ACL Assessment - Return to Sport
Post-operative Functional Evaluation & Return to Sport Criteria
Validated criteria
— %
Patient Information & Context
Pain – Numerical Rating Scale (NRS 0–10)
0
0 = No pain10 = Maximum
0
0 = No pain10 = Maximum
Muscle Strength – Hand-Held Dynamometer (HHD) at 80°
Force—
| Muscle | E1 Saint (N) | E2 | E3 | Max Sain | E1 Operated (N) | E2 | E3 | Max Operated | LSI % |
|---|---|---|---|---|---|---|---|---|---|
| Quadriceps | — | — | — | ||||||
| Hamstrings | — | — | — | ||||||
| IJ / Quadriceps Ratio (operated side) | — | ||||||||
Protocol: Standardized position, proximal stabilization. 80° knee flexion. Maximal isometric contraction 3–5 sec. 3 trials, best value retained. LSI = (Operated ÷ Healthy) × 100.
Star Excursion Balance Test (SEBT)
Dynamic equilibrium—
| Direction | E1 Saint | E2 | E3 | Max Sain | E1 Operated | E2 | E3 | Max Operated | LSI % |
|---|---|---|---|---|---|---|---|---|---|
| Anterior (ANT) | — | — | — | ||||||
| Postero-medial (PM) | — | — | — | ||||||
| Postero-lateral (PL) | — | — | — |
Long. lower limb (cm)
Composite Machine
—
%
Composite Operated
—
%
LSI Composite
—
%
Single Leg Stance – Static Balance
Static balance—
| Condition | S - E1 (s) | S – E2 | S – E3 | Best Healthy | O – E1 (seconds) | O – E2 | O – E3 | Best Operator | LSI % |
|---|---|---|---|---|---|---|---|---|---|
| Eyes Open (EO) | — | — | — | ||||||
| Eyes closed (EC) | — | — | — |
Single Leg Squat Test
Neuromuscular control—
Healthy Side
| Criteria | Result |
|---|---|
| Dynamic knee valgus | |
| Pelvic drop (Trendelenburg) | |
| Excessive trunk tilt | |
| Maintaining balance | |
| Depth ≥ 70° |
Operated side
| Criteria | Result |
|---|---|
| Dynamic knee valgus | |
| Pelvic drop (Trendelenburg) | |
| Excessive trunk tilt | |
| Maintaining balance | |
| Depth ≥ 70° |
Single Leg Hamstring Bridge Test
Force IJ—
| Parameter | Healthy Side | Operated Side | LSI % |
|---|---|---|---|
| Max reps (quality maintained) | — | ||
| Total time (sec) | — | ||
| Quality score /4 | — |
Psychological Criteria – ACL-RSI
5
0 = Zero10 = Total
5
0 = Zero10 = Extreme
RTP Standard: ≥ 56/100
Additional Clinical Criteria
Summary – Criteria for the Selected Phase
| Criteria | Norm (active phase) | Patient result | Validated? |
|---|---|---|---|
| Post-operative period | — | ||
| LSI Quadriceps (HHD) | — | — | — |
| Hamstring Strain (HHD) | — | — | — |
| IJ / Quadriceps Ratio | — | — | — |
| SEBT – LSI composite | — | — | — |
| Single Leg Stand YO | — | — | |
| Single Leg Squat (Quality) | — | ||
| South-West (Rep. / LSI) | — | — | — |
| Exertional pain | — | ||
| ACL-RSI (Confidence) | — |
Conclusion & Recommendations
Decision:
Therapist's signature
Patient signature