如果ACL损伤是多因素的，为什么重返运动测试不是？ACL康复与重返运动的决定因素匹配框架
简介
本文为Masterclass，提出ACL重建后晚期康复与重返运动的"决定因素对齐"框架：力量、跳跃、动作评估等体能测试虽必要，但知觉、神经认知、情境与专项运动需求的权重明显不足。作者区分"测试"（离散的能力测量）与"评估"（整合测试、运动行为、心理准备、暴露进阶与运动情境），主张由基础能力逐步过渡到负荷管理、知觉-动作整合与专项再暴露。该框架为假设生成性临床…
英文摘要
Anterior cruciate ligament (ACL) injury is multifactorial. Return-to-sport (RTS) practice after ACL reconstruction has also become increasingly multidimensional, but its dimensions are not weighted equally: physical capacity is assessed more routinely and objectively than perceptual, neurocognitive, contextual, and representative sport demands. Strength testing, hop performance, movement assessment, and patient-reported outcomes remain essential, but they sample only part of the system in which athletes are re-exposed to sport. This Masterclass proposes a determinant-alignment framework for late-stage rehabilitation and RTS assessment. Here, testing refers to discrete measures of capacity or performance, whereas assessment refers to the broader integration of tests, movement behavior, psychological readiness, exposure progression, and sport context. The framework is a hypothesis-generating clinical heuristic rather than a validated taxonomy, prediction algorithm, or evidence that broader assessment reduces second ACL injury. Its purpose is to identify potential assessment gaps and to progress from foundational capacity toward load management, perception-action integration, and representative sport re-exposure. The objective is alignment, not prediction.