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Quality of life and life satisfaction in former athletes:: a systematic review and meta-analysis

Quality of life and life satisfaction in former athletes:: a systematic review and meta-analysis
Quality of life and life satisfaction in former athletes:: a systematic review and meta-analysis
Background: sport participation has many physical and psychosocial benefits, but there is also an inherent risk of injury, subsequent osteoarthritis, and psychological challenges that can negatively impact quality of life (QOL). Considering the multifaceted impacts of sport participation on QOL across the lifespan, there is a need to consolidate and present the evidence on QOL in former sport participants.

Objective: to evaluate QOL and life satisfaction in former sport participants, and determine what factors are associated with QOL and life satisfaction in this population.

Methods: eight electronic databases were systematically searched in 07/2018 to retrieve all articles that evaluated QOL or life satisfaction in former sport participants. Two authors independently screened titles/abstracts and full texts, extracted data and appraised methodological quality using a modified Downs and Black Checklist. Random effects meta-analysis estimated pooled mean and 95% CI for Mental Component Scores (MCS) and Physical Component Scores (PCS) derived from the SF-12, SF-36, VR-12 and VR-36 measures. MCS and PCS were pooled for all former sport participants, as well as professional- and collegiate-athlete subgroups. Data that were inappropriate for meta-analysis (i.e. EQ-5D, PROMIS and life-satisfaction outcomes) were collated and reported descriptively.

Results: seventeen articles evaluated QOL or life satisfaction in a total of 6692 former athletes (8 studies (n=4255) former professional athletes; 6 studies (n=1946) former collegiate athletes; 2 studies (n=491) included both) with a mean age ranging from 21-66 years. Most studies were cross-sectional (15 of 17 articles) and 12 studies had a moderate risk of bias (n=1 high-risk, n=4 low-risk). Unpublished data were provided for five studies. Meta-analysis of 7 studies resulted in a pooled PCS mean(95% CI) of 50.0(46.6 to 53.3) (former professional athletes from 2 studies: 46.7(42.1 to 51.2), former collegiate athletes from 5 studies: 51.2(48.4 to 53.9)) and a pooled MCS of 51.4(50.5 to 52.2) (former professional athletes: 52.7(51.3 to 54.2), former collegiate athletes:
27 50.9(50.0 to 51.8)). Factors associated with worse QOL or life satisfaction in former athletes included involuntary retirement from sport (3 studies), collision/high-contact sport compared with low/no-contact sport (3 studies), ≥3 concussions compared with no/fewer concussions (2 studies), increased BMI (worse PCS, 3 studies), and osteoarthritis or musculoskeletal issues (worse PCS and MCS, 3 studies; worse PCS but not MCS, 2 studies).

Conclusions: former athletes had similar PCS and better MCS, compared to general-population norms. Former athletes with impaired PCS reported better MCS than population norms, highlighting the need to use an instrument that differentiates between physical and mental components of QOL in former sport participants. Factors associated with worse QOL that may explain between-study variation include involuntary retirement, collision/high contact sports, concussion, BMI and osteoarthritis.
0112-1642
1723–1738
Filbay, Stephanie R.
0dad06f8-766f-4046-9bc9-4f29b61bdd5e
Pandya, Tej
fa4655ae-28ce-4e14-8c44-cbf338f39d70
Thomas, Bryn
75c6371b-1f18-4a79-b02a-17c406fd9541
McKay, Carly
12af30d9-148f-4cb7-b14c-f356c30fe82a
Adams, Joanna
6e38b8bb-9467-4585-86e4-14062b02bcba
Arden, Nigel
251ccf48-60a1-4b27-a079-e6ae0fbdb129
Filbay, Stephanie R.
0dad06f8-766f-4046-9bc9-4f29b61bdd5e
Pandya, Tej
fa4655ae-28ce-4e14-8c44-cbf338f39d70
Thomas, Bryn
75c6371b-1f18-4a79-b02a-17c406fd9541
McKay, Carly
12af30d9-148f-4cb7-b14c-f356c30fe82a
Adams, Joanna
6e38b8bb-9467-4585-86e4-14062b02bcba
Arden, Nigel
251ccf48-60a1-4b27-a079-e6ae0fbdb129

Filbay, Stephanie R., Pandya, Tej, Thomas, Bryn, McKay, Carly, Adams, Joanna and Arden, Nigel (2019) Quality of life and life satisfaction in former athletes:: a systematic review and meta-analysis. Sports Medicine, 49, 1723–1738. (doi:10.1007/s40279-019-01163-0).

Record type: Article

Abstract

Background: sport participation has many physical and psychosocial benefits, but there is also an inherent risk of injury, subsequent osteoarthritis, and psychological challenges that can negatively impact quality of life (QOL). Considering the multifaceted impacts of sport participation on QOL across the lifespan, there is a need to consolidate and present the evidence on QOL in former sport participants.

Objective: to evaluate QOL and life satisfaction in former sport participants, and determine what factors are associated with QOL and life satisfaction in this population.

Methods: eight electronic databases were systematically searched in 07/2018 to retrieve all articles that evaluated QOL or life satisfaction in former sport participants. Two authors independently screened titles/abstracts and full texts, extracted data and appraised methodological quality using a modified Downs and Black Checklist. Random effects meta-analysis estimated pooled mean and 95% CI for Mental Component Scores (MCS) and Physical Component Scores (PCS) derived from the SF-12, SF-36, VR-12 and VR-36 measures. MCS and PCS were pooled for all former sport participants, as well as professional- and collegiate-athlete subgroups. Data that were inappropriate for meta-analysis (i.e. EQ-5D, PROMIS and life-satisfaction outcomes) were collated and reported descriptively.

Results: seventeen articles evaluated QOL or life satisfaction in a total of 6692 former athletes (8 studies (n=4255) former professional athletes; 6 studies (n=1946) former collegiate athletes; 2 studies (n=491) included both) with a mean age ranging from 21-66 years. Most studies were cross-sectional (15 of 17 articles) and 12 studies had a moderate risk of bias (n=1 high-risk, n=4 low-risk). Unpublished data were provided for five studies. Meta-analysis of 7 studies resulted in a pooled PCS mean(95% CI) of 50.0(46.6 to 53.3) (former professional athletes from 2 studies: 46.7(42.1 to 51.2), former collegiate athletes from 5 studies: 51.2(48.4 to 53.9)) and a pooled MCS of 51.4(50.5 to 52.2) (former professional athletes: 52.7(51.3 to 54.2), former collegiate athletes:
27 50.9(50.0 to 51.8)). Factors associated with worse QOL or life satisfaction in former athletes included involuntary retirement from sport (3 studies), collision/high-contact sport compared with low/no-contact sport (3 studies), ≥3 concussions compared with no/fewer concussions (2 studies), increased BMI (worse PCS, 3 studies), and osteoarthritis or musculoskeletal issues (worse PCS and MCS, 3 studies; worse PCS but not MCS, 2 studies).

Conclusions: former athletes had similar PCS and better MCS, compared to general-population norms. Former athletes with impaired PCS reported better MCS than population norms, highlighting the need to use an instrument that differentiates between physical and mental components of QOL in former sport participants. Factors associated with worse QOL that may explain between-study variation include involuntary retirement, collision/high contact sports, concussion, BMI and osteoarthritis.

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Manuscript - AAM - Filbay et al. 2019 - QOL in former athletes systematic review - Accepted Manuscript
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Accepted/In Press date: 24 July 2019
e-pub ahead of print date: 19 August 2019

Identifiers

Local EPrints ID: 432925
URI: http://eprints.soton.ac.uk/id/eprint/432925
ISSN: 0112-1642
PURE UUID: 82d09d15-26c9-454b-bcf7-f0341cc150f5
ORCID for Joanna Adams: ORCID iD orcid.org/0000-0003-1765-7060

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Date deposited: 01 Aug 2019 16:30
Last modified: 26 Nov 2021 07:13

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Contributors

Author: Stephanie R. Filbay
Author: Tej Pandya
Author: Bryn Thomas
Author: Carly McKay
Author: Joanna Adams ORCID iD
Author: Nigel Arden

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