Anterior Cruciate Ligament – Return to Sport after Injury (ACL-RSI)

Objective

The return to sport after anterior cruciate ligament (ACL) reconstruction requires optimal physical and psychological recovery. The Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale is a valuable tool for assessing this psychological dimension (1).

Interpretation

A high score indicates a positive psychological response (1).

Execution

This scale consists of 12 items and was developed from 3 components correlated with return to sport: emotions, confidence in performance, and risk appraisal (1).

Each question is rated on an 11-point numeric rating scale, where 0 corresponds to “not at all confident” and 10 corresponds to “fully confident.” A total score is calculated as follows: ACL-RSI score (total × 100) / 120 = .......%

Duration

Approximately 5 to 10 minutes.

Equipment

None.

Clinical Value

The ACL-RSI has been shown to be valid and reliable (1, 3).

Following ACL reconstruction, the psychological ACL-RSI score increases gradually over the course of follow-up and is strongly and significantly associated with a return to sport (2).

In their study, Sadeqi et al. (2018) observed that a high-level athlete who underwent primary reconstruction without postoperative complications and with an ACL-RSI score ≥ 60 at six months is significantly more likely to return to the same preinjury sport two years after surgery (2).

Acknowledgements

The ACL-RSI was developed by Kate E. Webster, J. A. Feller, and C. Lambros. We would like to thank Prof. Kate Webster and La Trobe University for allowing us to make the ACL-RSI available on Fullphysio.

1. Webster, Kate E., Julian A. Feller, and Christina Lambros. “Development and Preliminary Validation of a Scale to Measure the Psychological Impact of Returning to Sport Following Anterior Cruciate Ligament Reconstruction Surgery.” Physical Therapy in Sport 9, no. 1 (February 2008): 9–15. https://doi.org/10.1016/j.ptsp.2007.09.003.

2. Sadeqi, Mansour, Shahnaz Klouche, Yoann Bohu, Serge Herman, Nicolas Lefevre, and Antoine Gerometta. “Progression of the Psychological ACL-RSI Score and Return to Sport After Anterior Cruciate Ligament Reconstruction: A Prospective 2-Year Follow-up Study From the French Prospective Anterior Cruciate Ligament Reconstruction Cohort Study (FAST).” Orthopaedic Journal of Sports Medicine 6, no. 12 (December 17, 2018). https://doi.org/10.1177/2325967118812819.

3. Slagers, Anton J., Inge H. F. Reininga, and Inge van den Akker-Scheek. “The Dutch Language Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI) - Validity and Reliability.” Journal of Sports Sciences 35, no. 4 (February 2017): 393–401. https://doi.org/10.1080/02640414.2016.1167230.