The relationship between perceived social support and psychological factors related to returning to sport in adolescents following anterior cruciate ligament reconstruction

Purpose “Return-to-sport” (RTS) criteria following anterior cruciate ligament (ACL) reconstruction lacks standardization. In addition to functional strength and knee joint stability, psychological factors may also affect readiness to RTS. The present study aimed to assess the association between perceived levels of social support and confidence in RTS among adolescent athletes prior to undergoing ACL reconstruction. We hypothesized that youth athletes who perceived higher levels of social support would have greater confidence in ultimate ability to return to previous level of play after ACL reconstruction. Methods Fifty-three subjects completed two questionnaires prior to undergoing ACL reconstruction: the Multidimensional Scale of Perceived Social Support (MSPSS) and a psycho-vitality (PV) questionnaire. We performed a multiple linear regression to assess if MSPSS score was associated with confidence in returning to sport (PV score), while controlling for the independent effects of age and gender. Independent sample t-tests were also used to compare MSPSS scores between those who did and did not state that they had doubts in their ability to RTS and those who were and were not willing to settle for a less strenuous sporting activity than previously, based on the PV questionnaire responses. Results The mean participant age was 15.6±1.7 years (range 9-18 years) with 42% males. There was no significant association between total scores of MSPSS (mean= 6.22±0.375, range= 4-7) and PV (mean= 13.8±3.0, range= 8-18; β coefficient= -0.63, 95% CI= -1.77, 0.52, p = 0.28). Those who reported RTS doubts did not significantly differ than those who reported no doubts (n=19) in MSPSS total score (6.07±0.82 vs. 6.30±0.70; p = 0.29; Cohen’s d= 0.31). Similarly, those who did and did not respond that they were willing to settle for a less strenuous sporting activity had similar MSPSS scores (6.14±0.81 vs. 6.47±0.45; p= 0.17; Cohen’s d= 0.44). Conclusion The data suggest that prior to ACL reconstruction, perceived social support does not significantly influence confidence in ability to ultimately RTS following surgery and subsequent rehabilitation in adolescent athletes. Significance Previous studies suggest that psychological factors play a role in successful RTS, yet the specifics of how this pertains to adolescent athletes remain unknown. The present study indicates that perceived social support may not significantly influence an adolescent athlete’s confidence to RTS. Future studies will aim to correlate these variables between pre-operative and actual RTS time points, and investigate how other factors, such as motivation and self-esteem, are influenced by social support and affect ultimate RTS success. I'm