•  
  •  
 

Keywords

Clinical Practice in Athletic Training

Abstract

Focused Clinical Question: How can using the Shoulder Return to Sport after Injury (SI-RSI) scale to measure mental readiness in athletes after a shoulder injury improve return-to-play protocol? Data Sources: In September 2023, a computerized search of PubMed for evidence was completed. The search terms were fear of reinjury or psychological readiness, kinesiophobia, confidence, and return to play or return to sport, or RTP. The search was limited to studies published between 2018 and 2023. Study Selection: The inclusion criteria consisted of studies that used the SI-RSI to measure fear during return to play and shoulder injuries that required surgery. The criteria were written in English and performed using an observational or experimental design. Studies were excluded if the patients did not play sports preoperatively. Data Extraction: Outcomes included quantitative evidence of SI-RSI scores to identify a connection between SI-RSI scores and the athlete’s decision to return to play. One study took a cohort-study approach, one used a cross-sectional approach, and the third used a retrospective comparative cohort study. All three used the SI-RSI to analyze mental preparedness before return to play. Summary Measures: All three studies used the SI-RSI to measure psychological readiness before return to play. Two studies compared the SI-RSI score with the Subjective Shoulder Value (SSV). These two studies had a mean SI-RSI score of 68.9±22.0 and 41.5±21.9 with a p-value of p<0.0001. Evidence Appraisal: All three studies were evaluated using the STROBE Critical Appraisal Checklist. Search Results: The computerized search returned 534 studies, 46 of which were included based on inclusion criteria, eight of which were included based on title, and three articles that met the exclusion criteria were kept for review. Data Synthesis: Two of the included studies concluded that patients who returned to sport passed the SI-RSI benchmark of 56 73.1% and 81.4% of the time. One study revealed that participants who returned to sport scored higher on the reinjury fear and risk subscale 42.2±23 compared to those who did not return 27.3±16 (p<0.05) even if they didn’t pass the benchmark. Evidence Quality: The STROBE Critical Appraisal Checklist resulted in a score of 17/22 for the cross-sectional study and retrospective comparative cohort study and 18/22 for the cohort study. Points were removed for not including statistical analysis, bias, funding, and an explanation for the loss of participants. Conclusion: The Strength of Recommendation Taxonomy checklist concluded a Level C recommendation because of the consistent rating of Level 3 evidence across all three studies. Moderate evidence suggests that the SI-RSI helps evaluate psychological readiness before returning to play after a shoulder dislocation. Clinically, this may limit the recurrence of shoulder dislocations by requiring athletes to pass the SI-RSI benchmark of 56.

Download

Share

COinS