors also affect neurocognitive functioning in healthy athletes. Specifically, psychosocial factors have been associated with delayed reaction times.4 Consequently, deficits in reaction time can increase susceptibility to injury in the highly active population.10,11 Previous literature has shown that individuals who sustain non-contact ACL injuries have deficits in reaction time prior to sustaining their ACL injury when compared to healthy controls.12 Thus, it is imperative to...