Predicting return to preinjury level of sports participation after ACL rehabilitation

Abstract

Aim: The aim of this study is to investigate which prognostic factors are associated with return to preinjury level of sports participation one year after ACL rehabilitation (ACLR) and to develop a prediction model estimating the chance of returning to preinjury level of sports participation one year after ACLR. Methods: Prospective data from baseline measurement and outcomes one year after ACLR were used for analysis. Return to preinjury level of sports participation one year after ACLR was measured with a self-invented questionnaire. A literature search indicated that gender, Tegner score, Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) score, high performance on hop tests and fear of harm were important factors for return to play after ACL reconstruction. Factors associated with the outcome were identified by univariate analysis with these five predictors. To predict return to preinjury level of sports participation one year after ACLR a prediction model has been established by a logistic regression analysis Results: Data of 108 patients were used for analysis. Data showed a mean age of 24 years and a mean body mass index of 24. Forty-four patients returned to their preinjury level of sports participation one year after ACLR. Univariate analysis showed that gender and the ACL-RSI were significantly associated with return to preinjury level of sports participation one year after ACLR. Logistic regression led to a model that explained 9.3% of the variance. The Hosmer and Lemeshow test showed no significance (p=.637), indicating that the model is not a poor fit. Conclusion: Gender and the ACL-RSI were significantly associated with return to preinjury level of sports participation one year after ACLR.. Based on these findings it is advised for the sports physical therapist to monitor patient’s psychological readiness to return to sport during ACLR. How patient’s psychological readiness to return to sport can be increased needs further research. Clinical Relevance: The value of this research is that it is of great importance for the sports physical therapist to take patient’s psychological readiness to return to sport into account during ACLR.