Sport Participation and Psychosocial Factors Which Influence Athletic Identity in Youth Athletes With Anterior Cruciate Ligament Injury

Abstract

Athletic identity, or the degree with which individuals identify with the athlete role, is an important rehabilitation factor for sports care providers to consider; however, it lacks extensive study in youth. The purpose of this study was to identify demographic, sport participation, and psychosocial measures which correlate with youth athletic identity after anterior cruciate ligament injury. Participants completed standardized sports medicine intake and patient-reported outcome measures, including the Athletic Identity Measurement Scale (AIMS). A total of 226 participants were included, and two groups were created based on high or low total AIMS score. Results indicated that sex (p = 0.002), years active in sport (p = 0.049), activity level (p = 0.038), and ACSI-Coachability (p = 0.027) differed by AIMS score. While youth athletes appear resilient, these results emphasize that they identify strongly with the athlete role and may suffer psychosocial consequences after injury. Future work should evaluate similar factors over course of recovery in a larger, diversified population.

Differences in athletic identity, sport participation, and psychosocial factors following anterior cruciate ligament rehabilitation in youth athletes

“…Similar studies in mixed cohorts of youth and young adults reported AIMS scores between 44.2 and 57.5, which further support the current data ( Manuel et al, 2002 ; Brewer et al, 2003 ; McKay et al, 2013 ; Padaki et al, 2018 ; McGinley et al, 2022 ). The observed decrease in AIMS confirms Brewer and Cornelius’ (2010) findings in adults who reported a gradual decline in athletic identity over 24 months post-ACLR, with the most substantial decline at 6–12 months post-ACLR.…”

“…In this cohort, only pre-ACLR AIMS scores were different between males and females. Certain studies report that sex and athletic identity are related ( Babić et al, 2015 ; Şekeroğlu, 2017 ; McGinley et al, 2022 ) though the pattern is inconsistent. Others show no such relationships ( Proios et al, 2012 ; Piatt et al, 2018 ; Costa et al, 2020 ; Rae and Jenkins, 2021 ), yet only McGinley et al and Piatt et al studied youth exclusively.…”

“…Training volume (years in sport, days per week, weeks per year, and weeks off per year), recovery duration, and PROs were collected as standard-of-care at both pre-ACLR and 1-year post-ACLR from the patient’s intake form and/or surveys administered through the Outcome Based Electronic Research Database (OBERD; Universal Research Solution, LLC; Columbia, Missouri), an electronic PRO system validated in youth ( Sabatino et al, 2019 ). PROs included the AIMS, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (Pedi-FABS), the Pediatric International Knee Documentation Committee Subjective Form (Pedi-IKDC), the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI), and the Athletic Coping Skills Inventory-28 (ACSI-28; McGinley et al, 2022 ). Patients were asked to respond to PROs related to function only in their current injured state at pre-ACLR.…”

“…All athletes were then categorized into two groups based on the median AIMS score at 1-year post-ACLR. These groups were split by total AIMS scores greater than 50 (AIMS H ) and less than 50 (AIMS L ) similar to other relevant studies as no “high” or “low” AIMS cutoff score has been defined in the literature ( Padaki et al, 2018 ; Costa et al, 2020 ; McGinley et al, 2022 ). Independent samples t-tests and ANOVAs were performed to compare demographics, sport participation, and PROs between the two groups.…”

“…Finally, coping ability is likely relevant to rehabilitation success; athletes who can cope more effectively may alleviate these depressive symptoms and trauma ( Ardern et al, 2014 ; Samuel et al, 2015 ; Renton et al, 2021 ; Nyland and Pyle, 2022 ). Nevertheless, the relationship between coping ability and athletic identity is unclear as one study reported worsened coping in youth with high athletic identity ( McGinley et al, 2022 ), while another study reported better coping skills in specialized athletes of all ages, which was associated with higher athletic identity ( Christino et al, 2021 ). Overall, psychological measures of readiness appear to be related to one’s identity in sport, but expanded knowledge on specific positive and negative psychological factors is needed.…”