Knee and physical activity self-efficacy in female adolescent athletes following anterior cruciate ligament reconstruction
Allison M Ezzat,1,2 Christian Barton,1 Mariana Brussoni,3,4Carolyn Emery,5,6 Andrea Bruder1
1La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia; 2Department of Physical Therapy, University of British Columbia, Canada; 3Department of Pediatrics, University of British Columbia, Canada, 4Human Early Learning Partnership, University of British Columbia, Canada; 5Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Canada; 6Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
Introduction: Knee injury may influence self-efficacy (one’s belief in their own ability).This study comprehensively examined knee and physical activity self-efficacy in young female athletes.
Materials and Methods: This convergent design included 102 females aged 15-23 years: 51 with primary unilateral ACLR within 1-2 years and 51 age-and-sport-matched uninjured controls. Knee Self-Efficacy Scale (K-SES; 2 subscales, Likert scale 0-10) and Self-Efficacy to Overcome Barriers to Physical Activity Scale (SOBPAS; 5 subscales, Likert scale 1-5; 4.0= threshold for clinical importance) were measured. Data were summarized descriptively, and Wilcoxon signed-rank tests examined differences within subscales between groups (p<0.05). Semi-structured interviews (n=31 participants; 18 ACLR; 13 uninjured) were audio-recorded, transcribed, and thematically analyzed. Qualitative themes were deductively mapped to K-SES and SOBPAS quantitative data.
Results: Participants’ median age was 17.8 years (range 14-22). K-SES subscales were lower in the injured group versus the uninjured group [present: injured 9.1±1.7, uninjured 10±0.29;p<0.001; future: injured: 7.5±4.0, uninjured: 10±2.0;p<0.001]. Qualitative and quantitative data converged with injured adolescents reporting lack of trust in, and need to modify activities, due to their knee. No between-group differences for any SOBPAS subscales were found. Physical environment (i.e., programs, transportation) [injured: 3.8±1.3, uninjured 3.8±1.3] and responsibilities (i.e. school, job) [injured: 3.6±1.1, uninjured: 3.5±1.4] subscales most influenced physical activity self-efficacy. SOBPAS results were enriched by themes including program availability, competing life priorities, and friend support.
Conclusion Clinicians should consider knee self-efficacy as a concern in young female athletes after ACLR, as it may impact future knee-related quality of life and behaviours.