The ALR-RSI score is a valid and reproducible scale to assess psychological readiness before returning to sport after modified Broström-Gould procedure

Abstract

Purpose Psychological readiness scores have been developed to optimize the return to play in many sports-related injuries. The purpose of this study was to statistically validate the ankle ligament reconstruction-return to sport injury (ALR-RSI) scale after modified Broström-Gould (MBG) procedure. Methods A similar version of the ACL-RSI scale with 12 items was adapted to quantify the psychological readiness to RTS after MBG and to describe construct validity, discriminant validity, feasibility, reliability and internal consistency of the scale, according to the COSMIN methodology. The term “knee” was replaced by “ankle”. The AOFAS and Karlsson scores were used as references patient-related outcome measurements (PROMs). Results A total of 71 patients were included. The ALR-RSI score after MBG procedure was highly (r > 0.5) correlated to the AOFAS and Karlsson scores, with a Pearson coefficient r = 0.69 [0.54–0.80] and 0.72 [0.53–0.82], respectively. The mean ALR-RSI score was significantly greater in the subgroup of 55 patients who resumed sports activity compared to those that no longer practiced sport: 61.9 (43.8–79.6) vs 43.4 (25.0–55.6), (p = 0.01). The test–retest showed an “excellent” reproducibility with a ρ intraclass correlation coefficient of 0.93 [0.86–0.96]. The Cronbach’s alpha statistic was 0.95, attesting an “excellent” internal consistency between the 12 ALR-RSI items. Conclusion The ALR-RSI score is a valid and reproducible tool for the assessment of psychological readiness to RTS after an MBG procedure for the management of CLAI, in a young and active population. The ALR-RSI score may help to identify and counsel athletes on their ability to return to sport. Level of evidence III.

The Ankle Ligament Reconstruction‐Return to Sport after Injury (ALR‐RSI) is a valid and reliable measure to assess psychological readiness before returning to sport following peroneal tendon pathology surgery

“…These findings indicated that the ALR-RSI score is a valid instrument that can assist physicians in assessing the psychological factors that may influence recovery following surgical management of peroneal tendon pathology in an active and sporting population. The results from prior studies [19,26] employing ALR-RSI to assess ankle instability patients were in line with the outcomes of the present study regarding correlation with PROMs, validity, internal consistency, reliability and discriminant capacity. Notably, this is the first paper that evaluates ALR-RSI in peroneal tendon pathology population.…”

“…The ALR-RSI was derived from the ACL-RSI and validated for ankle ligament reconstruction [26] and then for the modified Broström-Gould procedure [19]. It includes 12 items that pertain to performance confidence, risk assessment and emotions.…”

“…As a result, psychological assessment instruments have been developed in attempts to improve RTS rates and reduce the likelihood of surgical failure following sports-related injuries. Notably, the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale [22,35] and its adaptation to the ankle joint named as Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) showed high correlation with functional scores and a great reproducibility [19,26].…”

Which Functional Tests and Self-Reported Questionnaires Can Help Clinicians Make Valid Return to Sport Decisions in Patients With Chronic Ankle Instability? A Narrative Review and Expert Opinion

“…A highly significant difference was found between the subgroup of patients who successfully returned to sport and those who did not 3 years after ankle ligament reconstruction (68.8 vs. 45.0 respectively) (Sigonney et al, 2020). This scale is used increasingly frequently after surgery and was recently validated among individuals with CAI who underwent a modified Broström-Gould procedure (Pioger et al, 2022). Results showed higher scores (61.9) in patients who returned to sports compared to those who no longer practiced a sport (43.4) 2 years after repair.…”

Anatomic reconstruction using the autologous gracilis tendon achieved less sprain recurrence than the Broström-Gould procedure but delayed recovery in chronic lateral ankle instability

“…As the first‐line operative treatment of CLAI, anatomic lateral ankle ligament stabilisation using the modified Broström‐Gould (MBG) procedure has been proven to be reliable to achieve favourable outcomes in CLAI cases [31]. However, the reconstruction using tendon or other grafts was recommended for those with obesity, high sports demands and general joint laxity, especially when the remnant tissue was poor [7, 23, 26].…”