ACL-RSI量表在内侧髌股韧带重建术后儿童及青少年患者中的验证
简介
一项针对32例MPFL重建术后儿童及青少年患者的验证研究显示，ACL-RSI量表（12条目及6条目简版）均可有效评估其重返运动的心理准备度，与IKDC/Pedi-IKDC及SANE评分呈中至强正相关，且信度优良，无天花板或地板效应。6条目简版量表问卷负担小、冗余度低，推荐用于MPFL重建术后年轻患者的心理评估。
英文摘要
BACKGROUND: The Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale assesses psychological readiness for return to sport (RTS) following anterior cruciate ligament reconstruction (ACLR). Although developed and validated in accordance with ACLR recovery, psychological responses may apply to those recovering from medial patellofemoral ligament reconstruction (MPFLR). PURPOSE: To validate the use of the ACL-RSI scale in pediatric and adolescent patients who underwent MPFLR. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: Scores of the 12-item and shortened 6-item ACL-RSI for patients who underwent their first RTS readiness assessment after MPFLR were analyzed. Statistical analysis was performed using Spearman correlation for convergent validity testing against the International Knee Documentation Committee (IKDC)/Pediatric (Pedi-)IKDC score, Single Assessment Numeric Evaluation (SANE) score, and peak strength symmetry of knee extension and flexion. Discriminant validity testing was performed comparing ACL-RSI with age (Spearman correlation), body mass index (BMI) (Spearman correlation), and sex (Mann-Whitney U tests). Internal consistency reliability was tested using Cronbach alpha. Floor and ceiling effect testing was performed by calculating the proportion of minimum and maximum scores in the cohort. RESULTS: A total of 32 patients (59% female; mean age, 15.6 ± 1.7 years) were included. Both 12-item and 6-item ACL-RSI scale versions demonstrated significant correlations of moderate to strong strength with the IKDC/Pedi-IKDC (R = 0.69 and R = 0.67, respectively; P < .001) and with the SANE score (R = 0.56 and R = 0.54, respectively; P = .002). Neither scale version was significantly correlated with peak strength symmetry of knee flexion or extension. Age, BMI, and sex were not significantly correlated with either scale. The 12-item ACL-RSI and 6-item short version demonstrated excellent internal reliability with a Cronbach alpha of .94 and .88, respectively, across individual items. No floor or ceiling effects were found with either scale as the minimum score, 0, was not observed and the maximum score, 100, was only observed twice in both versions (6%). CONCLUSION: The ACL-RSI scale may be valid for use in pediatric and adolescent patients who undergo MPFLR. Both the 12-item and the 6-item versions demonstrated convergent validity, discriminant validity, and internal reliability with no floor or ceiling effects. The 6-item scale version may be preferred, as it is able to quantify these vital psychological data but with minimal questionnaire burden and low redundancy.