Psychological Readiness to Return to Sport Is Associated With Knee Kinematic Asymmetry During Gait Following Anterior Cruciate Ligament Reconstruction.

The study design was cross-sectional, so it cannot determine cause and effect. The ACL-RSI explained less than 10% of the variance in the two knee flexion angle outcomes. Groups were formed by ACL-RSI quartiles, and a different way of dividing the athletes could change the group findings. Only the LOW group's peak knee flexion difference exceeded the minimal clinically important difference of 3 degrees; the initial contact difference did not. All participants had already met return-to-running criteria and had a quadriceps strength index of at least 80%, so the findings may not apply to athletes earlier after surgery or with more weakness. Individual inter-limb differences beyond the minimal clinically important difference occurred in both directions, so group averages do not describe every athlete.

The authors reported no conflicts of interest.

Do not conclude that low psychological readiness causes asymmetric gait or that treating readiness will correct gait. The study is cross-sectional, and less than 10% of the knee flexion variance was linked to readiness scores.