Psychological Factors Related to Return to Sport After ACL Reconstruction in Adolescents

Abstract

PURPOSE: The present study aimed to assess the relationship between psychological factors, including perceived social support and pre-operative expectations, and return to sport after ACL reconstruction in adolescents. METHODS: 56 participants completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS), the Psychovitality (PV) questionnaire, and the Multidimensional Scale of Perceived Social Support (MSPSS) prior to undergoing ACL reconstruction. We performed a multiple linear regression to assess if MSPSS score was associated with confidence in returning to sport (total PV score). Additionally, we divided participants into competitive and non-competitive groups based on their response to the HSS Pedi-FABS. Outcome variables obtained from the PV questionnaire addressing pre-operative expectations of returning to sport following surgery were compared between the competitive and non-competitive groups using a series of Chi-square analyses. RESULTS: Among all participants, 86% (n=48) reported that they expected to return to sport within less than six months of surgery. A higher proportion of competitive athletes (81%) expected to return to sport within six months post-operatively compared to the non-competitive athletes (63%; p=0.18). In addition, a significantly lower proportion of competitive athletes (14%) compared to non-competitive athletes (39%) reported that they would be content returning to an activity level that was less than their pre-injury activity level (p=0.037) and would be willing to settle for a less strenuous sport than their pre-injury sport (16% vs 42%; p=0.034). There was no significant association between MSPSS total score (mean= 6.22±0.375, range= 4-7) and PV total score (mean= 13.8±3.0, range= 8-18; β coefficient= -0.63, 95% CI= -1.77, 0.52, p = 0.28). CONCLUSIONS: The majority of all participants reported the expectation of returning to sport within six months of surgery. A significantly lower proportion of competitive athletes compared to non-competitive athletes reported that they would be content returning to a lesser activity level or less strenuous sport. There was no significant association between perceived social support and confidence in returning to sport.