🎯 Título: Una nueva escala para medir la preparación psicológica tras lesión de codo
📌 En breve: Se desarrolló y validó una escala específica (EI-RSI) para medir la preparación psicológica de volver al deporte tras cirugía de reconstrucción ligamentaria del codo, mostrando buena validez y excelente confiabilidad.
🔬 Puntos clave:
### El estudio
47 pacientes (edad promedio 40,7 años, seguimiento promedio de 77 meses) que se sometieron a reconstrucción del ligamento colateral cubital lateral por inestabilidad posterolateral del codo completaron la nueva escala EI-RSI, adaptada de escalas similares usadas en LCA y hombro.
### Qué tan buena es la escala
La escala mostró correlación moderada con medidas funcionales establecidas del codo, confiabilidad test-retest excelente (0,965) y consistencia interna muy alta (alfa de Cronbach 0,982), sin efectos de piso o techo.
### El hallazgo clínico
Los pacientes que efectivamente volvieron al deporte tuvieron puntajes de EI-RSI significativamente más altos (mediana 91,3) que quienes no volvieron (mediana 77,5; p = 0,017), confirmando que la escala distingue bien entre ambos grupos.
🎯 Aplicación clínica para LATAM: Cirujanos de codo y fisioterapeutas deportivos de la región que atienden inestabilidad posterolateral de codo pueden usar el EI-RSI para identificar pacientes con baja preparación psicológica que podrían beneficiarse de apoyo adicional antes de volver a competir.
⚠ Limitaciones: La validación se hizo en una sola cohorte retrospectiva relativamente pequeña (47 pacientes) de un tipo específico de lesión de codo, por lo que se necesita validación en otras poblaciones.
Background
Psychological readiness is an essential determinant of safe return to sport (RTS) after injury, yet it is often underrepresented in assessments of patients with elbow instability. The Elbow Instability-Return to Sport after Injury (EI-RSI) scale is a questionnaire designed to evaluate psychological readiness in athletes after lateral ulnar collateral ligament (LUCL) reconstruction for posterolateral rotatory instability of the elbow.
Purpose
To develop and validate the EI-RSI scale.
Study design
Cohort study (diagnosis); Level of evidence, 3.
Methods
The EI-RSI was developed from the anterior cruciate ligament return-to-sport index (ACL-RSI) and the shoulder instability return-to-sport index (SI-RSI) with input from 10 patients with LUCL reconstruction (10 elbow joints), then tested in a retrospective cohort (2015-2021). Validity was assessed by correlating with the Mayo Elbow Performance Score (MEPS) and the Patient-Rated Elbow Evaluation (PREE). Reliability was assessed using test-retest analysis. RTS was measured via a questionnaire assessing participation (yes/no), return to preinjury level, and time to return. Statistical analyses included the Mann-Whitney U test and the Cronbach alpha.
Results
A total of 47 patients (47 elbow joints; mean age, 40.7 ± 13 years; 22 men) were analyzed, with a median follow-up of 77 months (interquartile range [IQR], 36-110). The EI-RSI demonstrated good construct validity, showing a moderate positive correlation with MEPS (r = 0.472; P < .001) and moderate negative correlations with the PREE total (r = -0.572; P < .001), PREE pain (r = -0.610; P < .001), and PREE function (r = -0.595; P < .001) scores. Test-retest reliability was excellent (Spearman rho = 0.965; P < .001; ICCsingle = 0.965 [95% CI, 0.935-0.981]; ICCaverage = 0.982 [95% CI, 0.966-0.991]). Internal consistency was high (Cronbach α = 0.982). Patients who returned to sport exhibited significantly higher EI-RSI scores (median, 91.3 [IQR, 83.2-94.6]) compared with those who did not (median, 77.5 [IQR, 52.5-91.7]; P = .017). No floor or ceiling effects were observed.
Conclusion
Our study demonstrated that the EI-RSI is a valid and reliable instrument for evaluating psychological readiness to RTS after LUCL reconstruction for posterolateral rotatory elbow instability. Its clinical implementation may facilitate informed RTS decisions and identify patients who could benefit from psychological support before safely resuming athletic activity.
Cómo citar:
Kadantsev P, Ellafi A, Siebenlist S, Muench LN, Runer A, Hinz M, Geyer S, Lappen S. (2026).
Development and Validation of the Elbow Instability-Return to Sport After Injury (EI-RSI) Scale: Assessing Psychological Readiness for Return to Sport.. Orthopaedic journal of sports medicine.
DOI: 10.1177/23259671261442598 ↗ PMID: 42186511 ↗ Acceso al paper: Ver completo ↗
