Validation of a short version of the Italian anterior cruciate ligament return to sport after injury (ACL-RSI) scale for psychological readiness in return to sport.

Abstract

Psychological readiness is increasingly recognized as a key factor in return-to-sport (RTS) outcomes after anterior cruciate ligament reconstruction (ACLR). This study investigates the divergent and predictive validity of the Italian short version of the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale compared to the original Italian, longer form. A total of 249 patients (174 male, 75 female) were assessed at 3, 6, and 12 months post-ACLR, using both the full and short Italian versions of the ACL-RSI to measure psychological readiness. Divergent validity was demonstrated by significantly lower scores in patients who did not RTS compared to those who did, with no significant differences between the short and full versions. Predictive validity analysis showed that scores at 3 and 6 months were excellent predictors of RTS at pre-injury or higher levels by 12 months. The Italian short version of the ACL-RSI demonstrated strong divergent and predictive validity, performing similarly to the full version. Predictive values at 3 and 6 months may help clinicians identify patients at risk of not returning to sport, supporting more tailored and psychologically informed rehabilitation strategies.