The
Videoinsight Method: Improving Rehabilitation Following Anterior Cruciate
Ligament Reconstruction – a Preliminary Study

Zaffafnini
S, Russo RL, Muccioli GMM, & Marcacci M. Knee Sug Sports Traumatol Arthrosc. 2013.  Published online
January 30, 2013. Epub ahead of print. doi:10.1007/s00167-013-2392-4

Take
Home Message: A video of contemporary art, which invokes a positive “insight” that
is favorable to psychological recovery, may enhance the rehabilitation process
after knee surgery.


Rehabilitation
following anterior cruciate ligament (ACL) reconstruction is a relatively long,
arduous, physical, as well as mental process. 
During ACL rehabilitation, psychological interventions such as imagery,
goal-setting, and modeling are effective for improving recovery (e.g., decrease
pain, improve function).  A novel psychological
intervention not yet tested among patients undergoing ACL rehabilitation is
Videoinsight, which includes a video of contemporary art selected with the
intent of inspiring “insight” and stimulating psychological changes (e.g.,
emotions, sensations, learning). Therefore, the purpose of this randomized
controlled pilot trial was to compare the effects of Videoinsight
to an art video; which did not invoke insight that is favorable to
psychological recovery.  A total of 101
patients that were randomized into the Videoinsight (51 patients) or to the
control (50 patients) group completed the trial. All patients underwent ACL
surgery and were instructed to watch their assigned video 3 times a week for 2
months.  The patients were evaluated
pre-operatively and approximately 3 months after ACL surgery. Outcomes of
interest were general physical and mental health scores (
Short Form-36), physical activity scores (Tegner), subjective International Knee Documentation Committee score for knee-specific symptoms and function, time
to full weight bearing, and a score for fear of moving (Tampa Scale for Kinesiophobia).  While
patients in both groups improved over time in every score, patients who watched
Videoinsight had better patient-reported knee symptoms/function, less fear of
moving at follow-up, and a faster time to full weight bearing. 

These
findings indicate that images that invoke a positive “insight” may enhance
the rehabilitation process.  The authors
admitted that they could not pre-profile patients psychologically, which may
help determine if certain techniques work more effectively on certain people, thus
promoting individualized interventions. 
It would be very interesting to see what types of psychogical activities
work best in specific subsets of patients. This study reinforces that as
clinicians, who aim to promote a safe and rapid return to activity, we need to
pay more attention to the psychological component of rehabilitation in all of our
patients.  Has anyone integrated any
types of psychological interventions within their traditional ACL
rehabilitation program?  What things have
you found to be successful?

Written
by: Nicole Cattano
Reviewed
by: Jeffrey Driban

Related Posts:

Zaffagnini S, Russo RL, Marcheggiani Muccioli GM, & Marcacci M (2013). The Videoinsight(®) method: improving rehabilitation following anterior cruciate ligament reconstruction-a preliminary study. Knee Surgery, Sports Traumatology, Arthroscopy PMID: 23361651