UBC Theses and Dissertations
Physical activity and other health-related outcomes after knee injury in youth and young adults Ezzat, Allison Mairi
Traumatic knee injuries are among the most common sport-related injuries sustained by youth and are associated with significant personal and societal burden, including increased risk of post-traumatic osteoarthritis (PTOA). Despite the key role of physical activity (PA) in prevention of disease, disability, and death, there is a paucity of knowledge surrounding PA participation, and other health-related outcomes for these individuals. The overarching aim of this dissertation was to understand the attitudes and beliefs, health-related outcomes, and PA participation of youth and young adults after recovery from acute knee injury, yet before onset of symptomatic joint disease. This dissertation is comprised of four studies. First, qualitative interviews were conducted with youth and young adults 3-10 years following intra-articular knee injury examining the influence of their injury on attitudes and beliefs about PA and PTOA. Four main themes were: acceptance of the injury impact; high determination and resiliency; lack of knee confidence; and evolving sense of athletic identity. Second, knee confidence was quantitatively examined in youth and young adults 3-10 years after intra-articular knee injury and age-and sport-matched uninjured controls. Individuals with a previous knee injury had over seven times greater odds of being troubled by knee confidence than controls. Third, the Swedish Knee Self-Efficacy scale (K-SES) was translated and cross-culturally adapted into English for individuals with an intra-articular knee injury in the previous five years. Measurement properties were evaluated and revealed high internal consistency, acceptable validity, and very good reliability. Fourth, objectively measured PA and other health-related outcomes were examined in female youth and young adults, 1-2 years after anterior cruciate ligament reconstruction (ACLR), as well as in age-and-sport-matched uninjured female controls. Participants with previous ACLR had less vigorous PA; increased knee pain and symptoms; reduced function in sports; lower quality of life; as well as poorer neuromuscular control than controls. Taken together, these studies highlight specific longer-term physical and psychological health-related outcomes that should be addressed in youth and young adults with previous knee injury. They support that these individuals deserve intervention beyond the traditional injury recovery period with the ultimate goal of preventing PTOA.
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