前交叉韧带重建术后重返运动心理准备度的决定因素
简介
这项横断面研究纳入58例初次单侧ACL重建后约6个月、已完成标准化康复的患者，用ACL-RSI量表评估心理准备度并作分层回归，考察人口学、广泛性焦虑与恐动、膝关节特异性患者报告结局及客观功能（股四头肌力量、单腿跳对称性）各域的贡献。结果显示，焦虑与恐动（TSK-11）分别额外解释18.1%和22.3%的变异，KOOS生活质量与运动功能次之，而疼痛、症状及客观…
英文摘要
BACKGROUND: Psychological and physical factors influence recovery after anterior cruciate ligament (ACL) reconstruction (ACLR). However, the relative contributions of psychological, subjective, and objective recovery measures to psychological readiness for return to sport remain unclear. OBJECTIVE: To identify psychological, subjective, and objective recovery factors associated with psychological readiness to return to sport approximately 6 months after ACLR. DESIGN: Cross-sectional study. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 58 participants (31 [53%] females; age = 18.95 ± 5.20 years), who completed standardized postoperative rehabilitation and follow-up testing at approximately 6 months after primary unilateral ACLR, were included. MAIN OUTCOME MEASURES: We measured psychological readiness using the ACL-Return to Sport after Injury (ACL-RSI) scale and conducted hierarchical regression analyses to examine predictors of psychological readiness across 4 conceptually ordered domains: (1) demographics (age, sex, and time since surgery), (2) generalized anxiety (Patient-Reported Outcomes Measurement Information System Anxiety Scale) and kinesiophobia (Tampa Scale for Kinesiophobia 11), (3) knee-specific patient-reported outcomes (Knee Injury and Osteoarthritis Outcomes Scale [KOOS] subscales of Pain, Symptoms, Quality of Life [QoL], and Sport), and (4) objective functional measures (quadriceps strength and single-legged hop symmetry). We conducted hierarchical linear regression in conceptually ordered blocks. RESULTS: Demographic factors explained minimal variance in psychological readiness (1%-4%). Generalized anxiety contributed an additional 18.1%, and kinesiophobia (Tampa Scale for Kinesiophobia 11, 22.3%), QoL (KOOS-QoL, 9.8%), and subjective sport function (KOOS-Sport, 5.3%) emerged as the strongest incremental predictors. Pain, symptoms, and objective function contributed little additional variance. The full model explained 70.5% of the variance in ACL-RSI scores (adjusted R 2 = 0.64, P < .001), and cross-validation produced a comparable R 2 (0.61), indicating good model generalizability and minimal overfitting. CONCLUSIONS: Fear-related beliefs and perceived function exerted stronger influences on psychological readiness after ACLR than objective functional symmetry. These findings highlight the importance of biopsychosocial assessment models and sport-specific psychological measures to enhance return-to-sport decision-making and long-term recovery outcomes.