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Factors associated with sports function and psychological readiness to return to sports at 12 months after anterior cruciate ligament reconstruction: a cross-sectional study
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Health Sciences, Lund University, Lund, Sweden.ORCID iD: 0000-0002-3282-6320
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.ORCID iD: 0000-0002-0366-4609
Department of Health Sciences, Lund University, Lund, Sweden; Department of Orthopaedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Health Sciences, Lund University, Lund, Sweden.
2023 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 51, no 12, p. 3112-3120Article in journal (Refereed) Published
Abstract [en]

Background: Sports function and psychological readiness to return to sports (RTS) are important outcomes when evaluating rehabilitation after anterior cruciate ligament reconstruction (ACLR). It is, however, unclear which specific factors contribute most to these outcomes.

Purpose: To determine associations between demographic characteristics, objective measurements of physical function, patient-reported outcome measure scores, sports-related function assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) Sport and Recreation subscale, and psychological readiness to RTS assessed with the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale at 1 year after ACLR.

Study Design: Cross-sectional study; Level of evidence, 3. Methods: At a mean of 12.5 ± 2.0 months after ACLR, 143 participants (50.3% female), with a mean age of 25.0 ± 5.7 years, were assessed for demographic characteristics, physical factors (hop performance, muscle strength, ankle and hip range of motion), and psychological factors (KOOS Pain and Symptoms subscales, Perceived Stress Scale, fear of reinjury) as well as the KOOS Sport and Recreation subscale and ACL-RSI scale. Backward linear regression models were used to evaluate factors associated with sports function and psychological readiness to RTS.

Results: Lower isokinetic knee extension peak torque (limb symmetry index) (B = 18.38 [95% CI, 3.01-33.75]), lower preinjury activity level (B = 2.00 [95% CI, 0.87-3.14]), greater knee pain (B = 0.90 [95% CI, 0.70-1.10]), shorter time between injury and reconstruction (B = 0.16 [95% CI, 0.05-0.26]), and greater fear of reinjury (B = 0.11 [95% CI, 0.01-0.20]) were associated with a worse KOOS Sport and Recreation subscore (R2 = 0.683). A shorter hop distance (B = 0.15 [95% CI, 0.00-0.29]) was associated with a lower ACL-RSI score (R2 = 0.245).

Conclusion: A combination of knee muscle strength, activity level, knee pain, timing of surgery, and fear of reinjury accounted for approximately 70% of the variation in sports function at 1 year after ACLR. In contrast, there was only 1 weak association between physical function and psychological readiness to RTS at this time point. Thus, factors associated with current sports function are much better known than features related to psychological readiness to RTS.

Place, publisher, year, edition, pages
Sage Publications, 2023. Vol. 51, no 12, p. 3112-3120
Keywords [en]
anterior cruciate ligament, knee injury, patient-reported outcomes, physical function, psychology
National Category
Physiotherapy Sport and Fitness Sciences
Identifiers
URN: urn:nbn:se:umu:diva-214592DOI: 10.1177/03635465231192983ISI: 001061302500001PubMedID: 37681565Scopus ID: 2-s2.0-85170837103OAI: oai:DiVA.org:umu-214592DiVA, id: diva2:1800854
Funder
Swedish National Centre for Research in Sports, D209-005Swedish National Centre for Research in Sports, P2019-0011Available from: 2023-09-28 Created: 2023-09-28 Last updated: 2023-12-20Bibliographically approved

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Cronström, AnnaHäger, Charlotte

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