Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) subcategories are affected by subjective running ability and medial single-leg hop distance in postreconstruction patients at 6 months

Jun-Ya Aizawa; Kenji Hirohata; Shunsuke Ohji; Sho Mitomo; Takehiro Ohmi; Hideyuki Koga; Kazuyoshi Yagishita

doi:10.1002/jeo2.12004

Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) subcategories are affected by subjective running ability and medial single-leg hop distance in postreconstruction patients at 6 months

J Exp Orthop. 2024 Feb 3;11(1):e12004. doi: 10.1002/jeo2.12004. eCollection 2024 Jan.

Authors

Jun-Ya Aizawa^{1

2}, Kenji Hirohata³, Shunsuke Ohji³, Sho Mitomo^{2

4}, Takehiro Ohmi³, Hideyuki Koga⁵, Kazuyoshi Yagishita³

Affiliations

¹ Department of Physical Therapy Juntendo University Tokyo Japan.
² Department of Rehabilitation Medicine, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan.
³ Clinical Center for Sports Medicine and Sports Dentistry Tokyo Medical and Dental University Tokyo Japan.
⁴ Japan Sports Agency Tokyo Japan.
⁵ Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan.

Abstract

Purpose: This study aimed to investigate the intricate relationship between physical function factors and each subcategory score of the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale among patients following ACL reconstruction.

Methods: Participants comprised 59 patients who had undergone primary ACL reconstruction using hamstring tendon. The ACL-RSI was completed 6 months after reconstruction and five physical functions were measured in patients on the same day. Simple linear regression was performed multiple times to investigate the relationship between ACL-RSI subcategory scores as a dependent variable and each independent variable (knee strength, leg anterior reach distance, single-leg hop [SLH] distances, side bridge endurance, and subjective running ability). Multiple regression analysis was performed using a stepwise method, with factors showing a risk rate <0.05 in simple linear regression analyses as independent variables and the ACL-RSI in each subcategory score as the dependent variable.

Results: Multiple regression analysis showed that subjective running ability affected all subcategories (p ≤ 0.001), and that the limb symmetry index of medial SLH distance affected both the Emotions (p = 0.047) and Confidence (p = 0.009) subcategories. Higher subjective running ability and greater limb symmetry in the medial SLH were thus positively associated with each dimension of psychological readiness.

Conclusions: This study highlights the differential impact of physical function factors on specific subcategories of the ACL-RSI scale, providing clinicians with insights for designing targeted rehabilitation strategies. This original paper suggests the importance of analysing factors related to subcategory scores in addition to total ACL-RSI score, and could contribute to the understanding of determinants for a successful return to sport following ACL reconstruction.

Level of evidence: Level IV.

Keywords: ACL‐RSI; confidence; emotions; physical function; risk appraisal.