Anterior Cruciate Ligament Return to Sport after Injury Survey

International Knee Documentation Committee (IKDC)

Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) Survey

The Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale was created to evaluate psychological readiness with regard to Return-to-Sport and has identified psychological aspects for which patients may need counseling, concurrent with the physical rehabilitation, to increase their chances of a successful return to sport.


Validity and Reliability

Webster et al. (2008) report that with a Cronbach’s alpha of 0.92, the scale demonstrated satisfactory reliability. Participants who had stopped participating in sports had considerably lower scores on the scale than those who had resumed or planned to resume their participation (p<0.001), showing a more adverse psychological response.


Scoring and Interpretation

The 12 questions on the ACL-RSI scale ask about the psychological effects of returning to sports. The ACL-RSI items are graded using either a VAS (visual analog scale) from 0 to 100 or an NRS (numeric rating scale) from 0 to 10. It has three domains: risk appraisal, confidence, and emotions. 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.

ACL-RSI PDF Download


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Briggs, K. K., Lysholm, J., Tegner, Y., Rodkey, W. G., Kocher, M. S., & Steadman, J. R. (2009). The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee: 25 years later. The American journal of sports medicine, 37(5), 890–897. 

Briggs, K. K., Steadman, J. R., Hay, C. J., & Hines, S. L. (2009). Lysholm score and Tegner activity level in individuals with normal knees. The American journal of sports medicine, 37(5), 898–901. 

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