Isometric Knee Strength is Greater in Individuals Who Score Higher on Psychological Readiness to Return to Sport After Primary Anterior Cruciate Ligament Reconstruction.
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2022-01
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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.Type
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Sugarman, Barrie S, Zach B Sullivan, Daniel Le, Carolyn Killelea, Mallory S Faherty, Lee H Diehl, Jocelyn R Wittstein, Jonathan C Riboh, et al. (2022). Isometric Knee Strength is Greater in Individuals Who Score Higher on Psychological Readiness to Return to Sport After Primary Anterior Cruciate Ligament Reconstruction. International journal of sports physical therapy, 17(7). pp. 1330–1339. 10.26603/001c.39737 Retrieved from https://hdl.handle.net/10161/26548.
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Scholars@Duke
Lee Harold Diehl
Jocelyn Ross Wittstein
Alison Patricia Toth
Dr. Toth specializes in sports medicine with a focus on anterior cruciate ligament (ACL) and multi-ligament knee reconstruction, knee and shoulder arthroscopy, shoulder impingement and instability, rotator cuff tears, articular cartilage healing and repair; meniscus healing and repair; patella dislocation, and cell and molecular biology approaches to the treatment of musculoskeletal injuries.
Annunziato Amendola
Chief of Sports Medicine
Dean Curtis Taylor
Dr. Dean Taylor is a Sports Medicine Orthopaedic Surgeon whose practice and research interests include shoulder instability, shoulder arthroscopy, knee ligament injuries, meniscus injuries, knee cartilage injuries, and ACL injuries in adults and children. He attended the United States Military Academy at West Point and completed his medical training and residency at Duke University. Dr. Taylor went on to be a part of the John Feagin West Point Sports Medicine Fellowship, retired from the United States Army at the rank of Colonel, and returned to Duke in 2006.
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