Hospital for Special Surgery, New York, New York, USA.
SUNY Downstate College of Medicine, Brooklyn, New York, USA.
Am J Sports Med. 2023 Oct;51(12):3106-3111. doi: 10.1177/03635465231191778. Epub 2023 Aug 31.
The Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale is a 12-item questionnaire assessing psychological readiness to return to sport after anterior cruciate ligament reconstruction. It has been validated for use in adults in multiple languages and in an abbreviated 6-question short form. Additionally, literature has been published using this scale in pediatric and adolescent populations, however it has not yet been validated for use with them.
To validate the ACL-RSI scale for use with pediatric and adolescent patients.
Cohort study (Diagnosis); Level of evidence, 2.
Scores of 6- and 12-item ACL-RSI scales for patients undergoing return-to-sport readiness testing 6 to 8 months after anterior cruciate ligament reconstruction were analyzed. Convergent validity testing was performed against the International Knee Documentation Committee (IKDC)/Pediatric IKDC score, Single Assessment Numeric Evaluation (SANE) score, and peak torque asymmetry of knee flexion and extension using Spearman correlations. Discriminant validity testing was performed against age (Spearman correlation), body mass index (Spearman correlation), and sex (Mann-Whitney test). Reliability testing was performed by calculating Cronbach's alpha. Floor and ceiling effects were assessed by calculating the number of minimum and maximum scores in the cohort.
A total of 51 patients were included in the final analysis. The mean age at surgery was 15.2 ± 2.2 years, and 51.0% were female. The 6- and 12-item ACL-RSI scales demonstrated a strong significant positive correlation with IKDC/Pediatric IKDC scores ( = 0.723 and 0.717, respectively; < .001) and moderate significant positive correlation with Single Assessment Numeric Evaluation scores ( = 0.516 and 0.502, respectively; < .001) Age at surgery, body mass index, and sex were not correlated with either ACL-RSI scale. Cronbach's alpha values of the 12- and 6-item ACL-RSI scales in this population were 0.959 and 0.897, respectively. For both the 12- and the 6-item ACL-RSI scales, no floor or ceiling effects were found as the minimum score (0) was not observed in either version, and the maximum score (100) was only observed twice (3.9%) in both versions.
The ACL-RSI scale is valid to use with pediatric and adolescent patients. The 6-item scale may be a better choice because it has fewer redundancies and minimizes the risk of questionnaire fatigue.
前交叉韧带损伤后重返运动（ACL-RSI）量表是一种 12 项的问卷，用于评估前交叉韧带重建后重返运动的心理准备情况。该量表已在多种语言和简化的 6 项短表形式中得到验证，适用于成年人。此外，文献中也已经发表了使用该量表评估儿科和青少年人群的研究结果，但尚未对该量表在儿科和青少年人群中的使用进行验证。
验证 ACL-RSI 量表在儿科和青少年患者中的适用性。
队列研究（诊断）；证据水平，2 级。
分析了 6 项和 12 项 ACL-RSI 量表的评分，这些评分来自于接受前交叉韧带重建后 6 至 8 个月重返运动准备测试的患者。使用 Spearman 相关性分析对国际膝关节文献委员会（IKDC）/儿童 IKDC 评分、单评估数字评估（SANE）评分以及膝关节屈伸峰值扭矩的不对称性进行了聚合效度测试。使用 Spearman 相关性分析对年龄（Spearman 相关性）、体重指数（Spearman 相关性）和性别（Mann-Whitney U 检验）进行了区分效度测试。采用 Cronbach α 进行可靠性测试。通过计算队列中的最小和最大得分评估地板和天花板效应。
共有 51 例患者纳入最终分析。手术时的平均年龄为 15.2 ± 2.2 岁，51.0%为女性。6 项和 12 项 ACL-RSI 量表与 IKDC/儿童 IKDC 评分均呈强烈的显著正相关（ = 0.723 和 0.717，均 ＜.001），与 SANE 评分也呈中度显著正相关（ = 0.516 和 0.502，均 ＜.001）。手术时的年龄、体重指数和性别与任何 ACL-RSI 量表均无相关性。该人群中 12 项和 6 项 ACL-RSI 量表的 Cronbach α 值分别为 0.959 和 0.897。对于 12 项和 6 项 ACL-RSI 量表，均未发现地板或天花板效应，因为在两个版本中都没有观察到最小得分（0），并且在两个版本中都仅观察到两次（3.9%）最大得分（100）。
ACL-RSI 量表在儿科和青少年患者中是有效的。6 项量表可能是更好的选择，因为它的冗余较少，降低了问卷疲劳的风险。
