Physical activity in former elite cricketers and strategies for promoting physical activity after retirement from cricket: a qualitative study

OBJECTIVES: The health benefits of professional sport dissipate after retirement unless an active lifestyle is adopted, yet reasons for adopting an active or inactive lifestyle after retirement from sport are poorly understood. Elite cricket is all-encompassing, requiring a high volume of activity and unique physical demands. We aimed to identify influences on physical activity behaviours in active and insufficiently active former elite cricketers and provide practical strategies for promoting physical activity after cricket retirement. DESIGN: 18 audio-recorded semistructured telephone interviews were performed. An inductive thematic approach was used and coding was iterative and data-driven facilitated by NVivo software. Themes were compared between sufficiently active and insufficiently active participants. SETTING: All participants formerly played professional cricket in the UK. PARTICIPANTS: Participants were male, mean age 57±11 (range 34–77) years, participated in professional cricket for 12±7 seasons and retired on average 23±9 years previously. Ten participants (56%) were classified as sufficiently active according to the UK Physical Activity Guidelines (moderate-intensity activity ≥150 min per week or vigorous-intensity activity ≥75 min per week). Eight participants did not meet these guidelines and were classified as insufficiently active. RESULTS: Key physical activity influences were time constraints, habit formation, intrinsic and extrinsic motivation, physical activity preferences, pain/physical impairment and cricket coaching. Recommendations for optimising physical activity across the lifespan after cricket retirement included; prioritise physical activity, establish a physical activity plan prior to cricket retirement and don’t take a break from physical activity, evaluate sources of physical activity motivation and incorporate into a physical activity plan, find multiple forms of satisfying physical activity that can be adapted to accommodate fluctuations in physical capabilities across the lifespan and coach cricket. CONCLUSIONS: Physically active and less active retired cricketers shared contrasting attributes that informed recommendations for promoting a sustainable, physically active lifestyle after retirement from professional cricket

Quality of life impairments after hip arthroscopy in people with hip chondropathy

Many young individuals undergoing hip arthroscopic surgery have hip chondropathy. The impact of mild or more severe hip chondropathy 1-2 years following arthroscopy is poorly understood. The purpose of this study was to (i) compare health-related quality of life (HRQoL), anxiety and depression scores between people who underwent arthroscopic treatment for hip chondropathy 1-2 years previously and pain-free controls; (ii) compare HRQoL, hip-related quality of life (QoL) and anxiety/depression scores in people with mild versus severe hip chondropathy and (iii) compare hip-related QoL items between chondropathy groups. The Hip disability and Osteoarthritis Outcome Score (HOOS), International Hip Outcome Tool (iHOT-33), EuroQol-5D and Hospital Anxiety and Depression Scale (HADS) were compared between 71 individuals aged 18-60 years following arthroscopic treatment for hip chondroplasty (12-24 months previously) and 46 healthy controls. Comparisons were also performed between people with mild (Outerbridge grade 1-2) and severe (Outerbridge grade 3-4) hip chondropathy. Participants following arthroscopic treatment for hip chondroplasty reported worse HRQoL, hip-related QoL and anxiety, compared with pain-free controls (all P < 0.05), but no difference in self-care (P = 0.20). There were differences between mild and severe chondropathy groups for pain during sport/recreation [median (IQR) 20 (5-80) versus 60 (25-90) P = 0.01), pain after activity (40 (20-75) versus 75 (50-90) P = 0.01), difficulty maintaining fitness (30 (10-70) versus 75 (35-85) P = 0.02) and reduced hip confidence. Hip chondropathy was associated with significant QoL impairment, with severe chondropathy associated with the greatest impairment. The identification of specific areas of QoL impairment provides avenues to target rehabilitation and support

Evaluating patients’ expectations from a novel patient-centered perspective predicts knee arthroplasty outcome

Background One in five patients are dissatisfied following knee arthroplasty and <50% have fulfilled expectations. The relationship between knee-arthroplasty expectations and surgical outcome remains unclear. Purpose Are expectations regarding the impact of pain on life after knee arthroplasty predictive of one-year outcome? Does the impact of pain on preoperative quality of life (QOL) influence this relationship? Methods Longitudinal cohort study of 1044 uni-compartmental (43%) or total knee-arthroplasty (57%) (UKA or TKA) patients, aged mean 69±9 years. Preoperatively, patients reported the impact of pain on QOL and the expected impact of pain on life one-year post-arthroplasty (none, mild, moderate/severe/extreme). One-year postoperative outcomes: non-return to desired activity (specific activities were specified preoperatively), surgical dissatisfaction, not achieving Oxford Knee Score (OKS) minimal important change (MIC). Logistic regression including covariates was performed for all patients and subgroups (better vs. worse pre-operative pain-related QOL; UKA vs. TKA; osteoarthritis indication vs. other indication). Results Expecting moderate-to-extreme pain (vs. no pain) predicted non-return to activity (odds ratio (95% CI), 2.3(1.3, 4.1)), dissatisfaction (4.0(1.7, 9.3)), and not achieving OKS MIC (3.1(1.5, 6.3)). Expecting mild pain (vs. no pain) predicted worse outcomes for patients with better preoperative pain-related QOL (non-return to activity: 2.7(1.5, 4.8), not achieving OKS MIC: 2.5(1.1, 5.5)). Expecting moderate-to-extreme pain (vs. no pain) predicted worse outcomes for patients with worse preoperative pain-related QOL (non-return to activity: 2.4(1.1, 5.5), dissatisfaction: 5.0(1.7, 14.8), not achieving OKS MIC: 3.4(1.4, 8.6)). The odds of a poor outcome in people with worse expectations was higher for UKA patients. Conclusions Expecting a worse outcome predicted surgical dissatisfaction, less clinical improvement and non-return to desired activity. Patients expecting a more optimistic outcome relative to preoperative status achieved better surgical outcomes

The long-term outcome of ACL injury: 32 to 37 year follow-up

The state of the ACL injured knee and how this impacts on quality of life (QOL) more than 30 years after ACL injury, remains unclear. Additionally, the impact of surgical or non-surgical ACL treatment on outcome beyond 30 years of injury is uncertain. This study aimed to: i. Evaluate patient-reported outcomes (PROs) 32-37 years following acute ACL injury ii. Assess whether ACL treatment (surgical or non-surgical), baseline meniscus injury and knee function at mid-term follow-up were related to differences in PROs at 32-37 year follow-u

A 32 to 37 year follow-up of football and non-football related anterior cruciate ligament injury

The impact of the anterior cruciate ligament (ACL)-injured knee on quality of life (QOL) and knee function more than 30 years after ACL injury is unclear. Additionally, comparison in outcome following football and non-football related ACL injury, and the impact of meniscus injury, ACL treatment and knee function on patient-report outcomes (PROs) 32-37 years following injury has not been investigated. This study aimed to: i. Evaluate PROs 32-37 years following football compared with non-football related ACL injury; ii. Assess the relationship between ACL treatment, baseline meniscus injury and mid-term knee function with PROs, 32-37 years following football compared with non-football related ACL injur