CONTACT AND COLLISION SPORTS PARTICIPATION DURING ADOLESCENCE IS ASSOCIATED WITH REDUCED ANXIETY AND DEPRESSIVE SYMPTOMS
Authors: Howell David R. , Laker Scott , Kirkwood Michael W. , Wilson Julie 
Published: April 2020

Background: Recently, participation in contact and/or collision youth sports has received attention due to concern over exposure to repetitive head impacts. However, few studies have examined the relative risks and benefits of participation in contact and/or collision sports among young athletes currently engaged in these sports. Purposes and Hypotheses: We sought to examine whether participation in contact and/or collision sports during adolescence would be associated with quality of life (QOL) among a sample of healthy adolescent athletes undergoing a pre-participation examination. We hypothesized QOL domains scores would be similar between contact/collision and no/limited contact sport athletes. Methods: We conducted a cross-sectional study of adolescent athletes undergoing a pre-participation physical examination. During the assessment, participants completed a sport participation questionnaire and the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric-25 Profile, a measure of health-related quality of life. We grouped patients based on reported organized contact/collision or limited/non-contact sports participation in the past year, as delineated by Rice (2008). We compared PROMIS domain scores between groups using Mann-Whitney U tests, and used multivariable linear regression to identify the association between PROMIS domains scores and contact/collision sport participation while adjusting for covariates (sex, age, height, history of bone, muscle, ligament, or tendon injury, history of acute fracture or dislocation) in separate models. Results: A total of 281 adolescents participated: 143 (51%) reported contact or collision sport participation in the year prior to the study. There was a significantly greater proportion of females in the no/limited contact sport group compared to the contact/collision sport group (Table 1). There was a significantly greater proportion of contact/collision sport athletes who reported past bone, muscle, ligament, or tendon injuries and acute fracture or dislocation injuries compared to no/limited contact sport athletes (Table 1). Upon univariable comparison, those in the contact/collision sport group reported significantly lower anxiety and depressive symptom domain scores than the no/limited contact sport group (Table 2). After covariate adjustment, contact/collision sport participation was significantly associated with lower anxiety and depressive symptom domain scores (Table 3). Conclusion: Adolescents participating in organized contact/collision sports reported lower anxiety and depressive symptoms than adolescents participating in no/limited contact sports. These results reinforce the need to re-examine assumptions that youth contact/collision sports are necessarily associated with negative quality of life. Future prospective studies will be required to better understand any causal relationship between contact sports and psychological well-being in young athletes, both in the short- and long-term. [Table: see text][Table: see text][Table: see text]