Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI) Scores over Time After Anterior Cruciate Ligament Reconstruction: A Systematic Review with Meta-analysis

Linköpings universitet, Avdelningen för prevention, rehabilitering och nära vård Linköpings universitet, Medicinska fakulteten Atrium Hlth Musculoskeletal Inst, NC USA Atrium Hlth Musculoskeletal Inst, NC USA Atrium Hlth Musculoskeletal Inst, NC USA Atrium Hlth Musculoskeletal Inst, NC USA Atrium Hlth Musculoskeletal Inst, NC USA Wake Forest Sch Med, NC USA; Univ Oxford, England Univ New South Wales, Australia Western Univ Hlth Sci, OR USA; Univ Calgary, Canada Duke Sch Med, NC USA Univ Oxford, England; Oxford Univ Hosp NHS Fdn Trust, England Karolinska Inst, Sweden Univ Melbourne, Australia Univ British Columbia, Canada; Arthrit Res Canada, Canada SPRINGER 2024

Background Psychological readiness is an important consideration for athletes and clinicians when making return to sport decisions following anterior cruciate ligament reconstruction (ACLR). To improve our understanding of the extent of deficits in psychological readiness, a systematic review is necessary.Objective To investigate psychological readiness (measured via the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI)) over time after ACL tear and understand if time between injury and surgery, age, and sex are associated with ACL-RSI scores.Methods Seven databases were searched from the earliest date available to March 22, 2022. Articles reporting ACL-RSI scores after ACL tear were included. Risk of bias was assessed using the ROBINS-I, RoB-2, and RoBANS tools based on the study design. Evidence certainty was assessed for each analysis. Random-effects meta-analyses pooled ACL-RSI scores, stratified by time post-injury and based on treatment approach (i.e., early ACLR, delayed ACLR, and unclear approach).Results A total of 83 studies were included in this review (78% high risk of bias). Evidence certainty was 'weak' or 'limited' for all analyses. Overall, ACL-RSI scores were higher at 3 to 6 months post-ACLR (mean = 61.5 [95% confidence interval (CI) 58.6, 64.4], I2 = 94%) compared to pre-ACLR (mean = 44.4 [95% CI 38.2, 50.7], I2 = 98%), remained relatively stable, until they reached the highest point 2 to 5 years after ACLR (mean = 70.7 [95% CI 63.0, 78.5], I2 = 98%). Meta-regression suggests shorter time from injury to surgery, male sex, and older age were associated with higher ACL-RSI scores only 3 to 6 months post-ACLR (heterogeneity explained R2 = 47.6%), and this reduced 1-2 years after ACLR (heterogeneity explained R2 = 27.0%).Conclusion Psychological readiness to return to sport appears to improve early after ACL injury, with little subsequent improvement until >= 2-years after ACLR. Longer time from injury to surgery, female s

Psychological readiness; Return to sport; Knee; Athletes; Applied Psychology; Tillämpad psykologi; Article, review/survey; info:eu-repo/semantics/article; text

10.1186.s40798-024-00712-w

English

UPE oai:DiVA.org:liu-203582
0000-0003-3527-5488
doi:10.1186/s40798-024-00712-w
PMID 38689130
ISI:001210804700001
1442971651

UPPSALA UNIV LIBR
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