![]() ![]() This protocol outlines how we plan to assess the efficacy of a custom smartphone application, delivering cognitive-behavioural therapy to address fear, confidence and recovery expectations, for improving return to sport following serious sports-related musculoskeletal injury. A clinical assessment of strength, knee range of motion, effusion and hopping performance is completed by a blinded assessor at 12 months to assess physical function. Psychological readiness to return to sport, knee self-efficacy, motivation to participate in leisure time physical activity, knee-related quality of life, and self-reported knee function are also assessed at 3, 6, 9, 12 and 24 months after surgery. Physical activity participation and new injuries are self-reported every two weeks for 12 months, then every 4 weeks to 24 months follow-up. ![]() The secondary outcomes assess physical activity participation, new knee injuries, psychological factors, quality of life and physical function. The primary outcome is return to the preinjury sport and level at 12 months follow-up. ![]() Back in the Game is a 24-week Internet-delivered programme, based on cognitive-behavioural therapy. Participants are randomly allocated to receive either usual rehabilitation care alone or usual rehabilitation care plus the Back in the Game smartphone application intervention. We aim to recruit 222 participants (111 in each group) for the BANG trial. Participants scheduled for primary ACL reconstruction are recruited prior to surgery from one of six trial sites in Sweden. The primary aim of this trial is to test whether a custom smartphone application delivering cognitive-behavioural therapy is effective for improving the number of people who return to their preinjury sport and level following ACL reconstruction. Psychological factors including confidence and fear of new injury exert large effects on returning to sport. At least one in every three recreational athletes with anterior cruciate ligament (ACL) reconstruction do not return to their preinjury sport following treatment. Sustaining injury is a common consequence of playing sport. ![]()
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