Kinesiophobia as a factor of return to sport in patients undergoing anterior cruciate ligament reconstruction: A systematized review

Favorable physical outcomes for return to sport after anterior cruciate ligament reconstruction (ACLR) are contrasted with low rates of sports return, suggesting the contribution of other psychological factors such as kinesiophobia. This article aimed to systematically review the current evidence about kinesiophobia in return to sport following ACLR. A systematized review was conducted following the recommendations of the PRISMA checklist. A search of scientific articles published in English between 2018 and 2021 was performed in Pubmed, Web of Science, and Science Direct databases. We included those studies that reported kinesiophobia in athletic patients undergoing RLCA without discrimination of patients by sex or age. In this regard, 44 studies met the inclusion criteria (6,406 participants). Of these, 23 studies reported a return to sport rates averaging 61.5% (3,099 individuals), and 15 reported the rate of return to pre-injury level (55.2%). The included studies measured kinesiophobia using study-specific questionnaires, semi-structured interviews, the Tampa Scale of Kinesiophobia (TSK) and the ACL-Return to Sport after Injury scale (ACL-RSI). Thus, the rate of return to sport can be highly variable and dependent on multiple factors, kinesiophobia being one of the main ones. Its measurement through tools such as the TSK and the ACL-RSI is fundamental in rehabilitation and sports discharge.