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Is Fear of Harm (FoH) in Sports-Related Activities a Latent Trait? The Item Response Model Applied to the Photographic Series of Sports Activities for Anterior Cruciate Ligament Rupture (PHOSA-ACLR)

1
Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, 6503 GL Nijmegen, The Netherlands
2
Department of Methods and Statistics, Open University of The Netherlands, 6401 DL Heerlen, The Netherlands
3
Knee Expert Center Company Eindhoven, 5624 EB Eindhoven, The Netherlands
4
Radboud Institute for Health Sciences, IQ Healthcare, University Medical Center, 6500 HB Nijmegen, The Netherlands
5
Sport Medisch Centrum Company Papendal, 6816 VD Arnhem, The Netherlands
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6764; https://doi.org/10.3390/ijerph17186764
Received: 1 September 2020 / Accepted: 15 September 2020 / Published: 16 September 2020
(This article belongs to the Special Issue Physical Rehabilitation and Sports Medicine of Human Movement)
Background: Fear of Harm (FoH) predicts return to sports in Anterior Cruciate Ligament Reconstruction (ACLR) and can be assessed using the Photographic Sports Activities for ACLR (PHOSA-ACLR). This study was conducted to determine whether FoH assessed using the PHOSA-ACLR is a latent trait, and to analyze differences in PHOSA-ACLR in athletes with or without an ACL rupture. Methods: Three convenience samples completed the PHOSA-ACLR: (1) ACLR patients (n = 58; mean age 25.9 years; range 17–56; SD = 8.2; 43% male); (2) first year Physical Therapy (PT) students (n = 169; mean age = 19.2; SD = 2.0; 48% male), and (3) junior football players (n = 30; mean age = 18.3; range 17–20; SD = 3.2; 94% males). ACLR patients additionally reported functioning and Fear of Movement. PHOSA-ACLR items were analyzed with Item Response Theory using the Graded Response Model (GRM). Differences between three groups of participants were analyzed using Univariate Analysis of Variance. Results: Data fitted the two-parameter GRM, and therefore the items of the PHOSA-ACLR constitute a latent trait. There was a significant difference between the three groups in PHOSA-ACLR after controlling for age and gender (F (2, 255) = 17.1, p < 0.001). PT students reported higher levels of FoH compared to either ACLR patients or healthy soccer players. Conclusions: PHOSA-ACLR items constitute a latent trait of FoH for ACLR-specific movements. Contrary to expectations, PHOSA-ACLR is higher in first year physiotherapy students compared to patients rehabilitating from ACLR, and healthy junior soccer players. View Full-Text
Keywords: anterior cruciate ligament reconstruction (ACLR); kinesiophobia; fear of harm/movement/injury; validation anterior cruciate ligament reconstruction (ACLR); kinesiophobia; fear of harm/movement/injury; validation
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Lankveld, W.; Pat-El, R.J.; Melick, N.; Cingel, R.; Staal, J.B. Is Fear of Harm (FoH) in Sports-Related Activities a Latent Trait? The Item Response Model Applied to the Photographic Series of Sports Activities for Anterior Cruciate Ligament Rupture (PHOSA-ACLR). Int. J. Environ. Res. Public Health 2020, 17, 6764.

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