Abstract
Introduction:
The Anterior Cruciate Ligament–Return to Sport After Injury scale (ACL-RSI) measures athletes’ emotion, confidence, and risk appraisal when returning to sports after an anterior cruciate ligament (ACL) injury and/or ACL reconstruction (ACLR).
Objectives:
To assess the validity, reliability, and responsiveness of the Indonesian version of ACL-RSI scale for use in the Indonesian-speaking ACL population.
Material & Methods:
After a forward-and-backward translation procedure, validity and reliability of the (I-ACL-RSI were investigated. Patients who had undergone ACLR at a single hospital were asked to complete four questionnaires: the Indonesian version of the ACL-RSI (I-ACL-RSI), Injury–Psychological Readiness to Return to Sport scale, Tampa Scale of Kinesiophobia, and International Knee Documentation Committee Scale. After a two-week interval, patients were asked to complete the I-ACL-RSI a second time. Following COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) reporting guidelines, construct validity using hypothesis testing, test-retest reliability, internal consistency, floor and ceiling effects, and measurement error were determined. The Bland and Altman method was used to explore absolute agreement. The responsiveness was determined using the logistic regression-based method.
Results:
Of 200 eligible patients, 102 (51%) were included in the analysis. All predefined hypotheses on correlations between the I-ACL-RSI and the other questionnaires were confirmed, indicating good construct validity. An intraclass correlation coefficient (2-way random, type agreement) of 0.90 was found for the first and second I-ACL-RSI scores, indicating good test-retest reliability. A Cronbach α of .95 indicated good internal consistency, and no floor or ceiling effects were found. The standard error of measurement was 3.9, with the minimal detectable change calculated as 10.9 points at the individual level and 1.1 points at the group level. Responsiveness was considered good, especially at the group level.
Conclusion:
The ACL-RSI is a good evaluation instrument for Indonesian patients with anterior cruciate ligament injuries.