title: The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  This cross-sectional study aimed to examine whether appraisal of knee function, psychological and demographic factors were related to returning to the preinjury sport and recreational activity following anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  164 participants completed a questionnaire battery at 1-7 years after primary ACL reconstruction. The battery included questionnaires evaluating knee self-efficacy, health locus of control, psychological readiness to return to sport and recreational activity, and fear of reinjury; and self-reported knee function in sport-specific tasks, knee-related quality of life and satisfaction with knee function. The primary outcome was returning to the preinjury sport or recreational activity.
  
  
  RESULTS
  At follow-up, 40% (66/164) had returned to their preinjury activity. Those who returned had more positive psychological responses, reported better knee function in sport and recreational activities, perceived a higher knee-related quality of life and were more satisfied with their current knee function. The main reasons for not returning were not trusting the knee (28%), fear of a new injury (24%) and poor knee function (22%). Psychological readiness to return to sport and recreational activity, measured with the ACL-Return to Sport after Injury scale (was most strongly associated with returning to the preinjury activity). Age, sex and preinjury activity level were not related.
  
  
  CONCLUSIONS
  Less than 50% returned to their preinjury sport or recreational activity after ACL reconstruction. Psychological readiness to return to sport and recreation was the factor most strongly associated with returning to the preinjury activity. Including interventions aimed at improving this in postoperative rehabilitation programmes could be warranted to improve the rate of return to sport and recreational activities.
authors.affiliation: School of Allied Health, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia Division of Physiotherapy, Linköping University, Linköping, Sweden.
authors.forename: Clare L
authors.initials: CL
authors.lastname: Ardern
authors.affiliation: Division of Physiotherapy, Linköping University, Linköping, Sweden Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Österberg
authors.affiliation: Division of Physiotherapy, Linköping University, Linköping, Sweden.
authors.forename: Sofi
authors.initials: S
authors.lastname: Tagesson
authors.affiliation: Orthopaedic Department, Linköping University, Linköping, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Gauffin
authors.affiliation: School of Allied Health, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Webster
authors.affiliation: Division of Physiotherapy, Linköping University, Linköping, Sweden.
authors.forename: Joanna
authors.initials: J
authors.lastname: Kvist
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000523:psychology* / Q000534:rehabilitation; D001265:Athletic Injuries / Q000523:psychology* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011788:Quality of Life; D020127:Recovery of Function; D011998:Recreation / Q000523:psychology*; D020377:Self Efficacy; D055815:Young Adult
keywords: ACL; Knee ACL; Sport and exercise psychology