Grant: CIHR Fellowship

About 1 in 3 patients will not return to preinjury levels of physical activity after anterior cruciate ligament reconstruction (ACLR), with lower return to sport rates in females as compared to males. While physical deficits are present during recovery, the number one reason for patients not returning to sport after ACLR is injury-related fear. Injury-related fear significantly contributes to decreased return to sport, decreased physical activity engagement, and increased ACL reinjury risk in previously active and high functioning individuals. This suggests inadequate psychological readiness is a primary barrier to returning to sport after ACL injury that must be addressed. Unfortunately, current ACLR rehabilitation practices do not specifically address injury-related fear or psychological readiness to return to sport. Virtual reality mindfulness meditation (VR-MM) is a mental practice that involves focusing on experiences in the present moment and has been used to address depression, anxiety, and chronic pain. Therefore, a current NIH-funded clinical trial will determine the effect of an 8-week VR-MM program on injury-related fear, jump-landing movement patterns, and brain activity in females 1 to 5 years post-ACLR when compared to a virtual reality sham group. This proposal will add 2 key components to the funded NIH-trial: 1) ACL Return to Sport after Injury scale (ACL-RSI), and 2) focus groups, to test the hypothesis that VR-MM will improve female athletes' psychological readiness to return to sport following ACLR. The ACL-RSI is a patient reported questionnaire that evaluates 3 main psychological components of recovery: emotions, confidence in performance, and risk appraisal. Secondly, focus groups will be conducted to explore patients' experience with VR-MM, allowing for a better understanding of the how to tailor VR-MM to help individual patients improve psychological readiness and inform the design of larger high impact studies using this intervention.