The Influence of Strength and Sport Exposure on Psychological Readiness After ACL Reconstruction.

BACKGROUND: Among young athletes returning to sport after anterior cruciate ligament reconstruction (ACLR), the extent to which psychological readiness is influenced by factors beyond the psychological domain is largely unknown. HYPOTHESIS: Young athletes with recent sport exposure and higher quadriceps strength will demonstrate higher psychological readiness within 8 weeks of medical clearance to return to sport (RTS) after ACLR. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 38 young athletes after primary ACLR completed testing within 8 weeks of medical clearance to RTS. All participants completed isometric knee extension strength testing, in addition to the ACL Return to Sport after Injury (ACL-RSI) questionnaire. Athletes who participated in sport between time of medical clearance to RTS and date of study enrollment were categorized as SPORT-YES. Those who had not yet participated in sports were categorized as SPORT-NO. Multiple linear regression analyses were used to determine differences in ACL-RSI scores based on quadriceps strength and sport exposure status, while adjusting for age and sex. RESULTS: Of the 38 participants, 20 (52.6%) were categorized as SPORT-YES. The regression model estimating overall ACL-RSI score (P < 0.01, adjusted R2 = 0.389) included significant independent contributions from age, sex, and sport exposure variables (age: P = 0.01, ß [95% CI] = -2.01 [-3.54, -0.48]; sex (male): P = 0.02, ß [95% CI] = 12.50 [2.36, 22.64]; strength: P = 0.51, ß [95% CI] = -2.47 [-10.07,5.13]; sport exposure: P < 0.01, ß [95% CI] = 12.89 [3.58, 22.19]). CONCLUSION: In partial accordance with our hypothesis, recent sport exposure was significantly associated with higher ACL-RSI scores among young athletes in the weeks after medical clearance to RTS after ACLR, while quadriceps strength was not. CLINICAL RELEVANCE: Future prospective work is needed to determine the existence and direction of causal relationships between exposure to sport environment and psychological readiness among young athletes after ACLR.

The Association of Physical Competence With Psychological Response Among Young Athletes at Time of Return to Sport After ACL Reconstruction.

BACKGROUND: The traditional index of return-to-sport (RTS) readiness after anterior cruciate ligament reconstruction (ACLR) is the achievement of physical competence criteria. Emerging research indicates that psychological response and self-perceptions of physical competence may be critical mechanisms for successful RTS among young athletes. HYPOTHESIS: Young athletes with higher actual physical competence (APC) and perceived physical competence (PPC) will demonstrate a more positive psychological response at the time of RTS after ACLR. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 41 young athletes after primary ACLR completed testing within 8 weeks of medical clearance to RTS. APC was measured with isokinetic knee extension strength, single-limb crossover hop for distance, and the Knee injury and Osteoarthritis Outcome Score. PPC was measured with the Athletic Competence subscale of the Self-Perception Profile. Criteria for APC and PPC were based on established age- and activity-relevant cutoff scores. Different constructs of psychological response were assessed with the adapted Sport Motivation Scale, Brief Resilience Scale, and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) total and subscale scores (Emotions, Confidence, and Risk Appraisal). Multiple linear regression analyses were used to determine differences in measures of psychological response based on achievement of APC and PPC, while adjusting for age and sex. RESULTS: Of the 41 participants, 10 (24.4%) met all criteria for APC and 22 (53.7%) met the PPC criteria. The regression models estimating the ACL-RSI score (P < .001; adjusted R2 = 0.331), ACL-RSI Emotions score (P < .001; adjusted R2 = 0.427), and ACL-RSI Risk Appraisal score (P = .013; adjusted R2 = 0.212) were statistically significant. Although APC was not associated with any measure of psychological response, meeting PPC criteria, younger age, and male sex were found to be associated with a more positive psychological readiness to RTS, but not with motivation or resilience. CONCLUSION: Meeting PPC criteria was associated with higher psychological readiness to RTS among young athletes after ACLR, while meeting APC criteria was not associated with any construct of psychological response.

Investigating the Social Network Structure of Physical Literacy Scholars to Advance a Paradigm for Physical Activity Promotion.

Purpose: Physical literacy has quickly gained global attention as a holistic approach to combat physical inactivity and obesity. However, research silos may limit the growth and application of the physical literacy paradigm for effective physical activity promotion. The purpose of this study was to measure the underlying network structure of scholars publishing on physical literacy (focusing on empirical research) through co-authorship analysis. Methods: Data collection resulted in 1,070 documents related to physical literacy retrieved. A total of 198 articles met inclusion criteria and were included in the full network, with authors operationalized as actors in the network. A total of 75 empirical studies were included in the sub-network for critical appraisal and further analysis. Social network analysis was then conducted at the macro- and component-level, using quantification and visualization techniques. Results: Results revealed a collaborative, yet fragmented physical literacy network with sub-groups representing substantive and geographically diverse scholars. The majority of scholarship lacked empirical evidence, suggesting a research-practice gap. Conclusion: Recommendations for advancing physical literacy research and practice include strategic collaborations that transcend geographic and disciplinary boundaries, cooperative efforts across scholars and practitioners, and productive discourse through professional avenues to progress knowledge generation, dispersion, and application.