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CC2023: Patients Who Return to Sport After Primary ...
Patients Who Return to Sport After Primary Anterio ...
Patients Who Return to Sport After Primary Anterior Cruciate Ligament Reconstruction Have Significantly Higher Psychological Readiness: A Systematic Review and Meta-analysis of 3744 Patients
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A systematic review and meta-analysis led by Michelle Xiao et al. at Stanford University investigated the psychological readiness of athletes returning to sport post-primary anterior cruciate ligament (ACL) reconstruction. Analyzing data from 3,744 patients, the study found that psychological factors significantly influence the ability to return to sport.<br /><br />Key Findings:<br />1. **Return to Sport Rates:**<br /> - Overall, 61.8% of patients returned to sport, with higher rates in males (66.8%) compared to females (55.4%).<br /><br />2. **Psychological Assessment Tools:**<br /> - Three main psychological tools were used: the ACL–Return to Sport Injury (ACL-RSI) scale, the Knee Self-Efficacy Scale (K-SES), and the Tampa Scale of Kinesiophobia (TSK/TSK-11).<br /> - Athletes who returned to sport scored significantly higher on the ACL-RSI (mean difference [MD], 20.8), indicating greater psychological readiness.<br /> - They also had higher self-efficacy scores on the K-SES (MD, 1.3) and lower kinesiophobia scores on the TSK/TSK-11 (MD, 10.1%).<br /><br />3. **Physical vs. Psychological Factors:**<br /> - Although knee function outcomes, measured using the International Knee Documentation Committee (IKDC) score, showed no clinically significant differences, psychological readiness was a major determinant of return to sport.<br /> - The inclusion of psychological measures alongside physical metrics is essential in assessing an athlete’s readiness to return to sport.<br /><br />4. **Patient Characteristics:**<br /> - The mean age of participants varied between 17 and 28.7 years.<br /> - The study noted that psychological scores could be influenced by several factors, including age, sex, and type of sport played.<br /><br />5. **Recommendations:**<br /> - The findings suggest integrating psychological evaluations into return-to-sport assessments.<br /> - Further studies could enhance understanding of how psychological readiness influences reinjury risks and help develop comprehensive rehabilitation programs that address both physical and psychological aspects.<br /><br />Conclusion:<br />The study concludes that athletes who return to sport post-ACL reconstruction exhibit significantly higher psychological readiness, self-efficacy, and lower kinesiophobia, despite showing similar physical knee function to those who did not return. Therefore, psychological readiness should be a critical component of return-to-sport evaluations.
Keywords
psychological readiness
ACL reconstruction
return to sport
Michelle Xiao
Stanford University
ACL-RSI scale
Knee Self-Efficacy Scale
Tampa Scale of Kinesiophobia
psychological factors
athlete rehabilitation
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