An Examination of the Relationship Between Fear of Reinjury and Neuromuscular, Musculoskeletal, and Biomechanical Characteristics at the Time of Return to Sport following Anterior Cruciate Ligament Reconstruction.

Small sample: 27 people, 8 of them in the lower-fear group, and only 16 with usable biomechanical data. No a priori power analysis was done; the authors state the analyses are likely underpowered and the stop jump results should be treated as exploratory. Cross-sectional design, so it can only show that things occur together, not that fear causes poorer function or the reverse. Only athletes already cleared to return to sport took part. Athletes with substantial fear may never have returned and so are missing, which the authors say may explain the lack of differences. No TSK-11 scores were collected before the ACL injury, so it is not known whether fear was already present. No other psychological measures or patient-reported outcomes were collected, so other factors influencing these results were not examined. Testing happened on a single day, with no follow-up to see how scores or function changed. The cut-off used to define 'high' fear is not universally accepted, and the 'high' group's average score sits below thresholds other studies use for clinically meaningful kinesiophobia.

The authors state they have no conflicts of interest to report. The supplied text does not say who funded the study.

Do not read the higher-fear group as genuinely fearful. Their average TSK-11 score of 21.68 falls below the cutoffs of 25 and 36 used in other studies, so this was a comparison of relative levels within a cohort that was mostly not very fearful. Do not treat the knee valgus angle difference as established either: it came from just 16 people, and the authors themselves describe the biomechanical analysis as exploratory and underpowered.