Assessing implementation, limited efficacy, and acceptability of the BEAST tool: A rehabilitation and return-to-sport decision tool for nonprofessional athletes with anterior cruciate ligament reconstruction.

To assess the implementation, limited efficacy, and acceptability of the BEAST (better and safer return to sport) tool - a rehabilitation and return-to-sport (RTS) decision tool after anterior cruciate ligament reconstruction (ACLR) in nonprofessional athletes. Prospective cohort. 43 nonprofessional pivoting sport athletes with ACLR. Clinician- and athlete-experienced implementation challenges (implementation), changes in quadriceps power, side hop and triple hop performance from 6 to 8 months after ACLR (limited efficacy), athletes' beliefs about the individual rehabilitation and RTS plans produced by the BEAST tool (acceptability). The BEAST tool was developed and then implemented as planned for 39/43 (91%) athletes. Hop and quadriceps power performance improved significantly, with the largest improvement in involved quadriceps power (standardised response mean 1.4, 95% CI:1.1-1.8). Athletes believed the rehabilitation and RTS plan would facilitate RTS (8.2 [SD: 2.0]) and reduce injury risk (8.3 [SD: 1.2]; 0 = not likely at all, 10 = extremely likely). The BEAST tool was implemented with few challenges and adjustments were rarely necessary. Athletes had large improvements in quadriceps power and hop performance on the involved leg. Athletes believed that the individual rehabilitation and RTS plans produced by the tool would facilitate RTS and reduce injury risk.

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Déclaration de conflit d'intérêts

Declaration of competing interest CLA has received research salary support for work in return to sport from the Australian National Health and Medical Research Council (Early Career Fellowship APP1109779) Swedish Research Council (2015-03687) and Swedish Research Council for Sport Science (Postdoctoral fellowship D2018-0041), has received honoraria from non-profit post-professional sports medicine education providers for workshops and webinars on return to sport decision-making, and is Editor-in-Chief for Journal of Orthopaedic & Sports Physical Therapy (JOSPT). LE receives honorarium for instrument development for Arthrex and fellowship support and lecture fees for Smith & Nephew. He is an editor for the Journal of Bone and Joint Surgery and the British Journal of Sports Medicine (BJSM). MAR declares grant #R37HD37985 by the National Institutes of Health (The Delaware-Oslo ACL Cohort study). HG has received research salary support for work in return to sport from the Swedish Research Council for Sport Science, the International Olympic Committee, and the Norwegian Fund for Post-Graduate Training in Physiotherapy, has received honoraria from post-professional physical therapy education providers for workshops and lectures on rehabilitation and return to sport, and serves on the editorial boards of BJSM and JOSPT. HM, JK, GM: None declared