Physical and Mental Health Scores Worsen Over Division I Collegiate Sports Season and Decline Further Following Mid-Season Injury or Illness.
Collegiate athletes commonly report higher physical function and lower pain interference than the average population. However, limited information is available regarding how patient-reported outcome scores change across a sports season or following a mid-season injury or illness. It was hypothesized that collegiate athletes would report higher scores in Patient-Reported Outcomes Measurement Information System (PROMIS) physical, mental, and social health domains compared to the general population, and mid-season injury/illness would be associated with worsened post-season scores compared to pre-season.
Collegiate athletes across all varsity sports from one Division I institution were surveyed pre-season and post-season in this prospective cohort study. Mid-season injury/illness was self-reported and defined as an event interrupting in-season participation. Pre- and post-season PROMIS Physical Function (PF), Pain Interference (PI), Ability to Participate in Social Roles and Activities (APSRA), and Depression (D) were collected. Change from pre-season was compared between non-injured/non-ill and injured/ill athletes with paired non-parametric tests.
A total of 211 athletes were included, consisting of 117 (55%) males and a similar distribution across collegiate year (26%, 28%, 22%, 23%, respectively). Team field sports including football (42%), female lacrosse (12%) and female soccer (9%) made up a majority of respondents. Pre-season PROMIS PF (59.9±7.8) and APSRA (60.1±7.1) scores were nearly one standard deviation higher than the US population T-score (50±10). PI (48.6±7.6) and Depression (45.5±8.4) were within typical range. Athletes sustaining a mid-season injury/illness reported worse post-season scores in PF (-3.9±9.0, p<0.001, r=0.396), PI (2.5±10.7, p=0.034, r=0.213), APSRA (-2.6±7.5, p=0.003, r=0.325), and Depression (1.9±7.5, p=0.011, r=0.276) compared to their pre-season. Non-injured/ill athletes also demonstrated mildly worsened scores in PF (-2.3±7.3, p<0.001, r=.312) and APSRA (-1.3±7.9, p=0.049, r=0.183) compared to their pre-season.
Mid-season injury/illness was associated with worsened PROMIS scores across all measured physical and mental health domains. Athletes without an injury/illness also reported worsened PF and APSRA, indicating a potential impact from the sports season. However, the clinical significance of these score changes remains uncertain. The declines were modest and athlete-specific minimal clinically significant difference thresholds are needed to better define clinical significance in this population.
Level 2.
Collegiate athletes across all varsity sports from one Division I institution were surveyed pre-season and post-season in this prospective cohort study. Mid-season injury/illness was self-reported and defined as an event interrupting in-season participation. Pre- and post-season PROMIS Physical Function (PF), Pain Interference (PI), Ability to Participate in Social Roles and Activities (APSRA), and Depression (D) were collected. Change from pre-season was compared between non-injured/non-ill and injured/ill athletes with paired non-parametric tests.
A total of 211 athletes were included, consisting of 117 (55%) males and a similar distribution across collegiate year (26%, 28%, 22%, 23%, respectively). Team field sports including football (42%), female lacrosse (12%) and female soccer (9%) made up a majority of respondents. Pre-season PROMIS PF (59.9±7.8) and APSRA (60.1±7.1) scores were nearly one standard deviation higher than the US population T-score (50±10). PI (48.6±7.6) and Depression (45.5±8.4) were within typical range. Athletes sustaining a mid-season injury/illness reported worse post-season scores in PF (-3.9±9.0, p<0.001, r=0.396), PI (2.5±10.7, p=0.034, r=0.213), APSRA (-2.6±7.5, p=0.003, r=0.325), and Depression (1.9±7.5, p=0.011, r=0.276) compared to their pre-season. Non-injured/ill athletes also demonstrated mildly worsened scores in PF (-2.3±7.3, p<0.001, r=.312) and APSRA (-1.3±7.9, p=0.049, r=0.183) compared to their pre-season.
Mid-season injury/illness was associated with worsened PROMIS scores across all measured physical and mental health domains. Athletes without an injury/illness also reported worsened PF and APSRA, indicating a potential impact from the sports season. However, the clinical significance of these score changes remains uncertain. The declines were modest and athlete-specific minimal clinically significant difference thresholds are needed to better define clinical significance in this population.
Level 2.
Authors
Zona Zona, Hewitt Hewitt, Challa Challa, Buckley Buckley, Holliday Holliday, Hunt Hunt
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