Abstract
PurposeEvidence is emerging on the importance of psychological readiness to return to sport after anterior cruciate ligament (ACL) reconstruction. The ACL-Return to Sport after Injury scale (ACL-RSI) is developed to assess this. The aim of the current study was to translate ACL-RSI into Norwegian and examine the measurement properties of the Norwegian version (ACL-RSI-No).MethodsACL-RSI was translated according to international guidelines. A cohort of 197 ACL-reconstructed patients completed ACL-RSI-No and related questionnaires nine months post-surgery. One hundred and forty-six patients completed hop tests and 142 patients completed strength tests. Face and structural validity (confirmative factor analysis and explorative analyses), internal consistency [Cronbach’s alpha (α)], test–retest reliability [Intraclass Correlation Coefficients (ICC)], measurement error [Standard error of measurement (SEM) and smallest detectable change at individual (SDCind) and group level (SDCgroup)] and construct validity (hypotheses testing; independent t tests, Pearson’s r) were examined.ResultsACL-RSI-No had good face validity. Factor analyses suggested that the use of a sum score is reasonable. Internal consistency and test–retest reliability were good (α 0.95, ICC 0.94 (95% CI 0.84–0.97) and measurement error low (SEM 5.7). SDCind was 15.8 points and SDCgroup was 2.0. Six of seven hypotheses were confirmed.ConclusionsACL-RSI-No displayed good measurement properties. Factor analyses suggested one underlying explanatory factor for “psychological readiness”—supporting the use of a single sum score. ACL-RSI-No can be used in the evaluation of psychological readiness to return to sport after ACL injury.Level of evidence III.
Highlights
A majority of patients with an anterior cruciate ligament (ACL) tear choose to undergo surgery since their aim is to return to pre-injury level of sports [1, 2]
Results from the confirmative factor analysis (CFA) displayed that a one-factor solution had a poor fit to the data (Chi Square 274.80 (degrees of freedom 54, P < 0.01), SRMR 0.05, root mean square error of approximation (RMSEA) 0.14 and comparative fit index (CFI) 0.90)
Correlations between 15 pairs of residuals were needed to achieve a satisfactory fit by conventional standards and COSMIN criteria
Summary
A majority of patients with an anterior cruciate ligament (ACL) tear choose to undergo surgery since their aim is to return to pre-injury level of sports [1, 2]. In spite of stabilizing surgery and extensive postoperative rehabilitation, up to 40% of patients fail to return to their pre-injury level of sports and less than half return to competitive sport [1, 5]. The term “psychological readiness” is frequently used to describe mental factors influencing return to sports (RTS) after ACL injury. These factors include realistic expectations, confidence in performance, high levels of self-efficacy and low levels of fear and anxiety [6]
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