Impact of Injury on Academic Performance Outcomes in Collegiate Student-Athletes.
Purpose/Hypothesis: The high prevalence of specific neuromusculoskeletal injuries among collegiate student-athletes can have a significant impact on resource allocation not only within the sports medicine team, but surrounding healthcare community (Hootman et al 2007). Despite the robust research on injury prevention and injury risk (Bahr et al 2015, Lehr 2013 et al), minimal research has investigated the potential relationship between neuromusculoskeletal injury and academic outcomes in collegiate student-athletes, exclusion of concussion research. The researchers hypothesize that there is a relationship between athletic injury and student-athlete academic outcomes. By investigating this potential relationship, collegiate resources (both sports medicine and institutional personnel) can be better informed to create proactive approaches to improve on these institutional metrics facilitating student success both on the field and in the classroom. Number of Subjects: 496 Materials and Methods: Four hundred ninety six student-athlete participants with no notable difference in race/ethnicity or socioeconomic status created a sample of convenience and was prospectively followed between Fall 2016 and Spring 2018. Eligibility for voluntary participation included enrolment in the college as a fulltime student, and a verified member on the team roster. The study primarily utilized already existing data sources that were collected through typical academic and institutional procedures, as well as an injury surveillance software tracking system utilized by the athletic training department. Injury data and academic outcomes were analyzed using descriptive statistics and inferential statistical methods. Results: The 496 student-athletes in the study incurred 853 injuries during the study period. The majority of the injuries were non-contact (68%) injuries to the lower body (58%), specifically with ankle/Achilles (12%) and knee (12%) injuries occurring most frequently. These injuries most often occurred in the first and second semester of their collegiate enrollment. In the first semester, injuries were more likely to occur in the early in the term. To examine student success, data analysis focused on academic outcomes during the first term and first year. As was seen in the larger data set, the 194 first semester injuries mirrored incidence patterns as described in the overall data set. The study found that both male and female student-athletes who were injured in the first term earned lower first semester GPAs than did all student athletes of their respective gender. Specifically, overall male athlete first term GPA was 2.83 compared to 2.57 (p=.000) of injured male athletes and overall female athlete first term GPA was 3.12 compared to 3.02 (p<.05) of injured female athletes. There was no impact of first semester injury on first year retention. Following athletes injured in the first semester into the second semester, female athletes who were injured in the first semester had a GPA rebound (no statistically significant difference) to .01 above the female athletes and female college average 3.1365 compared to 3.128 and 3.121 respectively. Injured male student athletes do not make up this GPA gap from first to second semester (2.60 injured FY males second semester compared to all first year males 2.836 (p=.000)and first year male athletes at 2.726 (p=.000)). The study also found that student athletes who were better prepared academically benefitted from higher GPAs regardless of injury but still experienced a statistically significant GPA gap compared to non-injured athletes of the same gender. For injured first semester students (like other students) high school GPA and SATs continue to be highly positively correlated r=.702, p=.000 and r=.639, p=.000. The gap in male student GPA persisted through four semesters that were tracked in the study. Conclusions: The impact of injury to the collegiate student-athlete not only encompasses days lost to participation, but can transcend beyond to academic performance. Typically, most institutions gather injury data and academic data in isolation and rarely attempt to bridge these together in a meaningful manner. The risk of sustaining these injuries is multifactorial and can be broken down into intrinsic and extrinsic factors that are modifiable and non-modifiable (Lehr et al 2016). Prevention strategies could include screening to determine a risk profile for the student-athlete and then involve allocating already limited sports medicine resources to address the intrinsic modifiable factors. This would also allow for a focused and customized prevention program to be developed for the high-risk group. From an academic standpoint, male freshman who sustain an injury are more likely to have a negative association with GPA compared to their freshman student athlete male and female counterparts. Limitations of the study include a diminished ability to generalize to outside college populations. This study is unique and adds to the existing body of knowledge by providing the necessary next step forward in developing proactive intervention strategies with the primary aim of student-athlete success. Clinical Relevance: By identifying these relationships, institutions are in a better position to serve the student-athlete population by prioritizing resources for this higher risk group with the intent of optimizing student success, both from a return to sport and return to learn standpoint