PRE-ACL SURGERY PSYCHOLOGICAL DISTRESS AND THE PSYCHOLOGICAL READINESS TO RETURN TO SPORT: THE MODERATION ROLE OF SOCIAL SUPPORT.

Author(s): MALLIA, L., GALLI, F., MARI, F., DI MAURO, I., DE MARIA, A., Institution: UNIVERSITY OF FORO ITALICO, Country: ITALY, Abstract-ID: 2207

Literature reported several empirical evidence among the pivotal role of the psychological factors in the athletes’ return to sport process after anterior cruciate ligament reconstruction (ACLR), with particular attention to the psychological readiness [1]. The present study explores the role of pre-surgery psychological distress on the future psychological readiness trying to understand the possible moderation effect of social support, also controlling for other important variables in this process, such as fear of movement, self-efficacy on knees function and knee perceived functionality.
Forty-one patients (mean age = 27.7±12.7 years; 80,5% male) who have undergone ACL reconstruction surgery with the same surgical staff were enrolled in the study.
Participants were asked to respond to a set of questionnaires before the ACL reconstruction surgery (i.e., Pre-Surgery Assessment) and after 30 days of the surgery (Post-Surgery Assessment).
Pre-Surgery assessment included: a) psychological distress, namely anxiety and depression (Hospital Anxiety and Depression Scale – HADS); b) perceived social support (Multidimensional Scale of Perceived Social Support- MSPSS). Post-Surgery assessment included: d) psychological readiness in terms of emotions, confidence in performance, and risk appraisal with respect to return to sport after ACL reconstruction (Return to Sport after Injury Scale-ACL– RSI); e) fear of movement, or (re)injury (Tampa Scale of Kinesiophobia - TSK); f) perceived self-efficacy of knee function after ACL injury (Knee Self-Efficacy Scale- KSES); g) symptoms, function, and sports activity (International Knee Documentation Committee -IKDC).
Separated partial correlations were carried out for the two groups (HIGH Vs. LOW perceived support group) connecting psychological distress (i.e., Anxiety and Depression) with the psychological readiness to return to sport statistically controlling for TSK, KSES and IKDC. The partial correlations showed that for patients perceiving relatively HIGH support the psychological distress is not significantly related to their psychological readiness to return to sport 30 days after the surgery (r=-.271; p=.349). Otherwise, analyzing data of patients perceiving relatively LOW support, clearly emerged that their psychological distress before the ACL surgery is strongly and statistically significantly negatively associated with the readiness to return to sport after the surgery (r=-.728; p=.011).
The study attested the moderation role of perceived social support that seems to buffer the negative impact of psychological distress on return to sport. Results suggested the importance to consider and care the patients’ psychological distress as early as in the first stages of the surgical treatment also fostering the social support around the patient.
1. Nwachukwu, B.U et al. (2019). Orthop J Sports Med, 22: (5):2325967119845313.