Psychological factors as predictors of compliance and outcome in non-operative management of Achilles tendon rupture: a systematic review

Introduction: Non-operative management of acute Achilles tendon rupture (ATR) with early functional rehabilitation produces functional outcomes equivalent to surgery, but its effectiveness depends critically on patient compliance with bracing, weight-bearing and physiotherapy. Psychological factors, including motivation, self-efficacy, kinesiophobia, and social support, are plausible determinants of compliance and outcome, yet have received minimal systematic attention.