Quality-of-Life Outcomes in Individuals with a History of Sport-Related Concussion and ACL Reconstruction
Keywords:mild traumatic brain injuries, psychological considerations, physical functioning
The effect of sport-related injuries such as anterior cruciate ligament (ACL) tears and sport-related concussion (SRC) on health-related quality-of-life (HRQoL) has received increasing consideration. While previous literature has begun considering HRQoL associated with these injuries, little is known about these effects specifically of those suffering multiple injuries. Therefore, the purpose of this study was to examine the effects of previous concussion and ACL reconstruction on HRQoL in college-aged individuals. A sample of 47 active college-aged students were categorized into four groups: previous history of SRC, previous ACL reconstruction, combination of SRC and ACL, control group. All participants completed the 36-Item Short Form Health Survey (SF-36) assessing HRQoL. Results showed that there was a significant difference in physical function between all groups (p=0.003) with the ACL group scoring the lowest (93.33±6.5). There was also a significant difference between all groups in the general health category (p=0.042). All other categories were found to have no significant differences across groups. College-aged students who previously sustained a SRC and/or ACL tear and reconstruction may have lower HRQoL two or more years post injury, specifically in areas of physical function and general health indicating a need for further intervention and screening beyond one year post injury.
Ahman, S., Saveman, B. I., Styrke, J., Bjornstig, U., & Stalnacke, B. M. (2013). Long-term follow-up of patients with mild traumatic brain injury: a mixed-method study. Journal of Rehabilitation Medicine, 45(8), 758-764. doi:10.2340/16501977-1182
Ardern, C. L., Taylor, N. F., Feller, J. A., & Webster, K. E. (2012). Return-to-sport outcomes at 2 to 7 years after anterior cruciate ligament reconstruction surgery. American Journal of Sports Medicine, 40(1), 41-48. doi:10.1177/0363546511422999
Beaudart, C., Biver, E., Bruyere, O., Cooper, C., Al-Daghri, N., Reginster, J. Y., & Rizzoli, R. (2018). Quality of life assessment in musculo-skeletal health. Aging Clinical and Experimental Research, 30(5), 413-418. doi:10.1007/s40520-017-0794-8
Blake, A. L., McVicar, C. L., Retino, M., Hall, E. E., & Ketcham, C. J. (2019). Concussion history influences sleep disturbances, symptoms, and quality of life in collegiate student-athletes. Sleep Health, 5(1), 72-77. doi:10.1016/j.sleh.2018.10.011
Cowee, K., & Simon, J. E. (2019). A history of previous severe injury and health-related quality of life among former collegiate athletes. Journal of Athletic Training, 54(1), 64-69. doi:10.4085/1062-6050-377-17
Cross, S. J., Gill, D. L., Brown, P. K., & Reifsteck, E. J. (2021). Prior injury, health-related quality of life, disablement, and physical activity in former women's soccer players. Journal of Athletic Training. doi:10.4085/1062-6050-0731.20
Foss, K. D. B., Thomas, S., Khoury, J. C., Myer, G. D., & Hewett, T. E. (2018). A school-based neuromuscular training program and sport-related injury incidence: A prospective randomized controlled clinical trial. Journal of Athletic Training, 53(1), 20-28. doi:10.4085/1062-6050-173-16
Gard, A., Lehto, N., Engstrom, A., Shahim, P., Zetterberg, H., Blennow, K., . . . Tegner, Y. (2020). Quality of life of ice hockey players after retirement due to concussions. Concussion, 5(3), CNC78. doi:10.2217/cnc-2020-0007
Guilfoyle, M. R., Seeley, H. M., Corteen, E., Harkin, C., Richards, H., Menon, D. K., & Hutchinson, P. J. (2010). Assessing quality of life after traumatic brain injury: examination of the short form 36 health survey. Journal of Neurotrauma, 27(12), 2173-2181. doi:10.1089/neu.2010.1353
Harfmann, E. J., deRoon-Cassini, T. A., McCrea, M. A., Nader, A. M., & Nelson, L. D. (2020). Comparison of four quality of life inventories for patients with traumatic brain injuries and orthopedic injuries. Journal of Neurotrauma, 37(12), 1408-1417. doi:10.1089/neu.2019.6746
Herman, D. C., Jones, D., Harrison, A., Moser, M., Tillman, S., Farmer, K., . . . Chmielewski, T. L. (2017). Concussion may increase the risk of subsequent lower extremity musculoskeletal injury in collegiate athletes. Sports Medicine, 47(5), 1003-1010. doi:10.1007/s40279-016-0607-9
Houston, M. N., Hoch, J., Van Lunen, B. L., & Hoch, M. C. (2016). The impact of injury on health-related quality of life in college athletes. Journal of Sport Rehabilitaion, 26(5), 365-375.
Iadevaia, C., Roiger, T., & Zwart, M. B. (2015). Qualitative examination of adolescent health-related quality of life at 1 year postconcussion. Journal of Athletic Training, 50(11), 1182-1189. doi:10.4085/1062-6050-50.11.02
Kleis, R. R., Simon, J. E., Turner, M., Vela, L., Thomas, A., & Gribble, P. A. (2020). Differences in health-related quality of life among patients after knee injury. International Journal of Athletic Therapy & Training, 25(5), 247-253.
Lam, K. C., Thomas, S. S., Valier, A. R. S., McLeod, T. C. V., & Bay, R. C. (2017). Previous knee injury and health-related quality of life in collegiate athletes. Journal of Athletic Training, 52(6), 534-540. doi:10.4085/1062-6050-50.5.01
Lins, L., & Carvalho, F. M. (2016). SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med, 4, 2050312116671725. doi:10.1177/2050312116671725
Lutz, R. H., DeMoss, D. J., Roebuck, E. H., Mason, T., & Eiler, B. A. (2021). Sport-specific increased risk of anterior cruciate ligament injury following a concussion in collegiate female lacrosse. Current Sports Medicine Report, 20(10), 520-524. doi:10.1249/JSR.0000000000000839
Marshall, A. N., Snyder Valier, A. R., Yanda, A., & Lam, K. C. (2020). The impact of a previous ankle injury on current health-related quality of life in college thletes. Journal of Sport Rehabilitation, 29(1), 43-50. doi:10.1123/jsr.2018-0249
McPherson, A. L., Shirley, M. B., Schilaty, N. D., Larson, D. R., & Hewett, T. E. (2020). Effect of a concussion on anterior cruciate ligament injury risk in a general population. Sports Medicine, 50(6), 1203-1210. doi:10.1007/s40279-020-01262-3
Polinder, S., Haagsma, J. A., van Klaveren, D., Steyerberg, E. W., & van Beeck, E. F. (2015). Health-related quality of life after TBI: a systematic review of study design, instruments, measurement properties, and outcome. Population Health Metrics, 13, 4. doi:10.1186/s12963-015-0037-1
Simon, J. E., & Docherty, C. L. (2016). Current health-related quality of life in former national collegiate athletic association division I collision athletes compared with contact and limited-contact athletes. Journal of Athletic Training, 51(3), 205-212. doi:10.4085/1062-6050-51.4.05
Simon, J. E., Lorence, M., & Docherty, C. L. (2021). Health-related quality of life in former National Collegiate Athletic Association Division I collegiate athletes compared with noncollegiate athletes: A 5-Year follow-up. Journal of Athletic Training. doi:10.4085/1062-6050-0107.20
Snedden, T. R., Scerpella, J., Kliethermes, S. A., Norman, R. S., Blyholder, L., Sanfilippo, J., . . . Heiderscheit, B. (2019). Sport and physical activity level impacts health-related quality of life among collegiate students. American Journal of Health Promotion, 33(5), 675-682. doi:10.1177/0890117118817715
Stewart, A., Hays, R. D., & Ware, J. E., Jr. (1988). The MOS Short-form General Health Survey: Reliability and validity in a patient population. Med Care, 26(7), 724-735.
Valovich McLeod, T., Bay, C., & Snyder, A. (2010). Self-reported history of concussion affects health-related quality of life in adolescent athlete. Athletic Training & Sports Health Care, 2(5), 219-226.
Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection. Med Care, 30(6), 473-483.
Weber, M. L., Lynall, R. C., Hoffman, N. L., Miller, E. H., Kaminski, T. W., Buckley, T. A., . . . Investigators, C. C. (2019). Health-related quality of life following concussion in collegiate student-athletes with and without concussion history. Annals of Biomedical Engineering, 47(10), 2136-2146. doi:10.1007/s10439-018-02151-7
Webster, K. E., & Feller, J. A. (2014). Use of the short form health surveys as an outcome measure for anterior cruciate ligament reconstruction. European Society of Sports Traumatology Knee Surgery and Arthroscopy, 22(5), 1142-1148. doi:10.1007/s00167-013-2520-1