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P14

Assessments for psychological readiness for return to sports after anterior cruciate ligament injury

F. Hug1, G. Muri1, A. Blasimann1 (1Bern)


Einleitung

Despite physical fitness and restored knee stability, many athletes struggle to reach the previous level of performance after a rupture of the anterior cruciate ligament (ACL). In addition, around 20% of athletes suffer from a re-injury. Recently, psychological factors are discussed among others. Therefore, this systematic literature review aimed to summarize assessments for psychological readiness to return to sports (RTS) in ACL patients, and to investigate the methodological quality of the three most commonly used assessments.

Methodik

In a first literature search, PubMed, Cochrane, Google Scholar, Physiotherapy Evidence Database (PEDro) and CINAHL were searched for psychological assessments investigating readiness for RTS in ACL-injured adults. Afterwards, the three most commonly used assessments were determined. In a second literature search, PubMed, CINAHL and ScienceDirect were searched for psychometric properties of the three assessments. Risk of bias was evaluated with the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist.

Resultate

In 37 included studies from the first search, the Anterior Cruciate Ligament Return to Sports After Injury Scale (ACL-RSI) was used 20 times, the Tampa Scale for Kinesiophobia (TSK, short form TSK-11) 17 times and the Knee Self-efficacy Scale (K-SES) five times. The studies for the ACL-RSI scale had a medium to low risk of bias, followed by the almost equally rated K-SES and TSK-11, and the TSK.

Schlussfolgerungen

Of the included assessments, the ACL-RSI scale showed the best methodological quality. All quality criteria were rated as "adequate" to "excellent". Unlike the TSK-11 and TSK, the ACL-RSI scale was designed specifically for ACL patients. The K-SES is also ACL-specific and showed good methodological quality. However, there are only a few studies using the K-SES, most of which were written by the same authorship, who also developed the scale. In addition, the scale is only available in Swedish, Dutch and English. The TSK and TSK-11 detect pain-related anxiety but are not ACL-specific. In conclusion, the ACL-RSI scale is recommended to use in practice.

Bedeutung

The ACL-RSI scale is a valid and reliable tool to measure psychological readiness for RTS after ACL injury. It is available free of charge in German, French and other languages. Also, a short form exists. Moreover, it is easy to understand and filled out in five minutes.