ACL-RSI Short Form

ACL-RSI Short Form Survey

The Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale was developed to assess psychological readiness for returning to sport. It helps identify psychological factors that may require targeted support alongside physical rehabilitation to enhance the likelihood of a successful return to sport.

Even though the full ACL-RSI scale is relatively short, item redundancy is clearly present in this questionnaire. Later on, a shorter version of the ACL-RSI scale has been developed (Webster & Feller 2018). In each of the 3 domains, questions who were redundant were removed. Even though the scale was reduced by half, consisting of 6 items, the reliability and validity was not sacrificed. In other words, the psychometric properties of the scale remained the same. Therefore, this short version was found to be a robust substitute for the full version of the ACL-RSI scale for discriminating between patients who return to sport or not, and predicting return to sport outcomes.

Validity and Reliability

Webster et al. (2008) report that with a Cronbach’s alpha of 0.92, the full ACL-RSI scale demonstrated satisfactory reliability. The shortened version maintained strong reliability (Cronbach’s alpha = 0.92). Factor analysis supported a single-factor structure explaining 71% of the total variance. Scores on the shortened scale significantly distinguished between patients who had returned to sport and those who had not. At six months post-injury, both the full and short versions demonstrated fair to good predictive validity for return to sport at 12 months (full version: AUC = 0.77 [95% CI: 0.7–0.8]; short version: AUC = 0.75 [95% CI: 0.7–0.8]) (Webster & Feller 2018).

Scoring and Interpretation

Each item on the ACL-RSI is rated on a scale from 0 to 100, in 10-point increments. A total score between 0 and 100 is calculated by adding and averaging the scores for each item. Greater psychological preparation is indicated by higher scores.