{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T17:58:52Z","timestamp":1780855132426,"version":"3.54.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","funder":[{"name":"2024 Faculty Development Grant from The University of Scranton"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The success of anterior cruciate ligament reconstruction (ACLR) is influenced by factors such as time since surgery, psychological readiness, neuromuscular asymmetries, and ACLR graft type. The purpose of this study was to examine differences in psychological readiness and quadriceps strength symmetry after ACLR based on graft type in military academy cadets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This was a cross-sectional cohort study. Participants were included if they had a history of a unilateral ACLR within 10-24 months and were cleared by a medical provider to perform jump, hop, and strength testing. The Anterior Cruciate Ligament\u2014Return to Sport after Injury scale (ACL-RSI) assessed psychological readiness. Quadriceps peak torque limb symmetry index (QuadPT LSI) assessed neuromuscular asymmetry. Independent t-tests determined differences in ACL-RSI scores and QuadPT LSI based on graft type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 22 participants with a bone-patellar tendon-bone (BPTB) graft and 26 participants with quadriceps tendon (QT) graft. Participants with BPTB grafts had significantly greater ACL-RSI scores than those with QT grafts (t\u2009=\u20092.39, P = .02; mean difference 13.7 [95% CI, 2.1-25.3]). Participants with BPTB grafts also had significantly greater QuadPT LSI than those with QT grafts (t\u2009=\u20093.04, P &amp;lt; .01; mean difference 19.0% [95% CI, 6.4-31.6]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Military academy cadets who had an ACLR using a QT graft demonstrated lower psychological readiness and quadriceps strength symmetry compared to those with a BPTB graft and were less likely to meet strength symmetry criteria upon return to sport and duty. Rehabilitation professionals may consider closer monitoring of quadriceps strength for patients with QT grafts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag259","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:43:28Z","timestamp":1779277408000},"source":"Crossref","is-referenced-by-count":0,"title":["Differences in Psychological Readiness and Quadriceps Strength Symmetry Based on Anterior Cruciate Ligament Reconstruction Graft Type in Military Academy Cadets"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-0380","authenticated-orcid":false,"given":"Michael S","family":"Crowell","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, The University of Scranton , Scranton, PA 18510,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Pittsburgh , Pittsburgh, PA 15260,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin M","family":"Florkiewicz","sequence":"additional","affiliation":[{"name":"PhD in Health Sciences, Rocky Mountain University of Health Professions , Provo, UT 84606,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kuwik","sequence":"additional","affiliation":[{"name":"Army\u2014Baylor University Doctoral Program in Physical Therapy , Fort Sam Houston, TX 78234,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Borawski","sequence":"additional","affiliation":[{"name":"1st Special Operations Wing , Hurlburt Field, FL 32544,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie B","family":"Morris","sequence":"additional","affiliation":[{"name":"Baylor University\u2014Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship , West Point, NY 10996,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"2026060713171955200_usag259-B1","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1177\/0363546516629944","article-title":"Incidence of anterior cruciate ligament tears and reconstruction: a 21-year population-based study","volume":"44","author":"Sanders","year":"2016","journal-title":"Am J Sports Med"},{"key":"2026060713171955200_usag259-B2","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1249\/MSS.0000000000002246","article-title":"Return to sport tests\u2019 prognostic value for reinjury risk after anterior cruciate ligament reconstruction: a systematic review","volume":"52","author":"Ashigbi","year":"2020","journal-title":"Med Sci Sports Exerc"},{"key":"2026060713171955200_usag259-B3","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1177\/1941738120912846","article-title":"One in 5 athletes sustain reinjury upon return to high-risk sports after ACL reconstruction: a systematic review in 1239 athletes younger than 20 years","volume":"12","author":"Barber-Westin","year":"2020","journal-title":"Sports Health"},{"key":"2026060713171955200_usag259-B4","doi-asserted-by":"publisher","first-page":"e83","DOI":"10.1093\/milmed\/usx007","article-title":"Return to military duty after anterior cruciate ligament reconstruction","volume":"183","author":"Antosh","year":"2018","journal-title":"Mil Med"},{"key":"2026060713171955200_usag259-B5","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1007\/s40279-019-01093-x","article-title":"What is the evidence for and validity of return-to-sport testing after anterior cruciate ligament reconstruction surgery? 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