Sport-related Factors Research Articles

Investigation of sleep quality and mental toughness levels of young soccer players in terms of chronotypes

Background: The purpose of this research was to determine whether there is a relation between chronotype type and factors known to have a great impact on sports performance such as sleep quality and mental toughness.Methods: This cross-sectional study was conducted using the questionnaire technique. The population of this research consisted of 8.952 soccer players while the sample size consisted of 370 soccer players, with a confidence level of 95%. In this study, the "Turkish form of Morningness-Eveningness Stability Scale", "Mental Toughness Scale", and "Athlete Sleep Behavior Questionnaire- Turkish Version" scales were usedas data collection tools.Results: There was a positive and statistically significant relation between MorningType (M-Type) and Mental Toughness (p<.005). In terms of sleep behavior, a statistically significant relation was found between Evening-Type (E-Type) and sleep behavior (sport-related factors), between M-Type and Neither-Type (N-Type) andsleep behavior (sleep quality), between M-Type and sleep behavior (habitual sleep efficiency) (p<.005).Conclusion: Based on the data of this research, it was found that soccer players with M-Type had higher mental toughness than soccer players with E-Type and N-Type. Furthermore, it was concluded that soccer players had low sleep quality in terms of sleep habits. It was found that E-Type soccer players were affected by sport-relatedfactors, M-Type soccer players were affected by habitual sleep efficiency factors, and M-Type and N-Type soccer players were affected by inefficient sleep factors.

Sleep Difficulties in Swiss Elite Athletes.

For athletes, sleep is essential for recovery and performance. Yet, up to two-thirds of athletes report poor sleep quality. Comprehensive data across all sports disciplines on the underlying causes of sleep problems are missing. We reanalyzed a data set of N = 1004 Swiss top athletes across an extensive array of 88 sports to gain knowledge on the specific deficits in sleep health with respect to gender, sport classes, sport-related factors, and well-being. We found that 18% of athletes were affected by at least two out of five high-risk sleep factors: 9% of athletes slept less than 6 h per day, 30% were dissatisfied with their sleep, 17% showed problems falling asleep within 30 min, 18% of athletes reported difficulty maintaining sleep more than three times a week, and 6% of athletes used sleeping pills more than once a week. We found sleep health strongly linked to overall well-being and mental health (22% showed at least moderate symptoms of either depression or anxiety). Therefore, screening and treating sleep disorders might effectively improve mental health and general well-being as well as performance among athletes around the globe.

An initial exploration of fatigue as a predictor of quality of life in transplant athletes competing at national and international events

ABSTRACT Supporting organ transplant recipients’ quality of life after surgery continues to be of interest to health researchers and applied practitioners. However, literature and guidance on the factors linked to quality of life in transplant recipient athletes remains underreported. This study aimed to identify significant predictors of quality of life in an international sample of organ transplant recipient athletes (N = 99, Mage = 53 ± 14). Adopting a cross-sectional design, we collected the study data during the 2019 World Transplant Games which consisted of demographic items, health, and physical activity-related measures (i.e., task and ego orientation, fatigue severity, assessment of physical activity, physical activity enjoyment). Predictor variables were summarised into three categories: demographic factors, sport-related factors, and levels of fatigue with physical and mental quality of life functioning as the outcome variables. Hierarchical regression analyses exposed fatigue to exert a significant negative influence on both mental and physical quality of life perceptions explaining 49% and 64% of the variance in these variables respectively. Routine measurement and monitoring of transplant athletes’ level of fatigue in sport settings are recommended due to the negative bearing on quality of life that may be a potential barrier to sport participation and enjoyment.

How to reduce anxiety symptoms through individual sport in youth: A longitudinal study over 8-month observation.

Anxiety symptoms are widely observed among the youth, and engagement in sports has been demonstrated to mitigate these symptoms. Nonetheless, the effectiveness of specific sports and the potential moderating role of psychological factors, such as self-esteem and self-efficacy, on the influence of sports on anxiety, remains to be elucidated. This study was designed to longitudinally assess the impact of sports participation on anxiety symptoms among young individuals. The study encompassed 163 university students, with a male predominance of 81.6%, and explored the influence of sport-related factors (such as mastery of table tennis skills, level and engagement) and psychological aspects (including self-efficacy, self-esteem and resilience) on anxiety symptoms, employing an 8-month longitudinal approach. Physical activity, sedentary and sleep behaviour, along with age, body mass index (BMI), and sex, were accounted for as confounding variables. The study found that high table tennis performance score was found to buffer the development of anxiety symptoms in students with decreased self-esteem in an exploratory moderation model. Self-esteem and self-efficacy were negatively associated with the development of anxiety symptoms, whereas physical activity factors did not have a direct effect. This study highlights the potential of table tennis as a form of sport to alleviate anxiety symptoms in university students, particularly among those with decreased self-esteem. Future research should address the study's limitations and explore the potential moderating effects of other psychological factors. Overall, these findings suggest a potential new approach to treating anxiety symptoms among university students.

Organic self-talk content categories and their relations to sport-specific contextual and personal factors

While strategic self-talk interventions are well documented, less is known regarding organically occurring self-talk. Previously, eight organic self-talk content categories were identified, however contextual and personal factors relating to these categories is unexplored. The aim of the study was to explore the relationships between stress, coping, athletic identity, demographic and sport-related factors and the eight organic self-talk categories of anxiety control, confidence, disengagement, instruction, psych-up, somatic fatigue, worry, and irrelevant. 216 NCAA student-athletes were recruited. Regression was used to determine the relationships between the contextual and personal variables and organic self-talk. Stress, coping and self-talk categories were compared in and out-of-season. Stress was associated with all self-talk frequencies except confidence. Coping was associated with psych-up, confidence and worry. Athletic identity was associated with psych-up, confidence, instruction and disengagement. Age was associated with anxiety control and instruction. Lastly, sport type and division level were associated with disengagement and instruction self-talk respectively.

Sport culture and communication among middle school athletes, parents, and staff: A qualitative study.

Middle school (MS) is an intermediary level of education between elementary and secondary school that typically includes students aged 10-15 years. There is limited research within the MS sport setting, particularly related to sport-related injury prevention. This qualitative study aimed to better understand the sport culture within MS sports and the communication strategies used among invested groups (i.e., athletes, parents, staff inclusive of coaches and school nurses). Semi-structured interviews were conducted with 19 athletes, 20 parents, and 18 staff (e.g., coaches, school nurses) from seven MS in two school districts during the 2018/19 and 2019/20 school years. Topics focused on understanding school- and sport-related factors related to education, safety, and communication. Analysis used a consensual qualitative research tradition, in which the research team discussed individually developed themes and categories from transcribed interviews, with the goal of coming to a consensus and creating a codebook. Throughout the coding process, the research team would reconvene to discuss coding decisions until consensus was reached. This study focuses on the themes of sport culture and communication. Dominant categories identified within sport culture related to participants noting why they were interested in MS sports, and their struggles with their perceived roles and engagement (e.g., helping parents stay engaged, finding coaches, oversight of school nurses). Competitiveness and safety could have conflicting roles and priority. Dominant categories identified within communication centered around limited communication between coaches and parents. Technological assistance (e.g., phone apps, websites) was available, but often varied by school and sport. Concussions were seldom discussed unless during the preseason meeting or when one occurred. Findings highlight that the MS sport settings may struggle with incorporating primary prevention into their cultures and ensuring reliable communication among individuals. Novel and tailored approaches to injury prevention are needed to help ensure buy-in and proper implementation.

Scapular Dyskinesis in the Athletic Patient: A Sport-Specific Review.

Scapular dyskinesis is an alteration of normal scapular kinematics. It is essential that each patient be evaluated holistically and that sport-related factors be taken into account. The presentation of scapular dyskinesis may be highly variable depending on the underlying etiology or associated pathology, but the onset of symptoms is often gradual. Sport-specific literature on scapular dyskinesis is most commonly reported in the context of baseball, swimming, and tennis. Treatment is most often conservative and involves physical therapy directed at the scapular stabilizers.

Anorexic Readiness Syndrome in Elite Female Acrobatic Gymnasts-International Study.

Anorexic Readiness Syndrome (ARS) is a concept used in research for the early detection of disordered eating (DE). It is a set of indicators located primarily within the cognitive and behavioral sphere of an individual’s functioning. The aim of this study was to examine whether among the elite acrobats there are girls showing a high level of anorexic tendency, and if so, what behaviors and attitudes are the most common. In addition, an attempt to determine what sport-related factors or other non-sport variables may increase the risk of ARS was conducted. The study group was made up of 133 acrobatic gymnasts aged 10–19, representing six countries that participated in the Acro World Cup competition held in Poland. The study procedures included surveys (personal questionnaire and the Eating Attitudes Questionnaire), anthropometric measurements such as weight, height, waist circumference (WC) and determination of the Body Mass Index (BMI), fat percentage (Fat%), and waist to height ratio (WHtR). A high level of ARS was found in 9.8% of acrobats. This group most often declared attitudes and behaviors indicative of anorexic tendencies. A strong relationship with the level of ARS was noted in the following: the use of fasting and diets (p ≤ 0.001; V = 0.54), limiting of fats and carbohydrates (p ≤ 0.001; V = 0.60), feeling angry after eating too much (p ≤ 0.001; V = 0.55), knowing the caloric value of many food products (p ≤ 0.001; V = 0.59), and the desire to improve the appearance of one’s body (p ≤ 0.001; V = 0.52). The role played in the acrobatic partnership and the region of residence were considered as the sport-related risk factors. Among non-sport factors, the strongest predictor of ARS was the age of gymnasts (β = 0.516; p ≤ 0.001).

Athlete Mental Health & Psychological Impact of Sport Injury

Athletes may experience mental health concerns at similar rates, and in some instances, higher rates than nonathletes. Two other factors, sleep and substance use, play important roles in athlete mental health and well-being. A variety of nonsport and sport-related factors place athletes at risk for mental health concerns, and one important sport-related factor is injury. Sport injury and mental health appear to have a bidirectional relationship, and the sport injury and rehabilitation process is associated with a wide variety of psychological and mental health concerns. Existing literature suggests understanding of these variables allows the professional to proactively address psychological readiness for return to sport throughout the injury rehabilitation process. The objective of this paper is to present literature related to athlete mental health and address ways in which sport injury can contribute to athlete mental health, well-being, and psychological readiness for return to sport.

Assessing Gender Inequity in Local Athletic News Coverage

The amount of sports news coverage is generally less for women compared to men. This serves to promote sports as a predominantly male enterprise, hindering female athletics participation and marketing. In addition, it dissuades young women from participating in sports activities, which can lead to many negative mental and physical health outcomes. This study compared athletic news coverage of male and female athletes in a local suburban newspaper and assessed factors that may influence coverage. All articles published in the weekly Lexington Minuteman in 2017 were manually reviewed extracting the sex of the athletes, sport-related factors (e.g., sport played), and publication-related factors (e.g., front-page status). A one-proportion z-test was performed to compare the proportion of articles covering male and female athletes; chi-square and t-test were used to compare factors associated with articles that covered males and females. The study found that 70% of sports-related articles covered male athletes, significantly more than females (p<0.0001). Other factors did not differ significantly by sex, including criteria for accepting articles. Although publication-related factors were similar for articles covering males and females, underrepresentation of female athletes in local newspaper coverage suggests decreased stakeholders’ interest in submitting articles concerning female athletes. This may, in turn, impact female participation and interest in athletics. Improving sports consciousness needs to be addressed more widely by society to encourage female athletic participation in fitness and sports.

Disturbances in Brain Physiology Due to Season Play: A Multi-Sport Study of Male and Female University Athletes.

High-performance university athletes experience frequent exertion, resulting in disrupted biological homeostasis, but it is unclear to what extent brain physiology is affected. We examined whether athletes without overtraining symptoms show signs of increased neurophysiological stress over the course of a single athletic season, and whether the effects are modified by demographic factors of age, sex and concussion history, and sport-related factors of contact exposure and season length. Fifty-three university-level athletes were recruited from multiple sports at a single institution and followed longitudinally from beginning of season (BOS) to end of season (EOS) and 1 month afterwards, with a subset followed up at the subsequent beginning of season. MRI was used to comprehensively assess white matter (WM) diffusivity, cerebral blood flow (CBF), and brain activity, while overtraining symptoms were assessed with Hooper’s Index (HI). Although athletes did not report increased HI scores, they showed significantly increased white matter diffusivity and decreased CBF at EOS and 1 month afterwards, with recovery at follow-up. Global brain activity was not significantly altered though, highlighting the ability of the brain to adapt to exercise-related stressors. Male athletes had greater white matter diffusivity at EOS, but female athletes had greater declines in CBF at 1 month afterwards. Post-season changes in MRI measures were not related to change in HI score, age, concussion history, contact exposure, or length of athletic season. Hence, the brain shows substantial but reversible neurophysiological changes due to season play in the absence of overtraining symptoms, with effects that are sex-dependent but otherwise insensitive to demographic variations. These findings provide new insights into the effects of training and competitive play on brain health.

Profiling of Student-Athletes using Protective Behavioral Strategies and Alcohol Use Based on Cluster Analysis Assignment

An estimated 2 in 3 college students report consuming alcohol in the past month and 44% of students report engaging in high risk or heavy episodic drinking at least once in the previous 2 weeks. Despite evidence suggesting that participation in sports may be a protective factor for the use of alcohol, recent data from the National Collegiate Athletic Association (NCAA), finds that 77% college student-athletes report use. Though overall prevalence rates of alcohol consumption are similar among college student-athletes and non-athletes, student-athletes are more likely to engage in binge or high-risk drinking as compared to their non-athlete peers. An overwhelming majority of studies found that protective behavioral strategy (PBS) use was associated with less drinking and alcohol-related problems. There are sport-related factors that have been assessed to determine their association with use of alcohol-related PBS. With known factors in mind, prevention programs are typically developed to effect distal outcomes by way of these, more proximal, intermediate constructs that are thought to be related to the health problem of interest. The purpose of the current study was to examine the structural features that influence whether a given student-athlete will be categorized into one of three groups; a) high-risk drinking behaviors, b) moderate risk drinking behaviors, or c) low risk drinking behaviors.

Investigating the Prevalence and Predictors of Injury Occurrence in Competitive Hip Hop Dancers: Prospective Analysis.

Hip hop is a popular form of competitive and recreational sport worldwide, but studies rarely investigate injury prevalence and factors associated with injury occurrence in this sport. This study aimed to prospectively examine injury occurrence in hip hop dancers in a three-month period and to evaluate potential predictors of injury occurrence in hip hop dancers. The participants were 129 competitive hip hop dancers (114 females, 17.95 ± 4.15 years of age). Study predictors were obtained at study baseline and included sociodemographic factors, sport-related factors, previous injury status, anthropometric and body build indices (body height, mass, body mass index, and body composition variables), and dynamic balance performance (obtained by the Star Excursion Balance Test—SEBT). The outcome was injury occurrence, which was prospectively observed once a week by the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC). During the course of the study, 101 injuries occurred, equating to an annual injury incidence of 312%. On average, each dancer suffered 0.78 injuries (95% Confidence Interval (95% CI): 0.61–0.97) across a study period of three months (0.76 (95% CI: 0.60–0.95) and 0.93 (95% CI: 0.75–1.13), in females and males, respectively; Mann Whitney Z-value: 0.68, p = 0.52). Seventeen percent of dancers suffered multiple injuries, and 49% of all injuries were time-loss injuries. The knee was the most frequently injured body location (42% of all reported injuries), followed by the back region (32%) and the ankle (15%). Previous injury was a strong predictor of injury occurrence (Odds Ratio: 3.76, 95% CI: 1.87–4.59). Lower injury risk was evidenced among those participants who achieved better scores on several SEBT variables, irrespective of gender and previous injury status; with no significant influence of anthropometric and body build variables on injury occurrence. This study highlighted a high injury rate in hip hop dancers. Dancers and coaches should be informed about the certain protective effects of dynamic balance on the prevention of musculoskeletal injury in hip hop in order to assure safe and effective practices. The usage of SEBT as a convenient and cheap testing procedure is encouraged in other dance disciplines.

Prospective Analysis of Prevalence, Trajectories of Change, and Correlates of Cannabis Misuse in Older Adolescents from Coastal Touristic Regions in Croatia.

The prevalence of illicit drug misuse, including cannabis, in Croatian touristic regions is alarming. This study aimed to identify the prevalence of cannabis consumption (CC), to identify associations between sociodemographic and sport factors and CC, and to evaluate the predictors of CC initiation in adolescents residing in touristic regions. This study enrolled 644 adolescents from two touristic regions in Croatia (Split-Dalmatia and Dubrovnik-Neretva County) who were tested at baseline (16 years of age) and follow-up (18 years of age). The study instrument consisted of questions focused on predictors (age, gender (male, female), place of residence (urban or rural environment), familial social status, and different sport-related factors) and CC outcome. The results indicated a high prevalence of cannabis consumption (>30% of adolescents consumed cannabis), with a higher prevalence in males, and adolescents from rural communities. The prevalence of CC increased by 10% during the study period, with no significant differences between genders in trajectories of changes. Quitting sports was a risk factor for CC at baseline and follow-up. Better sport competitive results (odds ratio (OR): 0.80, 95% confidence interval (CI): 0.65–0.96) and familial social status (socioeconomic status: OR: 0.66, 95% CI: 0.39–0.91; maternal education: OR: 0.65, 95% CI: 0.48–0.88) were associated with lower likelihood of CC at baseline. The adolescents who reported better sport competitive results were at increased risk for initiation of CC during the course of the study (OR: 1.40, 95% CI: 1.03–2.01). The protective effects of sports at baseline were most likely related to various factors that prevent the consumption of substances in youth athletes (i.e., commitment to results, adult supervision); with the end of active participation, adolescent athletes are at high risk for CC initiation.

Educational and sport factors as predictors of harmful alcohol drinking in adolescence: a prospective study in Bosnia and Herzegovina.

The cause-effect relationship between educational and sport factors, and alcohol drinking in adolescents is rarely prospectively investigated. This study aimed to establish the possible influence of sport, scholastic and socio-demographic factors on harmful alcohol drinking (HD) and the initiation of HD in adolescents from Bosnia-Herzegovina. Study included 881 adolescents (49% females) and consisted of (1) baseline tests (16years of age) and (2) follow-up testing (18years of age). The independent variables were scholastic and sport-related factors. Alcohol Use Disorders Identification Test was used, with the following dependent variables: (1) HD at baseline, (2) HD at follow-up, and (3) HD initiation. Logistic regressions were applied to define the relationships. Higher likelihood of HD was evidenced in children who performed poorly in school. Sport factors were positively correlated with HD at study baseline. Higher odds for HD initiation were found for adolescents who reported a lower GPA, a lower behavioral grade, more frequent school absences, and more unexcused school absences. The results showed scholastic failure as the predictor of HD initiation. The potential influence of sport factors on HD initiation should be studied at an earlier age.

Sport and scholastic factors in relation to smoking and smoking initiation in older adolescents: a prospective cohort study in Bosnia and Herzegovina

ObjectiveSport and scholastic factors are known to be associated with cigarette smoking in adolescence, but little is known about the causality of this association. The aim of this study was...

Hair and Saliva Trace Elements Content in Young Athletes from Kazan Region, Russia

Active physical exercises are associated with high body mineral demand that can cause mineral disbalances with diverse negative health outcomes. The purpose of this study is to examine the impact of sport-related factors on mineral composition in young athletes. Saliva and hair samples were chosen for the analysis as reflecting immediate and more permanent mineral status, respectively. The samples were analysed by spectral methods with inductively coupled plasma for eight essential minerals: calcium (Ca), chromium (Cr), iron (Fe), potassium (K), magnesium (Mg), selenium (Se), and zinc (Zn). The results from athletes were compared to ones from the control group of adolescent non-athletes. Different minerals demonstrated sampling specific distribution. Sport type specificity of mineral content was found. These findings can help in the process of mineral status data standardization and in training process to correct the sport-associated mineral disbalances.

Sport- and sample-specific features of trace elements in adolescent female field hockey players and fencers

Active physical exercises and growth are associated with mineral imbalances in young athletes. The purpose of this study was to examine the impact of sport-related factors on tissue mineral status in adolescent female athletes. Saliva and hair samples were used for the analysis of immediate and more permanent tissue mineral status, respectively. Samples taken from a control non-athletic female group and two groups of female athletes (field hockey and fencing) were analyzed for seven essential minerals: calcium, chromium, iron, potassium, magnesium, selenium and zinc. Inductively-coupled plasma mass spectrometry was used for the quantification of elements having very low concentration range in samples (Se, Cr and Zn) whereas inductively coupled plasma optical emission spectrometry was used for quantification of more ubiquitous elements (Mg, К, Са, Fe). The obtained results for athletic groups were compared with control. Female athletes had increased levels of selenium in both saliva and hair as well as chromium in saliva. Field hockey players had the higher level of zinc in hair whereas fencers had the lower levels of salivary calcium. Strong negative correlation between potassium levels in saliva and hair was identified. Iron and magnesium did not differ between the studied groups. In conclusion, novel sport-specific features of chromium tissue levels in female athletes were found. The studied sport disciplines have different impact on the distribution of osteoporosis-related minerals (calcium and zinc). Our finding can help in the development of osteoporosis preventive trainings and in the proper nutrient supplementation to correct mineral imbalances in female athletes.

CIGARETTE SMOKING AMONG 17-18 YEAR OLD ADOLESCENTS - PREVALENCE AND ASSOCIATION WITH SOCIODEMOGRAPHIC, FAMILIAL, SPORT, AND SCHOLASTIC. FACTORS.

Though adolescence is recognised as a critical period for smoking prevention, there is a lack of research focused on this issue in Kosovo. The aim of this study has been to examine the gender-specific factors of influence (predictors) for smoking among adolescents in Pristina, Kosovo. The study sample comprised 1002 adolescents at the age of 17-18 (366 boys, 636 girls), all of whom were in the school's 12th grade. The predictors included sociodemographic variables, familial (i.e.,parental) monitoring, parents' educational background, and sport-related factors. The Chi2 and forward stepwise logistic regression analyses with a dichotomous criterion (smoking vs. non-smoking) were applied. The incidence of smoking was high (31% and 40% smokers, including 7% and 12% daily smokers for girls and boys, respectively). The regression model revealed more frequent absence from school(odds ratio (OR): 1.544; 95% confidence interval (Ci): 1.063-2.243), more unexcused school absences (OR: 1.360; 95% CI: 1.029-1.796), and frequent parental questioning (OR: 1.530; 95% CI: 1.020-2.295) to be significant predictors'of smoking among boys. For girls, a higher risk of smoking was associated with lower scholastic achievement (OR: 1.467; 95% CI: 1.089-1.977), more frequent absence from school (OR: 1.565; 95% CI: 1.137-2.155), increased conflict with parents (OR: 1.979; 95% CI: 1.405-2.789),and a self-declared perception of less parental care (OR: 0.602; 95% CI: 0.377-0.962). Sports were not found to be strongly related to smoking. However, a high riskof daily smoking was found among boys who participated in team sports and subsequently quit. This study reinforces the need for gender- and culture-specific approaches to studying the factors that influence smoking among adolescents.

Return to sport and quality of life in people with knee symptoms 5–20 years following anterior cruciate ligament reconstruction

Introduction:Anterior cruciate ligament reconstruction (ACLR) can result in psychological and physical impairments that impact on participation in desired activities and sports. To date, no study has explored the impact of sports restrictions on quality of life (QOL) in people with knee symptoms following ACLR. The aims of this study were to (i) quantify QOL; and (ii) explore relationships between participant characteristics, sport-related factors and QOL 5–20 years following ACLR. Methods: We conducted a cross-sectional analysis on 139 individuals with knee pain, stiffness or activity limitations 5–20 years following ACLR. Participants were recruited from surgical records of four experienced orthopaedic surgeons. All patients aged 18–55 years who had a hamstring or patellar-tendon autograft ACLR 5–20 years ago were invited to participate. People with significant comorbidities and those not fluent in English were excluded. Participants completed the Anterior Cruciate Ligament QOL Questionnaire (ACL-QOL), Knee injury andOsteoarthritis Outcome Score (KOOS) and a demographics questionnaire. KOOS and ACL-QOL scores range from 0 (worst) to 100 (best). KOOS cut-off criteria were applied to ensure all participants were symptomatic. Spearman rank correlations explored relationships between participant characteristics, return to sports information and QOL. Results: A total of 139 participants completed the questionnaires at a mean 9 years (range 5–20) following ACLR. Participants had a mean age of 38 years (range 20–55), a mean BMI of 27 (range 19–43) and 42% were female. Participants scored a mean 55±20on theKOOS-QOL subscale and57±21on theACL-QOL. The most impaired ACL-QOL itemswere sport/recreational frustrations (33±31), playing sport under caution (36±35) and fear of contact sports (35±37). The least impaired ACL-QOL subscale was workrelated concerns (78±22). Returning to sport at a lower level (27%) or not returning to sport (34%) was correlated with poor KOOSQOL scores (r=0.32, p<0.01). Reporting the knee as the reason for not returning to the same level of sport (77%) was correlated with competitive needs not being met (r=0.25, p=0.01) and poor knee confidence (r=0.20, p=0.05). Pain-free sport or exercise participation was considered preferable (78%) to pain-free participation in work (2%), family (15%) or social activities (5%). Discussion: The ability to participate in sport and exercise appear to be a high priority and is associatedwith QOL impairment in peoplewith knee symptoms 5–20 years after ACLR. Knee-related QOL was considerably lower than population norms. Addressing knee confidence, sport-related concerns, frustrations and fearsmay assist in improving QOL following ACLR.