Associations of Resilience and Social Support with Physical Readiness to Return to Sport and Kinesiophobia after Anterior Cruciate Ligament Reconstruction

Prior to clearance to return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR), a series of assessments are often used to determine physical and psychological readiness. However, limited research has examined how favorable psychosocial factors, such as resilience and social support, may affect RTS testing performance. The primary purpose of this study was to examine associations between resilience and social support and quadriceps strength and single-leg hop test outcomes after ACLR. The secondary purpose of this study was to assess associations between these factors and kinesiophobia. Patients post-ACLR completed the Brief Resilience Scale (BRS), Multidimensional Scale of Perceived Social Support (MSPSS), and Tampa Scale of Kinesiophobia-11 (TSK-11), and underwent isokinetic strength and single-leg hop testing. Partial correlations controlling for time since surgery (TSS) assessed associations between resilience and social support scores and Limb Symmetry Indexes (LSIs), and Pearson correlations examined associations with kinesiophobia. A moderate positive association was identified between MSPSS score and single-leg hop LSI (r=0.4805, p=0.05). No significant associations were observed between MSPSS score and strength LSI or between BRS scores and LSIs on either test. Moderate negative associations were identified between BRS and TSK-11 scores (r=-0.63, p=0.001) and MSPSS and TSK-11 scores (r=-0.47, p=0.010). Overall, resilience and social support showed limited associations with physical readiness to RTS but were significantly associated with lower kinesiophobia. Therefore, enhancing these favorable psychosocial factors may contribute to improved outcomes and higher RTS rates after ACLR, given the established relationship between lower kinesiophobia and these improved outcomes.