{"id":8012,"date":"2025-12-04T17:08:51","date_gmt":"2025-12-04T16:08:51","guid":{"rendered":"https:\/\/www.btsbioengineering.com\/?p=8012"},"modified":"2026-01-12T15:45:34","modified_gmt":"2026-01-12T14:45:34","slug":"rts-test-early-evidence-on-post-acl-reinjury-risk","status":"publish","type":"post","link":"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/","title":{"rendered":"RTS Test: Preliminary Findings on Predicting Reinjury Risk After ACL Reconstruction"},"content":{"rendered":"

How can clinicians objectively assess when an athlete is truly ready to return to sport after ACL surgery?<\/span><\/span>\u00a0<\/span><\/h3>\n

A recent collaborative study conducted by <\/span><\/span>Istituto<\/span> Prosperius<\/span><\/span> (<\/span><\/span>prosperius.it<\/span><\/span><\/a>), the <\/span><\/span>University of Florence<\/span><\/span>, and <\/span><\/span>BTS Bioengineering<\/span><\/span> provides<\/span> new insights into this question. The research highlights the potential of the <\/span><\/span>Return to Sport (RTS) test<\/span><\/span> to predict reinjury risk and support more informed, evidence-based return-to-play decisions.<\/span><\/span>\u00a0<\/span><\/p>\n

 <\/p>\n

Understanding the challenge: safe return to sport after ACL reconstruction<\/span><\/b>\u00a0<\/span><\/h3>\n

Returning to sport after an anterior cruciate ligament (ACL) reconstruction is one of the most critical and debated steps in an athlete\u2019s rehabilitation process. While medical clearance is typically based on functional and psychological assessments, determining the <\/span>true readiness<\/span><\/i> of an athlete to resume competition remains complex and multidimensional.<\/span>\u00a0<\/span><\/p>\n

In recent years, the RTS test has been introduced as a comprehensive tool to evaluate both the <\/span>physical and psychological preparedness<\/span><\/b> of athletes. However, its <\/span>predictive validity<\/span><\/b> has not been fully established.<\/span>\u00a0<\/span><\/p>\n

To address this gap, the research team combined <\/span>clinical expertise<\/span><\/b>, <\/span>academic rigor<\/span><\/b>, and <\/span>advanced motion analysis technology<\/span><\/b> from BTS Bioengineering to conduct an in-depth study on over one hundred athletes post-ACL reconstruction.<\/span>\u00a0<\/span><\/p>\n

 <\/p>\n

The RTS protocol: a multidimensional assessment<\/span><\/b>\u00a0<\/span><\/h3>\n

The RTS test is designed to provide a holistic view of an athlete\u2019s recovery status, combining multiple physical and mental dimensions. The standard protocol includes six complementary assessments:<\/span>\u00a0<\/span><\/p>\n

    \n
  • Isokinetic test<\/span><\/b> \u2013 evaluation of lower-limb strength<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
      \n
    • Single leg hop test<\/span><\/b> \u2013 assessment of symmetry and plyometric ability<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
        \n
      • Drop jump\/fall test<\/span><\/b> \u2013 analysis of motor control and landing stability<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
          \n
        • Qualitative movement analysis<\/span><\/b> \u2013 video-based assessment of movement quality<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
            \n
          • Metabolic treadmill test<\/span><\/b> \u2013 evaluation of aerobic endurance and exercise tolerance<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
              \n
            • Psychological questionnaire<\/span><\/b> \u2013 exploration of confidence, readiness, and fear of reinjury<\/span>\u00a0<\/span><\/li>\n<\/ul>\n

              Using <\/span><\/span>BTS motion analysis systems<\/span><\/span> and<\/span> in particular <\/span><\/span>FREEEMG<\/span><\/span> and<\/span> <\/span>G-<\/span>Sensor technology<\/span><\/span>, clinicians were able to collect and integrate biomechanical, neuromuscular, and psychometric data, enhancing the objectivity of the RTS evaluation.<\/span><\/span>\u00a0<\/span><\/p>\n

               <\/p>\n

              The study: population and methods<\/span><\/b>\u00a0<\/span><\/h3>\n

              The study involved <\/span>108 athletes<\/span><\/b> who had undergone ACL reconstruction and subsequently returned to sport. The average age was <\/span>24.6 years<\/span><\/b> (range 14\u201346). Each athlete completed the RTS test before returning to play and was monitored through a <\/span>12-month follow-up<\/span><\/b>, during which reinjuries, competitive level, and psychological readiness were reassessed.<\/span>\u00a0<\/span><\/p>\n

              The <\/span>average RTS score<\/span><\/b> was <\/span>78.8 points<\/span><\/b> (range 32\u2013100), and a <\/span>cut-off of 85 points<\/span><\/b> was used to define whether the test was \u201cpassed\u201d or \u201cnot passed.\u201d<\/span>\u00a0<\/span><\/p>\n

              \u00a0<\/span><\/p>\n

              Key findings: RTS score and reinjury risk<\/span><\/b>\u00a0<\/span><\/h3>\n

              Preliminary results revealed a <\/span>statistically significant association<\/span><\/b> between failing the RTS test (score <85) and higher reinjury rates (<\/span>p<\/span><\/i> = 0.044).<\/span>
              \nSpecifically:<\/span>\u00a0<\/span><\/p>\n

                \n
              • Sensitivity:<\/span><\/b> 77% \u2013 the test correctly identified approximately three out of four athletes who later sustained a reinjury.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
                  \n
                • Specificity:<\/span><\/b> 58% \u2013 about six out of ten athletes who remained injury-free passed the test.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n

                  In other words, athletes who did not meet the RTS threshold were <\/span>significantly more likely to experience reinjury<\/span><\/b> within a year. These findings suggest that the RTS test, while not conclusive on its own, can serve as a <\/span>valuable screening tool<\/span><\/b> for clinicians to assess risk before approving a return to sport (Fig.1).<\/span>\u00a0<\/span><\/p>\n\n\n\n
                  \"fig<\/td>\nFig 1. Relationship between RTS test completion (cut-off \u226585) and reinjury rate. Athletes who did not pass the test showed a higher recurrence of ACL injuries within 12 months.<\/span><\/p>\n

                   <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                  <\/h3>\n

                  The role of psychological readiness<\/span><\/b>\u00a0<\/span><\/h3>\n

                  Beyond physical performance, the study explored the <\/span>psychological dimension<\/span><\/b> of recovery.<\/span>
                  \nAthletes who expressed higher levels of <\/span>confidence and self-efficacy<\/span><\/b>\u2014for example, believing they could perform at their pre-injury level\u2014tended to score higher on the RTS test.<\/span>\u00a0<\/span><\/p>\n

                  This moderate yet consistent correlation highlights the importance of incorporating <\/span>mental readiness<\/span><\/b> into the return-to-sport decision-making process. A successful recovery is not only about physical strength and biomechanics, but also about <\/span>trusting one\u2019s body again<\/span><\/b>.<\/span>\u00a0<\/span><\/p>\n

                  \u00a0<\/span><\/p>\n

                  Rehabilitation time: not the only factor<\/span><\/b>\u00a0<\/span><\/h3>\n

                  Interestingly, the <\/span>length of the rehabilitation period<\/span><\/b> was not significantly different between athletes who did and did not experience a reinjury.<\/span>
                  \nThis finding indicates that <\/span>time alone is not a reliable measure of recovery<\/span><\/b>. Instead, a combination of <\/span>objective functional data<\/span><\/b> and <\/span>psychological assessment<\/span><\/b> provides a more accurate and individualized picture of readiness.<\/span>\u00a0<\/span><\/p>\n

                  \u00a0<\/span><\/p>\n

                  Conclusions and future directions<\/span><\/b>\u00a0<\/span><\/h3>\n

                  Although these findings are preliminary, they are <\/span>promising<\/span><\/b> and point toward the potential of the RTS test as a <\/span>clinically meaningful tool<\/span><\/b> for guiding return-to-sport decisions after ACL reconstruction.<\/span>\u00a0<\/span><\/p>\n

                  When combined with biomechanical and psychological indicators, the RTS protocol may help clinicians better identify athletes at risk and reduce reinjury rates\u2014contributing to <\/span>safer and more personalized rehabilitation strategies<\/span><\/b>.<\/span>\u00a0<\/span><\/p>\n

                  This collaborative project between <\/span>Centro Prosperius<\/span><\/b>, the <\/span>University of Florence<\/span><\/b>, and <\/span>BTS Bioengineering<\/span><\/b> underscores the value of integrating scientific research, clinical practice, and advanced technology in sports medicine.<\/span>\u00a0<\/span><\/p>\n

                  BTS Bioengineering<\/span><\/b> remains committed to supporting research and clinical innovation through motion analysis systems that help professionals translate data into better outcomes\u2014empowering athletes to return to sport with confidence, safety, and measurable readiness.<\/span>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

                  How can clinicians objectively assess when an athlete is truly ready to return to sport after ACL surgery?\u00a0 A recent collaborative study conducted by Istituto Prosperius (prosperius.it), the University of Florence, and BTS Bioengineering provides new insights into this question. The research highlights the potential of the Return to Sport (RTS) test to predict reinjury […]<\/p>\n","protected":false},"author":5,"featured_media":8021,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[22],"tags":[],"class_list":["post-8012","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-it"],"acf":[],"yoast_head":"\nRTS Test: Preliminary Findings on Predicting Reinjury Risk After ACL Reconstruction - BTS<\/title>\n<meta name=\"description\" content=\"A recent study highlights the RTS test\u2019s potential to predict reinjury risk and improve return-to-play decisions.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/\" \/>\n<meta property=\"og:locale\" content=\"it_IT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"RTS Test: Early Evidence on Post-ACL Reinjury Risk\" \/>\n<meta property=\"og:description\" content=\"A recent study highlights the RTS test\u2019s potential to predict reinjury risk and improve return-to-play decisions.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/\" \/>\n<meta property=\"og:site_name\" content=\"BTS\" \/>\n<meta property=\"article:published_time\" content=\"2025-12-04T16:08:51+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-01-12T14:45:34+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.btsbioengineering.com\/wp-content\/uploads\/2025\/12\/BTS-rts-project.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1640\" \/>\n\t<meta property=\"og:image:height\" content=\"924\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Cristina Gallelli\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Scritto da\" \/>\n\t<meta name=\"twitter:data1\" content=\"Cristina Gallelli\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tempo di lettura stimato\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minuti\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/\"},\"author\":{\"name\":\"Cristina Gallelli\",\"@id\":\"https:\/\/www.btsbioengineering.com\/it\/#\/schema\/person\/f13bd80a13632df211fd31534f776a7c\"},\"headline\":\"RTS Test: Preliminary Findings on Predicting Reinjury Risk After ACL Reconstruction\",\"datePublished\":\"2025-12-04T16:08:51+00:00\",\"dateModified\":\"2026-01-12T14:45:34+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/\"},\"wordCount\":799,\"image\":{\"@id\":\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.btsbioengineering.com\/wp-content\/uploads\/2025\/12\/BTS-rts-project.png\",\"articleSection\":[\"Blog\"],\"inLanguage\":\"it-IT\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/\",\"url\":\"https:\/\/www.btsbioengineering.com\/it\/rts-test-early-evidence-on-post-acl-reinjury-risk\/\",\"name\":\"RTS Test: Preliminary Findings on Predicting Reinjury Risk After ACL Reconstruction - 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