Abstract：
Ankle injuries account for 15% to 25% of all sports injuries resulting in significant pain and loss of function. The purpose of this cross-sectional study was to validate a scale to help surgeons quantify the psychological readiness to Return To Sport (RTS) in patients undergoing ankle fracture surgery. ALR-RSI was used to assess the psychological readiness for RTS in athletic patients who underwent ankle fracture fixation between January 2020 and January 2021. Participants filled out ALR-RSI and 2 Patient-Related Outcome Measurement (PROM) tools: Olerud-Molander Ankle Score (OMAS) and Self-Reported Foot and Ankle Score (SEFAS). A total of 93 patients were included. There was a strong correlation between ALR-RSI and both OMAS and SEFAS, with Pearson coefficients of r = 0.58 and 0.53, respectively. ALR-RSI was significantly higher in the RTS group than in those who no longer practiced their main preinjury sport. Moreover, the discriminant validity of ALR-RSI (AUC = 0.81) was better than that of the SEFAS and OMAS (AUC = 0.64 and 0.65, respectively, p = .001). The intra-class correlation coefficient ρ of 0.94 showed excellent reproducibility. At an optimal cutoff value of 76.7, ALR-RSI had a sensitivity of 81% and a specificity of 75% with a Youden index of 0.56. In conclusion, ALR-RSI was a valid and reproducible tool to evaluate the psychological readiness for RTS in an active population after an ankle fracture. This score could help surgeons identify athletes who may have unfavorable postoperative outcomes and provide support on the ability to RTS.
摘要：
踝关节损伤占所有运动损伤的15％至25％，导致明显的疼痛和功能丧失。这项横断面研究的目的是验证量表，以帮助外科医生量化接受踝关节骨折手术的患者重返运动（RTS）的心理准备。ALR-RSI用于评估在2020年1月至2021年1月期间接受踝关节骨折固定术的运动患者对RTS的心理准备。参与者填写了ALR-RSI和两个与患者相关的结果测量（PROM）工具：Olerud-Molander踝关节评分（OMAS）和自我报告的足踝评分（SEFAS）。共纳入93例患者。ALR-RSI与OMAS和SEFAS之间有很强的相关性，皮尔逊系数分别为r=0.58和0.53。RTS组的ALR-RSI明显高于不再进行主要损伤前运动的人。此外，ALR-RSI（AUC=0.81）的判别效度优于SEFAS和OMAS（AUC分别为0.64和0.65，p=0.001)。类内相关系数ρ为0.94显示出优异的再现性。在最佳截断值76.7时，ALR-RSI的灵敏度为81％，特异性为75％，Youden指数为0.56。总之,ALR-RSI是评估踝关节骨折后活跃人群对RTS心理准备的有效且可重复的工具。该评分可以帮助外科医生识别可能有不利的术后结果的运动员，并为RTS的能力提供支持。
