Anterior Cruciate Ligament-Return to Sport After Injury Scale: Reliability and Validity of the Persian Version

in Journal of Sport Rehabilitation

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Nahid PirayehMusculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran

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Farshid RazaviMusculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

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Amin BehdarvandanMusculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran

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Neda MostafaeeDepartment of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

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DOI:
https://doi.org/10.1123/jsr.2022-0107
Keywords:
ACL reconstruction; psychometric properties; psychological readiness
First Published Online:
23 Jan 2023
In Print:
Ahead of Print
Page Range:
1–7
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Background: The Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI) is used to measure athletes’ psychological readiness in terms of their emotions, confidence in performance, and risk appraisal with respect to return to sport after ACL reconstruction. Objective: To translate and cross-culturally adapt the ACL-RSI to the Persian version and evaluate the reliability and validity of this scale in patients with ACL reconstruction. Study Design: Clinical measurement study (psychometric analysis). Methods: To assess test–retest reliability, 100 participants were asked to complete the Persian version of the ACL-RSI 2 times with a 7- to 10-day interval. In the first assessment, the patients also filled the Injury-Psychological Readiness to Return to Sport Questionnaire, Tampa Scale of Kinesiophobia, International Knee Documentation Committee Subjective Knee Form, and Knee Injury and Osteoarthritis Outcome Score. Internal consistency (Cronbach alpha, α), test–retest reliability (intraclass correlation coefficients), measurement error (standard error of measurement and minimum detectable change), and construct validity (Pearson r) were determined. Results: Our results showed good internal consistency (Cronbach alpha = .94) and excellent test–retest reliability (intraclass correlation coefficients = .90 (.85−.93)]. Standard error of measurement and minimum detectable change were 4.64 and 12.85, respectively. No significant bias was observed between test and retest. In addition, based on the results of correlation analysis, all hypotheses of this study were confirmed. The Persian version of the ACL-RSI had a strong correlation with Injury-Psychological Readiness to Return to Sport (I-PPR) (P < .001, r = .76) and Tampa scale of Kinesiophobia (TKS) (P < .001, r = −.68). Furthermore, a moderate correlation was observed between the Persian version of the ACL-RSI and the International Knee Documentation Committee Subjective Knee Form (P < .001, r = .44) and between this version of the ACL-RSI and the subscales of Knee Injury and Osteoarthritis Outcome Score (P < .001, r = .30–.55). Conclusion: Given its acceptable reliability and validity, the Persian version of the ACL-RSI seems to be a suitable tool for evaluating psychological readiness to return to sport after ACL reconstruction.

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  • 1.

    Sanders TL, Maradit Kremers H, Bryan AJ, et al. Incidence of anterior cruciate ligament tears and reconstruction: a 21-year population-based study. Am J Sports Med. 2016;44(6):1502–1507. PubMed ID: 26920430 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Ardern CL, Taylor NF, Feller JA, Webster KE. A systematic review of the psychological factors associated with returning to sport following injury. Br J Sports Med. 2013;47(17):1120–1126. PubMed ID: 23064083 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Ivarsson A, Tranaeus U, Johnson U, Stenling A. Negative psychological responses of injury and rehabilitation adherence effects on return to play in competitive athletes: a systematic review and meta-analysis. Open Access J Sports Med. 2017;8:27–32. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Tripp DA, Stanish W, Ebel-Lam A, Brewer BW, Birchard J. Fear of reinjury, negative affect, and catastrophizing predicting return to sport in recreational athletes with anterior cruciate ligament injuries at 1 year postsurgery. Sport Exerc Perform Psychol. 2011;1(S):38–48. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Webster KE, Feller JA, Lambros C. Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery. Phys Ther Sport. 2008;9(1):9–15. PubMed ID: 19083699 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Knapik A, Saulicz E, Gnat R. Kinesiophobia—Introducing a new diagnostic tool. J Hum Kinet. 2011;28(2011):25–31. doi:

  • 7.

    Kvist J, Ek A, Sporrstedt K, Good L. Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2005;13(5):393–397. PubMed ID: 15703963 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Gobbi A, Francisco R. Factors affecting return to sports after anterior cruciate ligament reconstruction with patellar tendon and hamstring graft: a prospective clinical investigation. Knee Surg Sports Traumatol Arthrosc. 2006;14(10):1021–1028. PubMed ID: 16496124 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Morrey MA, Stuart MJ, Smith AM, Wiese-Bjornstal DM. A longitudinal examination of athletes’ emotional and cognitive responses to anterior cruciate ligament injury. Clin J Sport Med. 1999;9(2):63–69. PubMed ID: 10442619 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Thomeé P, Währborg P, Börjesson M, Thomeé R, Eriksson BI, Karlsson J. A new instrument for measuring self-efficacy in patients with an anterior cruciate ligament injury. Scand J Med Sci Sports. 2006;16(3):181–187. PubMed ID: 16643196 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Glazer DD. Development and preliminary validation of the injury-psychological readiness to return to sport (I-PRRS) scale. J Athl Train. 2009;44(2):185–189. PubMed ID: 19295964 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Terwee CB, Bot SD, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. Clin Epidemiol. 2007;60(1):34–42. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Valovich McLeod TC, Snyder AR, Parsons JT, Curtis Bay R, Michener LA, Sauers EL. Using disablement models and clinical outcomes assessment to enable evidence-based athletic training practice, part II: clinical outcomes assessment. J Athl Train. 2008;43(4):437–445. PubMed ID: 18668177 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Bohu Y, Klouche S, Lefevre N, Webster K, Herman S. Translation, cross-cultural adaptation and validation of the French version of the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale. Knee Surg Sports Traumatol Arthrosc. 2015;23(4):1192–1196. PubMed ID: 24676789 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Faleide AGH, Inderhaug E, Vervaat W, et al. Anterior cruciate ligament-return to sport after injury scale: validation of the Norwegian language version. Knee Surg Sports Traumatol Arthrosc. 2020;28(8):2634–2643. PubMed ID: 32062685 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Ha JK, Kim JG, Yoon KH, et al. Korean version of the anterior cruciate ligament-return to sport after injury scale: translation and cross-cultural adaptation. Clin Orthop Surg. 2019;11(2):164–169. PubMed ID: 31156767 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Harput G, Tok D, Ulusoy B, et al. Translation and cross-cultural adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Turkish. Knee Surg Sports Traumatol Arthrosc. 2017;25(1):159–164. PubMed ID: 27539403 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Kvist J, Österberg A, Gauffin H, Tagesson S, Webster K, Ardern C. Translation and measurement properties of the Swedish version of ACL-return to sports after injury questionnaire. Scand J Med Sci Sports. 2013;23(5):568–575. PubMed ID: 22257241 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Silva LO, Mendes LMR, Lima POP, Almeida GPL. Translation, cross-adaptation and measurement properties of the Brazilian version of the ACL-RSI Scale and ACL-QoL questionnaire in patients with anterior cruciate ligament reconstruction. Braz J Phys Ther. 2018;22(2):127–134. PubMed ID: 28941959 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Slagers AJ, Reininga IH, van den Akker-Scheek I. The Dutch language anterior cruciate ligament return to sport after injury scale (ACL-RSI)—Validity and reliability. J Sports Sci. 2017;35(4):393–401. PubMed ID: 27079625 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. Clin Epidemiol. 2010;63(7):737–745. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–3191. PubMed ID: 11124735 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Jia ZY, Cui J, Wang W, et al. Translation and validation of the simplified Chinese version of the anterior cruciate ligament-return to sport after injury (ACL-RSI). Knee Surg Sports Traumatol Arthrosc. 2018;26(10):2997–3003. PubMed ID: 29404654 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Naghdi S, Nakhostin Ansari N, Farhadi Y, Ebadi S, Entezary E, Glazer D. Cross-cultural adaptation and validation of the injury-psychological readiness to return to sport scale to Persian language. Physiother Theory Pract. 2016;32(7):528–535. PubMed ID: 27618418 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Jafari H, Ebrahimi I, Salavati M, Kamali M, Fata L. Psychometric properties of Iranian version of Tampa scale for kinesiophobia in low back pain patients. J Rehab. 2010;11(1):15–22.

    • Search Google Scholar
    • Export Citation
  • 26.

    Irrgang JJ, Anderson AF, Boland AL, et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med. 2001;29(5):600–613. PubMed ID: 11573919 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Rahimi A, Nowrouzi A, Sohani SM. The validity and reliability of the Persian version of the international knee documentation committee (IKDC) questionnaire in Iranian patients after ACL and meniscal surgeries. J Rehab. 2013;14(2):116–124.

    • Search Google Scholar
    • Export Citation
  • 28.

    Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee injury and osteoarthritis outcome score (KOOS)—Development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88–96. PubMed ID: 9699158 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Salavati M, Mazaheri M, Negahban H, et al. Validation of a Persian-version of knee injury and osteoarthritis outcome score (KOOS) in Iranians with knee injuries. Osteoarthritis Cartilage. 2008;16(10):1178–1182. PubMed ID: 18411065 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Bland JM, Altman DG. A note on the use of the intraclass correlation coefficient in the evaluation of agreement between two methods of measurement. Comput Biol Med. 1990;20(5):337–340. PubMed ID: 2257734 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
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