Summary

A history of surgery for a sports injury as well as increased levels of pain were the two main factors associated with the presence of anxiety in patients in a Sports Medicine Outpatient Clinic

Abstract

Introduction

Recovery from a sports injury entails several factors that play an important role in a patient’s outcome. Significant association has been shown between psychological factors and recovery time, patient satisfaction, pain control and return to sport. However, the ideal target population for psychological services has not been defined. This study aims to describe patients and their characteristics who have psychological distress following a sports injury.

Methods

The GAD-7 Anxiety Score Questionnaire, a validated questionnaire to detect psychological distress, was distributed among outpatients in a Sports Medicine Clinic. Patient demographics as well as information on the type of injury, level of sport, timeline in recovery, and history of surgery were obtained. All ages and genders were included. Using a GAD score of 10 as an indicator of psychological distress, descriptive statistics were used to present the characteristics of the population who met these criteria. Chi squared test was performed to compare the rates of psychological distress based on patient characteristics, and linear regression analyses were performed to identify the relationship between GAD-7 scores and injury characteristics.

Results

254 patients were included in this study, mean age of 40 (18) (88 males, 166 females). Mean GAD-7 scores were of 2.4 (3.9). 112 patients participated sports recreationally and 194 consulted for knee symptoms. 121 presented with an acute injury followed by those attending postoperative visits (83). 44% patients had surgery for their injuries while 55.9% had not. The average level of pain reported was of 4.1 on a 1-10 scale. Based on GAD-7 >=10 points, 18 patients (7%) reported significant levels of anxiety (7 males, 11 females). This constituted 8% for the male patients and 7% of the female patients. Significant association was found between current pain score and GAD-7 score in patients with a history of surgery associated with their injury, while none was identified in the non-surgical group. No relationship was found between other factors associated to the injury such as sport, type of injury, injured body part, level of sport, perceived percentage of joint function, or age. Linear regression to show association between GAD-7 and postoperative time showed trends toward significance. Within the GAD-7 components, feelings of nervousness or anxiety were reported by 33% of patients and the inability to relax was present in 30% overall.

Conclusions

Based on the results obtained, there is a significant increase in reports of anxiety among patients with higher levels of pain and a history of surgery associated to their injury. There was a trend towards significance for association between GAD-7 and postoperative time. A history of surgery for a sports injury as well as increased levels of pain were the two main factors associated with the presence of anxiety in patients in a Sports Medicine Outpatient Clinic. Establishing a screening process for patients with high levels of pain or in the setting of their postoperative visits in order to assess the need for psychological support might be beneficial to their wellbeing and recovery outcomes.