perceived physical capability and previous injury

Sciascia A, Haegele LE, Lucas J, Uhl TL. J
Athl Train 2015; 50(9):937-943.

Take Home Message: Athletes
that report a previous injury at preseason examination also reported lower
physical capabilities related to the knee or upper extremity before the
competitive season. Patient-reported joint-specific perceived capability
assessments might supplement preseason physical examination and aid in return
to play decisions following injury.

can collect patient-reported outcomes at initial evaluation and throughout
treatment to assess various outcomes, including an athlete’s perceived ability
to perform activities. However, clinicians lack data on preseason patient-reported
outcomes. This information could help clinicians determine how an athlete
perceived himself/herself before an injury. Therefore, the authors collected
perceived measures of physical capability for the knee, shoulder, and elbow
during preparticipation physical examinations and determined potential
differences in scores between collegiate athletes with and without history of
injuries. Overall, 738 athletes (486 men; ~19 years of age; 19 sports) from 5
collegiate institutions were medically cleared to participate in sport
following a physical examination. They then completed a general health history
questionnaire, which asked about history of knee, shoulder, or elbow injuries. Next,
athletes completed 2 questionnaires that assess an athlete’s perceived physical
capability: Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Kerlean-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) Score. Three hundred and fifty
athletes reported a history of 445 injuries. Athletes reported 208 knee
injuries, 180 shoulder injuries, and 57 elbow injuries. Athletes with no
history of injury reported nearly perfect preseason physical capabilities. Athletes
with previous injuries reported less perceived physical capability related to
the knee and upper extremity. Median values for perceived physical capability
of athletes with a history of injury were 3 to 12 points lower for each
questionnaire during preseason.

an athlete to their perceived preinjury capabilities is the goal of his/her
rehabilitation. Therefore, it is necessary to know what their preinjury
capabilities were. Overall, athletes reported high scores, on both KOOS and
KJOC, which was not surprising since these were healthy athletes. This
highlights that during rehabilitation and before return to play clinicians
should aim for a patient to report very high levels of perceived function. While
scores were generally high, the authors found that athletes with a history of injury
reported lower preseason physical capabilities. This finding suggests that
previous injury can adversely affect an athlete’s perceived physical capability.
The authors suggest that these simple patient-reported outcomes may supplement
preseason physical examinations and help identify athletes needing additional
care or monitoring. Future research will need to determine if these differences
are clinically meaningful and if they predict who is susceptible to new
injuries during an upcoming season. Presently, clinicians should use joint-specific
patient-reported outcomes during preseason to identify athletes who need
additional attention and to assist rehabilitation and return to play decisions.

Questions for Discussion:
Do you assess patient-reported quality of life, pain, or function at preseason to
compare pre and post injury levels to return to play?

by: Jane McDevitt, PhD
by: Jeff Driban


Sciascia A, Haegele LE, Lucas J, & Uhl TL (2015). Preseason Perceived Physical Capability and Previous Injury. Journal of Athletic Training, 50 (9), 937-43 PMID: 26287492