The Impact of Spine Injuries on Amateur Athletes: An Exploratory Analysis of Sport-Related Patient-Reported Outcomes
Abstract
:1. Introduction
1.1. Background
1.2. Aims
2. Materials and Methods
2.1. Participant Selection and Inclusion
2.2. Injury Treatment and Posttreatment Recommendations
2.3. Data Collection
2.4. Telephone Interview
2.5. Patient-Reported Outcome Measures
2.6. Statistical Analysis
3. Results
3.1. Participant Recruitment
3.2. Demographics and Preexisting Conditions
3.3. Injury Morphology and Treatment
3.4. Sports Activity before and after the Injury
3.5. Reported Problems during Sport
3.6. Subjective Range of Motion
3.7. Standardized Patient-Reported Outcome Measures and Potential Influencing Factors
4. Discussion
4.1. Changes in Sport Disciplines
4.2. Reported Problems during Sport and Range of Motion
4.3. Patient-Reported Outcome Measures and Influencing Factors
4.4. Practical Implications and Future Research
4.5. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CCI | Charlson Comorbidity Index |
HADS | Hospital Anxiety and Depression Scale |
IQR | interquartile range |
NDI | Neck Disability Index |
ODI | Oswestry Disability Index |
PRO | patient-reported outcomes |
PROM | patient-reported outcome measure |
ROM | range of movement |
RTS | return to sport |
SD | standard deviation |
SF-36 PCS | Short-Form-36 Physical Component Score |
sPILP | subjective preinjury level of performance |
TSK-17 | Tampa Scale of Kinesiophobia 17 Items |
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Inclusion | Exclusion |
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Inclusion | Exclusion |
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Sex | ||
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Women, n (%) | 30 | 38% |
Men, n (%) | 50 | 63% |
Age at injury (mean, SD, range) | 45.1 years | (SD 13.5, 16–60) |
Preexisting conditions | ||
Charlson Comorbidity Index (median, IQR, range) | 0 | (IQR 0, 0–4) |
Body Mass Index (mean, SD, range) | 25.6 kg/m2 | (SD 4.8, 17.9–46.9) |
Preexisting spine pathology, n (%) | 46 | 58% |
Time from injury to interview (mean, SD, range) | 3.2 years | (SD 1.1, 1.5–5.6) |
Distribution | Treatment | ||||
---|---|---|---|---|---|
n | % | Conservative (n) | Surgical (n) | ||
Injured region | Cervical | 14 | 18 | 4 | 10 |
Thoracic | 22 | 28 | 10 | 12 | |
Lumbar | 32 | 40 | 8 | 24 | |
Multiple | 12 | 15 | 3 | 9 | |
Injury morphology (AO Spine) * | A0 | 3 | 4 | 3 | 0 |
A1 | 9 | 11 | 9 | 0 | |
A2 | 5 | 6 | 1 | 4 | |
A3 | 28 | 35 | 10 | 18 | |
A4 | 17 | 21 | 0 | 17 | |
B1 | 1 | 1 | 0 | 1 | |
B2 | 5 | 6 | 0 | 5 | |
B3 | 3 | 4 | 0 | 3 | |
C | 7 | 9 | 0 | 7 | |
F1 | 1 | 1 | 1 | 0 | |
F2 | 1 | 1 | 1 | 0 |
Cervical Spine | n = 21 | Thoracolumbar Spine | n = 66 | |
---|---|---|---|---|
Median (IQR) | Min–Max | Median (IQR) | Min–Max | |
Flexion | 83 (41) | 44–100 | 72.5 (59) | 0–100 |
Extension | 78 (46) | 1–100 | 53.5 (57.5) | 0–100 |
Rotation right | 79 (57) | 19–100 | 72.5 (50.25) | 0–100 |
Rotation left | 71 (66) | 18–100 | 73.5 (45.25) | 0–100 |
Lateral bending right | 75 (19) | 17–100 | 75 (50.75) | 2–100 |
Lateral bending left | 64 (37) | 15–100 | 71 (51.75) | 0–100 |
SF-36 PCS | ODI [%] | NDI [%] | TSK-17 | HADS | Pain 5-Day Maximum * | |
---|---|---|---|---|---|---|
mean | 44.5 | 19.6 | 18.0 | 36.9 | 11.7 | 31.2 |
95% CI | [41.7;47.1] | [15.2;24.0] | [9.4;26.6] | [35.1;38.8] | [9.9;13.6] | [24.1;38.3] |
median | 46 | 12 | 18 | 37 | 9 | 16,5 |
min | 16 | 0 | 0 | 21 | 0 | 0 |
max | 68 | 68 | 66 | 60 | 34 | 94 |
IQR | 20.25 | 24 | 30 | 13 | 12.25 | 59 |
SD | 12.6 | 18.1 | 19.1 | 8.3 | 8.3 | 31.9 |
SF-36 PCS | p-Value | ODI | p-Value | NDI | p-Value | |
---|---|---|---|---|---|---|
Median (IQR) | Median (IQR) | Median (IQR) | ||||
Time since injury above average (yes/no) | 47.0 (16.25)/44.0 (22.25) | 0.934 | 12.0 (27.0)/11.0 (22.5) | 0.219 | 8.0 (20.0)/20.0 (30.0) | 0.666 |
Sport activity | ||||||
Returned to sport at time of interview (yes/no) | 48.0 (18.75)/41.5 (24.5) | 0.044 | 12.0 (23.0)/14.0 (34.0) | 0.082 | 8.0 (25.5)/32.0 (0.0) | 0.315 |
Subjective same level if active in sport (yes/no) | 55.5 (9.75)/38.5 (12.0) | <0.001 | 8.0 (9.5)/26.0 (27.25) | 0.001 | 3.0 (8.0)/28.0 (26.0) | 0.002 |
Patient characteristics | ||||||
Age (under mean/over mean) | 51.13.75/40.0 (23.5) | 0.005 | 8.0 (6.0)/20.0 (28.0) | 0.036 | 8.0 (18.0)/14.0 (30.0) | 0.545 |
Sex (female/male) | 42.0 (20.5)/49.5 (17.0) | 0.342 | 18.0 (28.0)/11.0 (19.5) | 0.141 | 22.0 (11.0)/8.0 (30.0) | 0.716 |
Charlson Comorbidity Index (0/>0) | 48.5 (17.75)/37.5 (15.25) | 0.016 | 12.0 (19.5)/36.0 (38.0) | 0.153 | 8.0 (31.0)/20.0 (0.0) | 0.761 |
Preexisting spine pathology (no/yes) | 49.5 (16.75)/39.5 (24.50) | 0.007 | 9.0 (16.5)/24.0 (29.0) | 0.001 | 7.0 (23.0)/20.0 (30.0) | 0.268 |
BMI (≤25/>25) | 48.0 (17.0)/44.0 (22.0) | 0.245 | 12.0 (30.0)/12.0 (25.0) | 0.777 | 13.0 (25.5)/8.0 (24.0) | 0.640 |
Injury and therapy | ||||||
Only cervical spine affected (yes/no) | 53.5 (24.5)/45.0 (18.5) | 0.526 | n.a. | 7.0 (21.5)/24.0 (18.0) | 0.186 | |
Multiple regions of the spine affected (no/yes) | 48.5 (19.25)/40.5 (9.5) | 0.053 | 11.0 (19.0)/32.0 (24.0) | 0.131 | 8.0 (21.0)/28.0 (11.0) | 0.144 |
Treatment (conservative/surgical) | 50.0 (13.0)/44.0 (23.5) | 0.081 | 10.0 (9.0)/20.0 (30.5) | 0.036 | 8.0 (16.0)/14.0 (30.5) | 0.867 |
Injury type B, C, or A4 (AO Spine) (no/yes) | 48.0 (17.75)/43.0 (24.5) | 0.409 | 10.0 (29.0)/20.0 (24.0) | 0.228 | 14.0 (22.5)/8.0 (27.0) | 0.617 |
Sport injury (no/yes) | 45.0 (20)/48.0 (18) | 0.345 | 12.0 (26.0)/8.0 (28.5) | 0.482 | 21.0 (24.5)/0.0 (6.0) | 0.045 |
Posttreatment | ||||||
Physical therapy (no/yes) | 54.0 (12.0)/44.0 (22.5) | 0.058 | 7.0 (8.0)/14.0 (30.0) | 0.019 | 0.0 (11.0)/14.0 (25.5) | 0.241 |
Rehabilitation (no/yes) | 53.0 (13.25)/37.5 (20.0) | <0.001 | 8.0 (8.5)/24.0 (29.5) | 0.001 | 8.0 (20.0)/31.0 (12.0) | 0.023 |
Motivation | ||||||
At least 5 h sport/week before injury (yes/no) | 45.0 (19.0)/48.0 (22.5) | 0.843 | 14.0 (26.0)/11.0 (29.0) | 0.63 | 16.0 (27.5)/8.0 (20.0) | 0.564 |
At least 3 x sport/week before injury (yes/no) | 44.0 (19.0)/50.0 (24.5) | 0.823 | 18.0 (20.0)/10.0 (33.5) | 0.321 | 14.0 (25.5)/8.0 (21.0) | 0.520 |
Tampa Scale of Kinesiophobia | HADS | Pain 5-Day Maximum | ||||
---|---|---|---|---|---|---|
Median (IQR) | p-Value | Median (IQR) | p-Value | Median (IQR) | p-Value | |
Time since injury above average (yes/no) | 38.0 (12.0)/34.5 (13.5) | 0.728 | 9.0 (12.75)/8.5 (10.75) | 0.861 | 16.5 (55.5)/14.5 (49.75) | 0.234 |
Sport activity | ||||||
Returned to sport at time of interview (yes/no) | 35.0 (11.0)/42.0 (13.5) | 0.016 | 8.0 (11.75)/14.0 (11.25) | 0.050 | 10.5 (49.75)/34.0 (66.0) | 0.025 |
Subjective same level if active in sport (yes/no) | 31.0 (9.0)/39.0 (10.0) | 0.002 | 6.0 (5.75)/15.5 (14.25) | <0.001 | 4.5 (16.5)/51.5 (66.0) | <0.001 |
Patient characteristics | ||||||
Age (under mean/over mean) | 34.0 (9.0)/38.5 (14.25) | 0.174 | 7.0 (9.75)/12.0 (12.0) | 0.145 | 12.0 (41.25)/20.0 (66.25) | 0.269 |
Sex (female/male) | 38.0 (13.0)/34.0 (13.0) | 0.720 | 11.0 (10.75)/8.0 (12.75) | 0.502 | 47.5 (63.5)/12.0 (42.75) | 0.099 |
Charlson Comorbidity Index (0/>0) | 36.0 (13.0)/38.0 (14.5) | 0.236 | 8.0 (12.0)/14.5 (12.75) | 0.085 | 12.0 (48.0)/63.0 (58.25) | 0.015 |
Preexisting spine pathology (no/yes) | 34.0 (11.25)/39.0 (13.0) | 0.037 | 7.5 (12.5)/12.0 (11.0) | 0.365 | 12.0 (44.0)/32.5 (69.0) | 0.059 |
BMI (≤25/>25) | 37.0 (10.75)/36.0 (12.0) | 0.753 | 9.0 (10.5)/9.0 (13.0) | 0.938 | 10.0 (61.0)/26.0 (46.0) | 0.25 |
Injury and therapy | ||||||
Only cervical spine affected (yes/no) | 31.0 (13.0)/37.0 (11.75) | 0.701 | 5.5 (4.0)/11.0 (12.0) | 0.017 | 6.5 (16.5)/19.5 (56.75) | 0.033 |
Multiple regions of the spine affected (no/yes) | 34.0 (13.0)/39.0 (5.5) | 0.075 | 8.0 (11.0)/18.0 (12.25) | 0.018 | 13.5 (52.5)/49.5 (50.75) | 0.054 |
Treatment (conservative/surgical) | 32.0 (9.0)/38.0 (12.75) | 0.058 | 6.0 (10.0)/10.0 (11.5) | 0.164 | 7. 0 (42.0)/20.0 (62.5) | 0.061 |
Injury type B, C or A4 (AO Spine) (no/yes) | 34.5 (13.25)/39.0 (10.5) | 0.232 | 8.0 (12.0)/9.0 (11.25) | 0.602 | 13.5 (56.25)/24.5 (55.75) | 0.485 |
Sport injury (no/yes) | 38.5 (12.0)/30.0 (8.0) | 0.005 | 9.0 (12.0)/7.0 (11.0) | 0.272 | 17.0 (52.0)/10.0 (62.0) | 0.195 |
Posttreatment | ||||||
Physical therapy (no/yes) | 32.0 (9.0)/37.0 (12.0) | 0.102 | 8.0 (8.0)/9.0 (12.5) | 0.215 | 2.0 (10.0)/20.0 (60.0) | 0.005 |
Rehabilitation (no/yes) | 32.0 (9.5)/39.0 (12.25) | 0.002 | 6.5 (10.25)/14.0 (15.25) | <0.001 | 6.0 (15.75)/51.5 (64.0) | <0.001 |
Motivation | ||||||
At least 5 h sport/week before injury (yes/no) | 36.0 (10.5)/37.5 (14.25) | 0.748 | 11.0 (11.25)/8.0 (10.5) | 0.150 | 17.0 (56.25)/15.5 (59.0) | 0.797 |
At least 3 x sport/week before injury (yes/no) | 37.0 (10.5)/36.0 (16.0) | 0.969 | 12.0 (11.0)/7.0 (11.5) | 0.031 | 19.0 (55.0)/12.0 (69.5) | 0.996 |
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Raisch, P.; Hirth, T.; Kreinest, M.; Vetter, S.Y.; Grützner, P.A.; Jung, M.K. The Impact of Spine Injuries on Amateur Athletes: An Exploratory Analysis of Sport-Related Patient-Reported Outcomes. Sports 2024, 12, 213. https://doi.org/10.3390/sports12080213
Raisch P, Hirth T, Kreinest M, Vetter SY, Grützner PA, Jung MK. The Impact of Spine Injuries on Amateur Athletes: An Exploratory Analysis of Sport-Related Patient-Reported Outcomes. Sports. 2024; 12(8):213. https://doi.org/10.3390/sports12080213
Chicago/Turabian StyleRaisch, Philipp, Tabea Hirth, Michael Kreinest, Sven Y. Vetter, Paul A. Grützner, and Matthias K. Jung. 2024. "The Impact of Spine Injuries on Amateur Athletes: An Exploratory Analysis of Sport-Related Patient-Reported Outcomes" Sports 12, no. 8: 213. https://doi.org/10.3390/sports12080213