前交叉韧带重建术后患者重返运动的心理与身体准备度特征分析：822例患者研究
简介
一项纳入822例ACL重建术后患者的横断面研究发现，仅不到三分之一患者的心理准备状态（ACL-RSI评分≥65分）与体能准备状态（等速股四头肌肌力及单腿跳跃测试的肢体对称指数≥90%）相匹配。最常见的模式是心理和跳跃测试达标但股四头肌力量不达标（32%），且年龄较大患者更易出现心理与体能均不达标，男性患者的心理与体能匹配度优于女性。该结果提示临床在制定重返运…
英文摘要
BACKGROUND: Psychological factors influence return to sport (RTS) and reinjury rates following anterior cruciate ligament (ACL) reconstruction (ACLR). However, many RTS decisions are made without considering psychological factors, or consider psychological and physical factors in isolation, leading to suboptimal RTS and reinjury rates. PURPOSE: To identify distinct profiles of psychological and physical readiness to RTS following ACLR using strength- and performance-based measures of physical readiness and to examine the extent to which these readiness domains align. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Data from the ACL Reconstruction Rehabilitation Outcomes Workgroup (ARROW) registry were used to construct patient profiles of psychological and physical readiness to RTS based on established criteria. Psychological readiness was defined by an ACL Return to Sport after Injury Scale (ACL-RSI) score ≥65 points out of 100. Strength-based and performance-based physical readiness was defined by a limb symmetry index ≥90% in isokinetic quadriceps strength and single-limb hop testing, respectively. Frequencies of all profiles were reported, alignment between psychological and physical domains was assessed, and sensitivity analyses were conducted to investigate differences in age, sex, and time since surgery. RESULTS: A total of 822 patients were included in the analysis (age: mean ± SD, 18.8 ± 6.2 years; 51% female). The most common profile represented patients who met psychological (ACL-RSI) and performance-based physical readiness criteria (single-leg hop) but not strength-based physical readiness criteria (quadriceps strength) (32%; 261/822). When considering ACL-RSI, single-leg hop, and quadriceps criteria together, psychological and physical readiness did not align for 69% (571/822) of patients. Patients in the "neither psychologically nor physically ready" profile were older than patients in any other profiles. Male patients obtained psychological and physical readiness scores that aligned more often than female patients. CONCLUSION: There were a variety of distinct profiles of psychological and physical readiness in patients post-ACLR. Psychological, strength-based, and performance-based physical readiness to RTS criteria aligned for less than one-third of participants. Patients who did not meet psychological or physical readiness criteria tended to be older in age, and male patients were more likely to have alignment between their psychological and physical readiness domains.