Isometric Knee Strength is Greater in Individuals Who Score Higher on Psychological Readiness to Return to Sport After Primary Anterior Cruciate Ligament Reconstruction

Overview

Journal Int J Sports Phys Ther

Specialty Rehabilitation Medicine

Date 2022 Dec 15

PMID 36518832

Authors

Barrie S Sugarman

Zach B Sullivan

Daniel Le

Carolyn Killelea

Mallory S Faherty

Lee H Diehl

Jocelyn R Wittstein

Jonathan C Riboh

Alison P Toth

Annunziato Amendola

Dean C Taylor

Timothy C Sell

Affiliations

Soon will be listed here.

Abstract

Background: Anterior cruciate ligament (ACL) injury is extremely common among athletes. Rate of second ACL injury due to surgical graft rupture or contralateral limb ACL injury is approximately 15-32%. Psychological readiness to return to sport (RTS) may be an important predictor of successful RTS outcomes. Psychological readiness can be quantified using the ACL Return to Sport after Injury (ACL-RSI) questionnaire, with higher scores demonstrating greater psychological readiness.

Purpose: The purpose of this study was to investigate differences in functional performance and psychological readiness to return to sport among athletes who have undergone primary ACL reconstruction (ACLR).

Study Design: Descriptive cohort study.

Methods: Eighteen athletes who had undergone primary ACLR were tested at time of RTS clearance. The cohort was divided into two groups, high score (HS) and low score (LS), based on median ACL-RSI score, and performance on static and dynamic postural stability testing, lower extremity isokinetic and isometric strength testing, and single leg hop testing was compared between the groups using an independent samples t-test.

Results: The median ACL-RSI score was 74.17. The average ACL-RSI score was 83.1±6.2 for the HS group and 61.8±8.0 for the LS group. High scorers on the ACL-RSI performed significantly better on isometric knee flexion as measured via handheld dynamometry (22.61% ±6.01 vs. 12.12% ±4.88, p=0.001) than the low score group.

Conclusion: The findings suggest that increased knee flexion strength may be important for psychological readiness to RTS after primary ACLR. Further research is indicated to explore this relationship, however, a continued emphasis on improving hamstring strength may be appropriate during rehabilitation following ACLR to positively impact psychological readiness for RTS.

Level Of Evidence: III.

Citing Articles

Effect of Age and Sex on Anterior Cruciate Ligament Functional Tests Approximately 6 Months After Anterior Cruciate Ligament Reconstruction.

Sugimoto D, Milewski M, Williams K, Coene R, Nunally K, Kocher M Arthrosc Sports Med Rehabil. 2024; 6(3):100897.

PMID: 39006798 PMC: 11240043. DOI: 10.1016/j.asmr.2024.100897.

The Influence of Psychosocial Factors on Patients Undergoing Anterior Cruciate Ligament Reconstruction.

Momaya A, Wood A, Benson E, Kwapisz A Sports Health. 2024; 16(2):230-238.

PMID: 38297441 PMC: 10916773. DOI: 10.1177/19417381231223560.

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