Long-Term Health-Related Quality of Life After Sport-Related Injury in Youth Athletes: A Longitudinal Cohort Study

Rajiv Verma; Alexandria Render; Mario Ramirez; Neeta Shenvi; Kirk A Easley; Cynthia LaBella; Andrea Stracciolini; Neeru Jayanthi

doi:10.1177/23259671251341467

Long-Term Health-Related Quality of Life After Sport-Related Injury in Youth Athletes: A Longitudinal Cohort Study

Orthop J Sports Med. 2025 Jun 5;13(6):23259671251341467. doi: 10.1177/23259671251341467. eCollection 2025 Jun.

Authors

Rajiv Verma¹, Alexandria Render², Mario Ramirez², Neeta Shenvi³, Kirk A Easley³, Cynthia LaBella^{4

5}, Andrea Stracciolini^{6

7}, Neeru Jayanthi^{2

8}

Affiliations

¹ Endeavor Health, Glenview, Illinois, USA.
² Emory Sports Medicine Center, Johns Creek, Georgia, USA.
³ Emory University Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Atlanta, Georgia, USA.
⁴ Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
⁵ Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
⁶ Boston Children's Hospital, Boston, Massachusetts, USA.
⁷ Harvard Medical School, Boston, Massachusetts, USA.
⁸ Emory University School of Medicine, Atlanta, Georgia, USA.

Abstract

Background: Long-term effects of sport-related injury (SRI) on health-related quality of life (HRQoL) in young athletes are unknown.

Purposes: To compare 2-year long-term HRQoL outcomes between injured young athletes and available normative data for healthy youth (NDHY) and evaluate these outcomes by sex, age, surgical status, and sport attrition status.

Study design: Cohort study; Level of evidence, 3.

Methods: Patients ages 8 to 18 years who presented to 1 of 3 sports medicine clinics with SRI were included in the study. Baseline sport and injury history were collected. HRQoL was measured at 1, 12, and 24 months after injury via the PROMIS Pediatric-25 v2.0. Six HRQoL domains were analyzed by injury type (acute, overuse, concussion) with a mixed model for repeated measures. Scores >0.5 standard deviations from the reference mean were considered statistically significant.

Results: 357 patients completed baseline surveys (36% male, 64% female; mean age, 14.4 years) at 1 month after injury. There were 119 (33.3%) acute injuries, 42 (11.8%) concussions, and 196 (54.9%) overuse injuries. Of the sample, 336 (94.2%) were athletes and 21 (5.8%) were nonathletes. Cohort retention was 64% (228/357) at 12 months and 35% (126/357) at 24 months. Patients with overuse injury showed worse mobility at 1 month after injury compared with NDHY (mean [95% CI], 44.4 [43.1-45.6]), with resolution of this finding at 12- and 24-month follow-up (50.8 [48.9-52.7] and 51.8 [49.4-54.2], respectively). Patients who were older, were female, quit sport, or underwent surgery showed worse mobility compared with NDHY at 1 month after injury (44.0 [41.9-46.1], 44.7 [43.5-45.9], 40.8 [38.4-43.2], 34.3 [30.6-37.9], respectively), with similar resolution at 12- and 24-month follow-up. Female patients showed worse anxiety/fear, depression/sadness, and pain interference than male patients at 1-month follow-up (P = .002, P = .001, and P = .021, respectively), 12-month follow-up (P < .001, P = .001, P = .009), and 24-month follow-up (P≤ .001, P = .001, P≤ .001) but were no worse than NDHY at 12- and 24-month follow-up.

Conclusion: SRI in youth athletes does not negatively affect long-term HRQoL outcomes 24 months after injury. Female sex was found to be associated with worse short- and long-term HRQoL outcomes.

Keywords: acute injury; concussion; health-related quality of life; overuse injury; pediatrics; youth sports.