scholarly journals Relationships Between Physical Function and Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction

2021 ◽  
Author(s):  
Junya Aizawa ◽  
Kenji Hirohata ◽  
Shunsuke Ohji ◽  
Takehiro Ohmi ◽  
Sho Mitomo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Function ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Return To Sports ◽  
Knee Strength ◽  
Physical Functions ◽  
Anterior Cruciate ◽  
Flexion Strength

Abstract Background: Information about specific factors of physical function that contribute to psychological readiness is needed to plan rehabilitation for a return to sports. The purpose of this study was to identify specific physical functions related to the psychological readiness of patients aiming to return to sports 6 months after reconstruction. We hypothesized that the knee strength is a factor related to the Anterior Cruciate Ligament–Return to Sport After Injury Scale (ACL-RSI) cutoff score for a return to sports at 2 years after reconstruction.Methods: Fifty-four patients who had undergone primary reconstruction using hamstring tendon participated in this study. Psychological readiness was measured using the ACL-RSI in patients at 6 months after reconstruction. To identify specific physical functions related to the ACL-RSI score, participants were divided into groups with ACL-RSI scores of ³60 or <60. Non-paired t-tests or the Mann-Whitney test were performed to analyze group differences in objective variables in physical function: 1) knee strength in both legs; 2) leg anterior reach distance on both sides; and 3) single-leg hop (SLH) distances in three directions for both legs.Results: Significant differences between groups were identified in knee flexion strength (60°/s) for the uninvolved limb, hamstring-to-quadriceps ratio (60°/s) for the uninvolved limb, knee flexion strength (180°/s) for the involved limb, limb symmetry index (LSI) of leg anterior reach distance, the ratio of the distance to the height of the patient and LSI of SLH distances in lateral and medial directions. Conclusion: This study revealed that at 6 months after reconstruction, increased knee flexion strength (Ratio of the peak torque measured to the body mass of the patient), hamstring-to-quadriceps ratio, leg anterior reach distance LSI, and lateral and medial SLH appear important to exceed the ACL-RSI cutoff for a return to sports at 2 years after reconstruction. The present results may be useful for planning post-operative rehabilitation for long-term return to sports after reconstruction.

scholarly journals Arabic Version of the Short Anterior Cruciate Ligament–Return to Sport After Injury Scale: Translation, Cross-cultural Adaptation, and Validation

2022 ◽  
Vol 10 (1) ◽  
pp. 232596712110665
Author(s):  
Msaad Alzhrani ◽  
Hosam Alzahrani ◽  
Yasir S. Alshehri
Keyword(s):  
Anterior Cruciate Ligament ◽  
Internal Consistency ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Short Version ◽  
Return To Sports ◽  
Strongly Correlated ◽  
Retest Reliability ◽  
Anterior Cruciate ◽  
Test Retest Reliability

Background: The short version of the Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI) scale is a self-reported questionnaire developed to assess the psychological readiness of patients to return to sports after ACL reconstruction (ACLR). Purpose: To translate, cross-culturally adapt, and validate the short version of the ACL-RSI scale into the Arabic language (ACL-RSI-Ar). Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The original short version of the ACL-RSI scale was forward and backward translated, cross-culturally adapted, and validated following international standardized guidelines. Sixty patients who participated in sports activities and underwent ACLR completed the ACL-RSI-Ar, the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and Knee injury and Osteoarthritis Outcome Score (KOOS) scales. To assess test-retest reliability, 34 participants completed the ACL-RSI-Ar scale twice. Statistical tests were conducted to test the internal consistency, reliability, and construct and discriminant validity of the ACL-RSI-Ar scale. Results: The ACL-RSI-Ar showed adequate internal consistency (Cronbach alpha = 0.734) and excellent test-retest reliability (intraclass correlation coefficient, 0.871). The ACL-RSI-Ar was strongly correlated with the IKDC (Spearman ρ = 0.515, P < .001) and weakly to strongly correlated with all KOOS subscales (Spearman ρ = 0.247-0.590, P < .05). Patients who returned to sports had significantly higher scores on the ACL-RSI-Ar scale when compared with those who did not return to sports ( P = .001). Conclusion: The short ACL-RSI-Ar scale, as translated, was internally consistent, reliable, and valid for evaluating psychological readiness to return to sports after ACLR in Arabic-speaking patients.

scholarly journals HOP TEST AS A TOOL FOR THE ASSESSMENT AND PREVENTION OF INJURIES IN FOOTBALLERS DURING PRESEASON

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
F García-Bol ◽  
V Posada-Franco ◽  
A Roldán-Valero ◽  
R Del Caño-Espinel
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Reference Values ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Performance Criteria ◽  
Return To Sports ◽  
Hop Tests ◽  
Hop Test ◽  
Anterior Cruciate

Hop Tests (unipodal horizontal jumps) have been recommended as one of the reliable assessment tests when allowing a return to competition for a sportsperson after an anterior cruciate ligament injury1,2,3,4. Currently, comparison is made of the results with the contralateral limb through the symmetry index, a method which might not provide sufficient security upon the return to competitive sport5. Hop tests can be used in preseason to gain reference values prior to a possible injury. The objective of this review is to analise the scientific literature such as the F-Marc6 (reference manual of FIFA) to confirm whether include said tests in preseason for football teams. A search was conducted in the Pubmed y Cochrane databases (17/04/17) with the search terms “Hop Test”, “Football”, “Soccer”, and “Preseason”. Articles in English and Spanish were both accepted. Articles excluded were those that did not make reference to the knee, to football, and those that did not conduct tests during preseason. From a total of 33 articles, 4 with these search criteria were included, 5 articles were added trough the bibliography of other studies, and the F-Marc manual was analised. 4 of the articles used the hop tests in preseason for some type of study, of which 3 were used as part of a prospective assessment for the season. On the other hand, the F-Marc does not consider Hop Tests as an assessment test. Hop tests were not found to be used in preseason as reference values prior to possible future injuries, data which could be beneficial for a safe return to sport. Harris J, Abrams G, Bach B, Williams D, Heidloff D, Bush-Joseph C, Verma N, Forsythe B, Cole B. Return to Sport After ACL Reconstruction. ORTHOPEDICS. 2014; 37: e103-e108. Barber-Westin SD, Noyes FR. Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. Arthroscopy. 2011 Dec;27(12):1697-705. Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, Tsepis E, Werner S, Wondrasch B, Witvrouw E. Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2011 Nov;19(11):1798-805. Bolgla LA, Keskula DR. Reliability of lower extremity functional performance tests. J Orthop Sports Phys Ther. 1997 Sep;26(3):138-42. Wellsandt E, Failla MJ, Snyder-Mackler L. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury. J Orthop Sports Phys Ther. 2017 Mar 29:1-18. F-MARC. Football Medicine Manual. 2nd Edition. Available from: http://f-marc.com . 2017.

scholarly journals EVALUATION OF THE UTILITY OF THE ANTERIOR CRUCIATE LIGAMENT RETURN TO SPORT AFTER INJURY (ACL-RSI) SCALE WITHIN PEDIATRIC ATHLETES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0003
Author(s):  
Elliot Greenberg ◽  
Miranda Dabbous ◽  
Anne Leung ◽  
Gabriella Marinaccio ◽  
Benjamin Ruley ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Pediatric Population ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
The United States ◽  
Return To Play ◽  
Return To Sports ◽  
Youth Athletes ◽  
The Mean ◽  
Anterior Cruciate

Background: The incidence of anterior cruciate ligament (ACL) injury and surgical reconstruction in youth athletes is increasing. In the United States, most athletes elect to undergo ACL reconstruction (ACLR), with the goal of returning to their previous level of athletic performance. Although surgery and rehabilitation address the underlying impairments in knee stability and function, recent literature indicates psychological or emotional factors, such as fear or confidence, may be contributing factors limiting successful return to play. The Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) is a 12-item scale designed to assess an athlete’s psychological readiness to return to sports across three separate domains (emotions, confidence in performance and risk appraisal). In adults, the ACL-RSI is reliable and valid, and several studies have documented that athletes with higher scores are more likely to successfully return to their pre-injury level of sports participation. The predictive abilities of this scale, have led many experts to advocate for the ACL-RSI to be used as part of rehabilitation guidelines, in order to identify those athletes that may benefit from a modified course of post-operative rehabilitation or additional emotional or psychological support. Although the information from the ACL-RSI is valuable in adults, the utility of this scale has never been explored within the pediatric population. Thus, the purpose of this study is to evaluate the utility of the ACL-RSI within the pediatric population and establish normative values among healthy children. Hypothesis: As all of these subjects were currently healthy, we hypothesized that mean scores should demonstrate a positive skew towards higher levels of confidence (ceiling effect) with values of 80-100 on each question. Methods: A group of 84 healthy, youth athletes between the ages of 8-14, completed the ACL-RSI. All subjects were currently involved in competitive sports at the time of participation. The athletes were instructed to complete the 12-item ACL-RSI questionnaire and were able to seek assistance from parents as necessary. Each item is scored on a scale ranging from 0-100 and a total score is calculated from summing all responses and expressing them a percentage of 100%. Higher scores indicate a greater degree of athletic confidence or more positive psychological response to injury. Mean and variability measures for each question and total score were calculated and compared to existing literature. Results: A total of 83 subjects (mean age 11.1 ± 1.2) completed the questionnaire in full. There were slightly more females (n=46, 54.8%) than males. The majority of participants were White (70%), African American (13%) or more than one race (10%). The most frequent primary sport was soccer (38%), followed by baseball (27%) and basketball (26%). The mean ACL-RSI score for the entire sample was 79.9 (SD 14.1). Individual question analysis revealed lower than expected mean scores (<80%) with large standard deviations for 7 out of 12 questions. (Table 1) With the exception of only question #1 and #12, responses demonstrated such large variability that both the maximum and minimum (0-100) scores were selected, indicating both ceiling and floor effects. (Table 1) Conclusions/Significance: The mean ACL-RSI score (79.9) within this group of uninjured pediatric athletes was similar to previous values for post-ACLR adults that successfully return to sports. However, it was surprising that the mean score wasn’t higher, as this was a healthy population of un-injured youth athletes, and we hypothesized that our data would demonstrate a positive skew towards the upper range of this scale. Response ranges including 0 (indicating either high fear or severe lack of confidence) within nearly all questions was unexpected. Additionally, there were particularly low mean scores and high variability within 7 of the 12 questions. All of these factors raise the suspicion that children may not fully comprehend the material or have difficulty interpreting the response system of the ACL-RSI and thus calls into question the validity of this scale in youth athletes. Similar to other research efforts that have modified adult outcome scales to be utilized within the pediatric population, our results support further exploration of the utility of the ACL-RSI within pediatric athletes and may possibly suggest that a pediatric specific version should be created. [Table: see text]

scholarly journals Knee Extensor and Flexor Strength are Related to One-Leg Hop Distances in Three Directions in Patients Six Months After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Author(s):  
Junya Aizawa ◽  
Kenji Hirohata ◽  
Shunsuke Ohji ◽  
Takehiro Ohmi ◽  
Sho Mitomo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Knee Extension ◽  
Return To Sports ◽  
Cruciate Ligament Reconstruction ◽  
Knee Strength ◽  
Anterior Cruciate

Abstract Background: When planning rehabilitation and conditioning for performance enhancement and a return to sports after anterior cruciate ligament reconstruction, identifying the elements of physical function associated with one-leg hop is important. The purpose of this study was to clarify the relationship between one-leg hop distances in 3 directions and knee extensor and flexor strengths at 6 months after reconstruction.Methods: Participants were 47 patients taking part in training sessions for sports involving cutting, pivoting, and jump-landing 6 months after reconstruction using a hamstring tendon. Demographics, activity scale score, days before and after reconstruction, and meniscus surgery procedure were analyzed. One-leg hop distances in 3 directions (anterior, lateral, and medial) and isokinetic strengths of knee extension and flexion were measured. Simple regression analyses using Spearman's rank correlation coefficient were performed to assess relationships between one-leg hop distances and knee strengths.Results: In the involved limb, correlations between one-leg hop distance in 3 directions and knee strengths were significant and effect sizes ranged from medium to large. Correlation coefficients between all one-leg hop parameters and knee extension/flexion strengths at an angular velocity of 180°/s were greater than those of 60°/s.Conclusions: Knee strength showed moderate to high associations with lateral and medial one-leg hop distances in addition to anterior one-leg hop distance. The results of this study will be useful in planning and teaching conditioning to improve multi-directional one-legged hop skills and improve knee strength for a full-scale return to sports after reconstruction.

scholarly journals What is the Importance of Psychological Measures to Determine Readiness to Return to Sports After Anterior Cruciate Ligament Reconstruction?

2021 ◽  
Author(s):  
Tate Newmarch ◽  
Marcel Betsch ◽  
Roman Michalik ◽  
Tim Dwyer ◽  
Daniel Whelan ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Psychological Factors ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Psychological Tests ◽  
Return To Sports ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Abstract Background: Recent studies have suggested that psychological factors are important components of successful return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to survey physicians on their criteria used to determine readiness to RTS after ACLR and understand the significance of psychological factors on RTS.Methods: A survey was designed to understand the practices of clinicians managing rehabilitation after ACLR consisting of 25 questions divided in 3 different sections, including one section about psychological scores and factors affecting RTS. The survey was delivered to three North-American orthopaedic sports medicine organizations.Results: The total number of respondents was 113. 95% of respondents considered psychological tests at least “somewhat important” (33% “important”, 23% selected “very important”). Routine use of psychological tests in practice was only reported by 35% of respondents. The ACL-Return to Sport after Injury Scale was the most frequently used psychological test (23%). Fear of reinjury was considered the most common patient-cited psychological factor affecting RTS. Psychological factors ranked 8th out of 9 outcomes measures in determining readiness to RTS.Conclusion: This study demonstrates a discrepancy between the importance of psychological tests and the frequency of use in practice. Additional education on this topic, web-based applications and a multidisciplinary approach may increase the usage of psychological tests to determine RTS after ACLR.

scholarly journals Anterior Cruciate Ligament Reconstruction with Concomitant Osteochondral Allograft Transplantation versus Anterior Cruciate Ligament Reconstruction: A Comparative Matched-Group Analysis of Return to Sport and Satisfaction

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0026
Author(s):  
Grant Hoerig Garcia ◽  
Michael L. Redondo ◽  
Joseph Liu ◽  
David R. Christian ◽  
Adam Blair Yanke ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Activity Level ◽  
Return To Sports ◽  
Inclusion Criteria ◽  
Pain Scores ◽  
Anterior Cruciate

Objectives: Anterior cruciate ligament (ACL) rupture is commonly associated with articular cartilage injury. Few studies have evaluated the influence of cartilage repair on the outcome of ACL reconstruction. Currently, no known study has examined the return to sport rates of concomitant ACL reconstruction and OCA. The purpose of this study is to evaluate rate and level of return to sports, as well as long-term outcomes, between a matched cohort of isolated ACL reconstruction (ACLR) versus ACL reconstruction with concomitant OCA (ACLR/OCA). Methods: A prospectively collected registry was queried retrospectively for consecutive patients who underwent ACL reconstruction with concomitant OCA. Inclusion criteria were preoperative diagnosis of ACL rupture and more than 2 years of follow-up. After meeting the inclusion criteria, all ACL reconstructions with concomitant OCA were matched to two isolated ACL reconstruction patients via +/- 5 years of age at time of surgery, gender, revision status, and ACL reconstruction graft type. At final follow-up, patients were asked to complete a subjective sports questionnaire, the Marx activity scale, a visual analog scale (VAS), and a satisfaction questionnaire. Results: Seventeen ACL/OCA patients met inclusion criteria. Fourteen eligible 2:1 matched pairs (28 ACLR; 14 ACLR/OCA;), were identified for analysis. The average age at the time of surgery was 33.89 +/- 8.64 and 35.92 +/- 6.22 for the ACLR and ACLR/OCA groups, respectively (P = .44). Average follow-up was 4.09 years and 5.14 years for the ACLR and ACLR/OCA groups, respectively (P = .17). At final follow-up, the average Marx activity scalescores were 6.54 for ACRL patients and 1.57 for ACLR/OCA patients; final scores were significantly different between groups (P < 0.01). The average VAS pain scores at final follow-up were 1.96 in the ACLR and 3.64 in ACLR/OCA groups with the ACLR/OCA patients displaying significantly worse final VAS pain scores (P = .03). 89.3% of ACLR patients (25 of 28) returned to at least 1 sport postoperatively compared with 57.1% of ACLR/OCA patients (8 of 14) (P=0.04). At final follow-up, 14.2% (2 of 14) of the ACLR/OCA group and 32.1% (9 of 28) of the ACLR group reported starting a new sport or activity. Average timing for full return to sports was 9.57 +/- 5.53 months and 9.27 +/- 3.25 months for the ACLR/OCA and ACLR groups, respectively (P = .86). At final follow-up, 33.3% and 57.1% of patients returned to better or same level of sport for the ACLR/OCA and ACLR groups, respectively (P = .06). Significantly more ACLR/OCA patients reported their activity level was hindered by their knee (92.8% ACLR/OCA; 60.7% ACLR). Significantly more ACLR patients reported satisfaction with their surgery compared with ACLR/OCA patients (89% vs 57%) (P < 0.01), however no statistical difference was observed in satisfaction with ability to play sports between groups. Conclusion: Significantly less ACLR/OCA patients (57.1%) were able to return to at least 1 sport when compared to a matched ACLR cohort (89.3%). At final follow-up, a higher percentage of ACLR patients were able to return to pretreatment activity intensity level or better (ACLR/OCA, 33.3%; ACLR, 57.1%). ACLR/OCA patients had significantly more pain and lower Marx activity scores. Despite a lower return to sport rate, there was no statistical difference in reported satisfaction with activity level between the groups, however the ACLR/OCA groups reported significantly lower overall surgical satisfaction.

scholarly journals Responsiveness of the anterior cruciate ligament – Return to Sports after Injury (ACL-RSI) and Injury – Psychological Readiness to Return to Sport (I-PRRS) scales

2019 ◽  
Vol 37 (21) ◽  
pp. 2499-2505
Author(s):  
Anton J. Slagers ◽  
Inge van den Akker-Scheek ◽  
Jan H. B. Geertzen ◽  
Johannes Zwerver ◽  
Inge H. F. Reininga
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Return To Sports ◽  
Anterior Cruciate
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