Assessed Capacity − Demanded Competence (AC-DC Score): A Dynamic Gap-Oriented Assessment of Return-to-Sport Continuum and Application to Anterior Cruciate Ligament Injuries

A sport-related musculoskeletal injury carries substantial consequences. It is essential to individualize management of these injuries with a model optimizing goal-oriented rehabilitation. A major challenge is to link a patient’s goal for returning to sport with the restoration of performance assessed through the rehabilitation process. Even more challenging is that the demanded movement competence is a moving target based on the type of sport and level of competition the athlete seeks to return to. Currently, no single standardized test battery can elucidate a patient’s readiness to return to their desired sport at their desired level. We propose a clinical framework to link the assessed capacity (AC) of patients and the demanded competence (DC) of a sport/recreational activity to develop a readiness score (the AC-DC score). The AC-DC score provides a starting point for exploring the critical elements in the decision-making process surrounding the return-to-sport continuum.