Background:Recent studies have investigated the effect of psychological factors on return to sport (RTS), but none has tested the existence of psychological profiles linked to reinjury anxiety and its links with RTS and reinjury.Purpose:To assess the effect of different psychological profiles on RTS and reinjury.Study Design:Cohort study; Level of evidence, 2.Methods:The study screened patients who were involved in all types of sports for anterior cruciate ligament (ACL) reconstruction (hamstring and patellar tendon autografts). All participants were included during the RTS phase (90-180 days after ACL reconstruction). Reinjury anxiety, fear of reinjury, kinesiophobia, perceived stress, anxiety, depression, knee confidence, self-esteem, optimism, coping, and pain were measured. Hierarchical cluster analysis (Ward method) and analysis of variance were performed. In the second year after surgery, patients were recontacted by telephone to follow-up. RTS and reinjury were compared by profile type.Results:A total of 162 athletes were initially included, of whom 123 responded regarding RTS and reinjury. Cluster analysis showed a 4-cluster solution (χ2[21] = 428.59; λ = .064; P < .001). Profile 1 (27.8%) was characterized by moderate reinjury anxiety and no depression. Profile 2 (22.8%) was characterized by moderate reinjury anxiety and minor anxious-depressive reaction. Profile 3 (30.9%) was characterized by no reinjury anxiety, no depression, and high confidence. Profile 4 (18.5%) was characterized by high anxiety, high depression, and low confidence. Profile 4 had the lowest self-esteem and optimism scores compared with profile 3 ( P < .001). In addition, a higher percentage of men was found in profile 3 as opposed to profile 4 (χ2[3] = 11.35; P < .01). Profile 4 had the highest rate of non-RTS with 54.2% (profile 1: 14.3%, P = .001; profile 2: 25.0%, P = .031; profile 3: 22.2%, P = .011). Finally, patients with profile 3 had a higher risk of reinjury (13.9%) than those with profile 4 (0%) ( P = .047), who had an extremely conservative RTS.Conclusion:The different profiles will affect RTS, but also the risk of reinjury exclusively for profiles 3 and 4. Rehabilitation management will probably require all stakeholders to understand psychological profiles of athletes to develop an on-demand rehabilitation plan.

中文翻译：

---

前十字韧带重建后的再伤焦虑和重返运动：162 名运动员的聚类分析和前瞻性研究


背景：最近的研究调查了心理因素对重返运动（RTS）的影响，但没有测试与再受伤焦虑相关的心理特征的存在及其与 RTS 和再伤害的联系。目的：评估不同心理特征的影响研究设计：队列研究；证据级别，2。方法：该研究筛选了参与各种类型运动的患者进行前交叉韧带（ACL）重建（腿筋和髌腱自体移植）。所有参与者均参与 RTS 阶段（ACL 重建后 90-180 天）。测量了再次受伤的焦虑、对再次受伤的恐惧、运动恐惧症、感知压力、焦虑、抑郁、膝盖信心、自尊、乐观、应对和疼痛。进行层次聚类分析（Ward 方法）和方差分析。术后第二年，通过电话再次联系患者进行随访。按概况类型比较 RTS 和再损伤。结果：最初纳入了 162 名运动员，其中 123 人对 RTS 和再损伤做出了回应。聚类分析显示 4 聚类解 (χ 2 [21] = 428.59； λ = .064； P < .001)。情况 1 (27.8%) 的特点是中度再受伤焦虑，无抑郁。情况2（22.8%）的特点是中度的再受伤焦虑和轻微的焦虑抑郁反应。第 3 类（30.9%）的特点是没有再受伤焦虑、没有抑郁和高自信心。第 4 类（18.5%）的特点是高度焦虑、高度抑郁和低自信。与档案 3 相比，档案 4 的自尊和乐观得分最低 (P < .001)。 此外，与概况 4 相比，概况 3 中男性的比例更高（χ 2 [3] = 11.35； P < .01)。配置文件 4 的非 RTS 率最高，为 54.2%（配置文件 1：14.3%，P = .001；配置文件 2：25.0%，P = .031；配置文件 3：22.2%，P = .011）。最后，轮廓 3 的患者再次受伤的风险 (13.9%) 高于轮廓 4 的患者 (0%) (P = .047)，后者的 RTS 极其保守。结论：不同的轮廓会影响 RTS，但也会影响 RTS。再次受伤的风险仅适用于情况 3 和 4。康复管理可能需要所有利益相关者了解运动员的心理状况，以制定按需康复计划。