Ecological and Specific Evidence-Based Safe Return To Play After Anterior Cruciate Ligament Reconstruction In Soccer Players: A New International Paradigm.
Florian Forelli, Nicolas Le Coroller, Maxime Gaspar and 7 others
PMID 37020454WHAT IT FOUND
Current return-to-play testing for soccer players after ACL reconstruction often misses ecological demands.
A proposed two-phase protocol combines standard clinical measures with field-based simulations of match intensity, fatigue, and dual-tasking to better predict safe readiness.
Key findings
01Standard assessments like isokinetic testing and hop tests are criticized for lacking specificity and ecological validity in predicting return-to-play risk.
02The proposed paradigm divides assessment into a clinical phase using standardized tools and a field phase using ecological, sport-specific simulations.
03Field assessment includes a 45-minute match simulation to evaluate acceleration, deceleration, and decision-making under fatigue and dual-task conditions.
STILL TO COME
What it means for PTs
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What it does not show
This is a narrative review proposing a new paradigm, not a study testing its efficacy or safety. The authors acknowledge that the proposed field simulation lacks high reproducibility and is not yet a validated 'test'. The protocol relies on specific equipment (e.g., robotic laximeters, force platforms, GPS) that may not be available in all clinical settings.
Declared interests
The authors declare that they have no competing interests.
The easy way to misread this
Do not treat this proposed assessment sequence as a validated protocol that guarantees safe return to play; it is a theoretical framework based on current limitations in existing tests, and its predictive accuracy has not been established by outcome data in this paper.