A Framework for Clinicians to Improve the Decision-Making Process in Return to Sport

Area of Science:

• Sports Medicine
• Clinical Decision Analysis
• Biopsychosocial Health

Background:

• Return-to-sport (RTS) decisions are crucial in sports medicine, balancing athlete health with performance demands.
• These decisions are complex, influenced by re-injury risks, time pressures, and social factors.
• Current RTS decision-making lacks a standardized framework, impacting athletes and sports organizations.

Purpose of the Study:

• To evaluate clinical return-to-sport (RTS) decision-making using a decision analysis perspective.
• To adapt decision-making theories and frameworks for the unique context of RTS.
• To propose an improved framework for clinicians to enhance the quality of RTS decisions.

Main Methods:

• Narrative review of decision analysis principles applied to RTS.
• Elucidation of methodological considerations for gathering information from RTS tests.
• Analysis of evolving decision-making frameworks and adaptation to the RTS context.
• Discussion of stakeholder perspectives (athlete, coach, manager).

Main Results:

• RTS decision-making can be conceptualized as a sequential process with a core decision basis.
• Existing decision-making theories can be adapted to inform RTS protocols.
• Understanding diverse stakeholder preferences is vital for effective RTS decisions.

Conclusions:

• A decision analysis framework can improve the quality of return-to-sport (RTS) decisions.
• Proposed framework offers recommendations for clinical practice and future research in sports medicine.
• Enhanced RTS decision-making supports athlete well-being and optimizes sports participation.