{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:04:16Z","timestamp":1793714656455,"version":"4.6.1"},"reference-count":36,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T00:00:00Z","timestamp":1600214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Fear of Harm (FoH) predicts return to sports in Anterior Cruciate Ligament Reconstruction (ACLR) and can be assessed using the Photographic Sports Activities for ACLR (PHOSA-ACLR). This study was conducted to determine whether FoH assessed using the PHOSA-ACLR is a latent trait, and to analyze differences in PHOSA-ACLR in athletes with or without an ACL rupture. Methods: Three convenience samples completed the PHOSA-ACLR: (1) ACLR patients (n = 58; mean age 25.9 years; range 17\u201356; SD = 8.2; 43% male); (2) first year Physical Therapy (PT) students (n = 169; mean age = 19.2; SD = 2.0; 48% male), and (3) junior football players (n = 30; mean age = 18.3; range 17\u201320; SD = 3.2; 94% males). ACLR patients additionally reported functioning and Fear of Movement. PHOSA-ACLR items were analyzed with Item Response Theory using the Graded Response Model (GRM). Differences between three groups of participants were analyzed using Univariate Analysis of Variance. Results: Data fitted the two-parameter GRM, and therefore the items of the PHOSA-ACLR constitute a latent trait. There was a significant difference between the three groups in PHOSA-ACLR after controlling for age and gender (F (2, 255) = 17.1, p &lt; 0.001). PT students reported higher levels of FoH compared to either ACLR patients or healthy soccer players. Conclusions: PHOSA-ACLR items constitute a latent trait of FoH for ACLR-specific movements. Contrary to expectations, PHOSA-ACLR is higher in first year physiotherapy students compared to patients rehabilitating from ACLR, and healthy junior soccer players.<\/jats:p>","DOI":"10.3390\/ijerph17186764","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T20:44:13Z","timestamp":1600289053000},"page":"6764","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Is Fear of Harm (FoH) in Sports-Related Activities a Latent Trait? The Item Response Model Applied to the Photographic Series of Sports Activities for Anterior Cruciate Ligament Rupture (PHOSA-ACLR)"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6102-2997","authenticated-orcid":false,"given":"Wim van","family":"Lankveld","sequence":"first","affiliation":[{"name":"Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, 6503 GL Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4742-0163","authenticated-orcid":false,"given":"Ron J.","family":"Pat-El","sequence":"additional","affiliation":[{"name":"Department of Methods and Statistics, Open University of The Netherlands, 6401 DL Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-1453","authenticated-orcid":false,"given":"Nicky van","family":"Melick","sequence":"additional","affiliation":[{"name":"Knee Expert Center Company Eindhoven, 5624 EB Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9309-9940","authenticated-orcid":false,"given":"Robert van","family":"Cingel","sequence":"additional","affiliation":[{"name":"Radboud Institute for Health Sciences, IQ Healthcare, University Medical Center, 6500 HB Nijmegen, The Netherlands"},{"name":"Sport Medisch Centrum Company Papendal, 6816 VD Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0083-6380","authenticated-orcid":false,"given":"J. Bart","family":"Staal","sequence":"additional","affiliation":[{"name":"Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, 6503 GL Nijmegen, The Netherlands"},{"name":"Radboud Institute for Health Sciences, IQ Healthcare, University Medical Center, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","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. 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