The Influence of Strength and Sport Exposure on Psychological Readiness After ACL Reconstruction.

BACKGROUND

Among young athletes returning to sport after anterior cruciate ligament reconstruction (ACLR), the extent to which psychological readiness is influenced by factors beyond the psychological domain is largely unknown.

HYPOTHESIS

Young athletes with recent sport exposure and higher quadriceps strength will demonstrate higher psychological readiness within 8 weeks of medical clearance to return to sport (RTS) after ACLR.

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 38 young athletes after primary ACLR completed testing within 8 weeks of medical clearance to RTS. All participants completed isometric knee extension strength testing, in addition to the ACL Return to Sport after Injury (ACL-RSI) questionnaire. Athletes who participated in sport between time of medical clearance to RTS and date of study enrollment were categorized as SPORT-YES. Those who had not yet participated in sports were categorized as SPORT-NO. Multiple linear regression analyses were used to determine differences in ACL-RSI scores based on quadriceps strength and sport exposure status, while adjusting for age and sex.

RESULTS

Of the 38 participants, 20 (52.6%) were categorized as SPORT-YES. The regression model estimating overall ACL-RSI score ( < 0.01, adjusted = 0.389) included significant independent contributions from age, sex, and sport exposure variables (age: = 0.01, [95% CI] = -2.01 [-3.54, -0.48]; sex (male): = 0.02, [95% CI] = 12.50 [2.36, 22.64]; strength: = 0.51, [95% CI] = -2.47 [-10.07,5.13]; sport exposure: < 0.01, [95% CI] = 12.89 [3.58, 22.19]).

CONCLUSION

In partial accordance with our hypothesis, recent sport exposure was significantly associated with higher ACL-RSI scores among young athletes in the weeks after medical clearance to RTS after ACLR, while quadriceps strength was not.

CLINICAL RELEVANCE

Future prospective work is needed to determine the existence and direction of causal relationships between exposure to sport environment and psychological readiness among young athletes after ACLR.