{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:03:20Z","timestamp":1789391000994,"version":"build-2803163510"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sports Health: A Multidisciplinary Approach"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction (ACLR) depends on both physical performance and psychological readiness. Although functional tests and patient-reported outcome measures (PROMs) are used widely, the most sensitive and clinically relevant criteria for predicting safe RTS and reducing reinjury risk in elite athletes remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Absolute hop performance metrics, combined with psychological readiness scores, will more accurately discriminate reinjury risk than traditional limb symmetry index (LSI) thresholds in professional athletes after ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Prospective cohort with nested retrospective matched case-control design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level\u20092.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 127 professional athletes completed standardized testing (2021 to 2024) comprising 10 functional hop tests and 3 PROMs, including the ACL-RTS after Injury (ACL-RSI) scale. Reinjury outcomes were tracked for 3\u2009years. In the nested case-control analysis, 32 athletes with noncontact graft reinjury were matched with 32 injury-free ACLR controls. Between-group differences in hop performance, LSI, and PROM scores were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 10 hop tests, 7 showed significant side-to-side differences in absolute performance (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.01-0.04). LSI had limited discriminatory value, with only 1 significant result among female athletes (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.03). Strong and significant correlations were found between hop performance and ACL-RSI scores (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.43-0.73;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.05), indicating a substantial link between physical performance and psychological readiness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Absolute hop performance measures combined with PROMs are more sensitive than LSI in detecting elevated reinjury risk. The ACL-RSI scale may help determine readiness for high-demand functional testing and safe RTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Incorporating absolute hop performance metrics with psychological readiness assessment may improve RTS decision-making and reduce reinjury risk in elite athletes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19417381261480055","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:15:01Z","timestamp":1789125301000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional and Psychological Predictors of Return to Sport and Reinjury Risk in Professional Athletes After ACL Reconstruction"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7356-3064","authenticated-orcid":false,"given":"Mohammad","family":"Rahimi Khoygani","sequence":"first","affiliation":[{"name":"Departments of Experimental Medicine and Surgery, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6882-2612","authenticated-orcid":false,"given":"Hamed","family":"Esmaeili","sequence":"additional","affiliation":[{"name":"Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.12004"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513489284"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/19417381251334639"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4085\/JAT0042-20"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/19417381221146557"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2022.1089882"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.4324\/9780203771587"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2019.06.010"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.26603\/001c.21140"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738119886593"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738119846502"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12405"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/sms.13259"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-103677"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2023.11389"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-095908"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jisako.2024.100369"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2019.8190"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519825499"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2018.8041"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2021.01.030"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738117745806"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117745279"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2020.04.031"},{"key":"e_1_3_2_26_2","volume-title":"Foundations of Clinical Research: Applications to Practice","author":"Portney LG","year":"2002","unstructured":"Portney LG, Watkins MP. 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