Prompt engineering a large language model with evidence-based persuasive features to improve confidence in mental health professionals: a pilot randomized experiment.

The growing interest in competitive sports, recreational activities, and fitness has led to an increasing incidence of anterior cruciate ligament (ACL) injuries (). ACL injuries affect approximately 3% of amateur athletes and up to 15% of elite athletes annually (). These injuries not only impair athletic performance but also predispose the knee to long-term degenerative changes, including meniscal and cartilage damage, if left inadequately treated (; ). For young, active individuals, anterior cruciate ligament reconstruction (ACL-R) is generally considered the gold standard. Its goals are to restore joint stability, prevent further structural damage, and enable a safe return to high-intensity activities such as jumping, cutting, and rotation (). Following an ACL-R, postoperative rehabilitation is a difficult and drawn-out process that starts as soon as surgery is performed and lasts until the athlete is judged ready to resume sports. Early rehabilitation focuses on pain and swelling management, restoration of full knee extension, and normalization of gait, while later stages incorporate progressive neuromuscular training to improve strength, endurance, balance, and cardiovascular fitness. While activity level is often evaluated using objective measures, such as isokinetic strength testing and jump performance assessments, these criteria alone may not fully predict a successful return to sport (; ). It is becoming more well-acknowledged that psychological variables, such as kinesiophobia, anxiety associated with injuries, and fear of re-injury, are important predictors of healing and return to sport (; ). Several instruments are available to measure these variables. Still, their use in standard clinical practice remains limited, and there is insufficient data on the psychological effects of ACL-R, particularly among professional athletes ().