Background:

Literature is scarce regarding the influence of psychological readiness on return to sports after shoulder instability surgery.

Purpose:

To evaluate the predictive ability of the Shoulder Instability–Return to Sport after Injury (SIRSI) score in measuring the effect of psychological readiness on return to sports and to compare it between athletes who returned to sports and athletes who did not return to sports.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A prospective analysis was performed of patients who underwent an arthroscopic Bankart repair or a Latarjet procedure between January 2019 and September 2020. Psychological readiness to return to play was evaluated using the SIRSI instrument. Preoperative and postoperative functional outcomes were measured by the Rowe, Athletic Shoulder Outcome Scoring System, and Western Ontario Shoulder Instability Index scores. The predictive validity of the SIRSI was assessed by the use of receiver operating characteristic (ROC) curve statistics. The Youden index was calculated and used to determine a SIRSI score cutoff point that best discriminated psychological readiness to return to sports. A logistic regression analysis was performed to evaluate the effect of psychological readiness on return to sports and return to preinjury sports level.

Results:

A total of 104 patients were included in this study. Overall, 79% returned to sports. The SIRSI had excellent predictive ability for return-to-sport outcomes (return to sports: area under ROC curve, 0.87 [95% CI, 0.80-0.93]; return to preinjury sports level: area under ROC curve, 0.96; [95% CI, 0.8-0.9]). A cutoff level of ≥55 was used to determine whether an athlete was psychologically ready to return to sports and to return to preinjury sports level (Youden index, 0.7 and 0.9, respectively). Of those who returned to sports, 76.8% were psychologically ready to return to play, with a median SIRSI score of 65 (interquartile range, 57-80). In comparison, in the group that did not return to sports, only 4.5% achieved psychological readiness with a median SIRSI score of 38.5 (interquartile range, 35-41) (P < .001). Regression analysis for the effect of SIRSI score on return to sports was performed. For every 10-point increase in the SIRSI score, the odds of returning to sports increased by 2.9 times. Moreover, those who did not achieve their preinjury sports level showed poorer psychological readiness to return to play and SIRSI score results.

Conclusion:

The SIRSI was a useful tool for predicting whether patients were psychologically ready to return to sports after glenohumeral stabilization surgery. Patients who returned to sports and those who returned to their preinjury sports level were significantly more psychologically ready than those who did not return. Therefore, we believe that the SIRSI score should be considered along with other criteria that are used to decide whether the patient is ready to return to sports.

中文翻译：

---

SIRSI评分与盂肱关节不稳手术稳定后恢复运动的关系

背景：

关于心理准备对肩部不稳定手术后恢复运动的影响的文献很少。

目的：

评估肩部不稳-受伤后重返运动 (SIRSI) 评分在衡量心理准备对重返运动的影响方面的预测能力，并在重返运动的运动员和未重返运动的运动员之间进行比较。

学习规划：

队列研究；证据水平，2。

方法：

对 2019 年 1 月至 2020 年 9 月期间接受关节镜 Bankart 修复或 Latarjet 手术的患者进行前瞻性分析。使用 SIRSI 仪器评估重返赛场的心理准备情况。术前和术后功能结果通过 Rowe、运动肩部结果评分系统和西安大略肩部不稳定性指数评分来衡量。SIRSI 的预测有效性通过使用受试者工作特征 (ROC) 曲线统计来评估。计算了约登指数并用于确定最能区分重返运动的心理准备情况的 SIRSI 分数截止点。进行逻辑回归分析以评估心理准备对恢复运动和恢复到伤前运动水平的影响。

结果：

本研究共纳入 104 名患者。总体而言，79% 的人重返体育运动。SIRSI 对恢复运动结果具有出色的预测能力（恢复运动：ROC 曲线下面积，0.87 [95% CI，0.80-0.93]；恢复到伤前运动水平：ROC 曲线下面积，0.96；[95% CI，0.8-0.9]）。≥55 的临界值用于确定运动员是否在心理上准备好重返运动和恢复到受伤前的运动水平（约登指数分别为 0.7 和 0.9）。在重返运动场的人中，76.8% 的人在心理上做好重返赛场的准备，SIRSI 得分中位数为 65（四分位距，57-80）。相比之下，在没有重返运动的那组中，只有 4.5% 的人达到了心理准备状态，SIRSI 得分中位数为 38.5（四分位距，35-41）（P< .001)。对SIRSI评分对恢复运动的影响进行回归分析。SIRSI分数每增加10分，重返运动的几率增加2.9倍。此外，那些没有达到伤前运动水平的人表现出较差的重返赛场的心理准备和SIRSI评分结果。

结论：

SIRSI 是一种有用的工具，可用于预测患者在盂肱关节稳定手术后是否在心理上做好重返运动的准备。恢复运动的患者和恢复到受伤前运动水平的患者比没有恢复的患者在心理上准备得更好。因此，我们认为 SIRSI 评分应与用于决定患者是否准备好重返运动的其他标准一起考虑。