Realignment osteotomy of the knee allows for return to work and sport activities in the young athletic population

2018 ◽  
Vol 3 (4) ◽  
pp. 213-219
Author(s):  
Suzanne Witjes ◽  
Stacey Wanlin ◽  
Robert Litchfield ◽  
Rutger C I van Geenen ◽  
Gino M M J Kerkhoffs ◽  
...  
Keyword(s):  
Return To Work ◽  
Sport Participation ◽  
Rating Scale ◽  
Sports Participation ◽  
Activity Level ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Sport Activities ◽  
Knee Osteotomy

ObjectiveTo evaluate return to work and sport rates of young athletic patients following knee osteotomy, including the highest level of sports participation and satisfaction with activities.MethodsWe performed a cross-sectional study of patients of age 45 years or younger who underwent realignment osteotomy of the knee between 2005 and 2015. Data concerning work activities, sports participation and satisfaction were collected by a survey including the modified Naal and Weiss questionnaires, Numeric Rating Scale (NRS) of satisfaction and Net Promoter Score (NPS).ResultsAnalysis of data from 60 patients with a median age of 38 (15–45) was performed. Of those 60 patients, 95% returned to sports following surgery, of whom 74% could return to their main preinjury sport or to a different sport of higher impact. The main preoperative sport types involved 65% high-impact, 23% intermediate-impact and 12% low-impact activities. The highest level of sport participation preoperatively was 13% professional, 7% varsity and 80% amateur (58% competitive, 42% recreational). Postoperatively 5% returned to professional level, 4% varsity and 91% amateur (14% competitive, 86% recreational), and at follow-up 22% of patients had retired from sports. At follow-up 88% of patients were still working, with 61% at the same activity level and 12% at a higher level than before surgery. The median NRS satisfaction score with activities in general was 6 (0–10), and with activities of daily living, work and leisure time 9 (0–10), 7 (0–10) and 6 (0–10), respectively. The main reasons for dissatisfaction were persisting knee pain (67%) and lack of range of motion (29%). The NPS was 14, indicating that patients would recommend the surgery to friends or family.ConclusionYoung athletes can return to work and sport activities following realignment osteotomy of the knee. Although their levels of sports participation significantly decreased and satisfaction with their activity level was limited, we disagree with the opinion that a knee osteotomy directly leads to the end of an athlete’s sporting career.Level of evidenceLevel III, prospective cohort study.

scholarly journals Symmetries in Muscle Torque and Landing Kinematics Are Associated With Maintenance of Sports Participation at 5 to 10 Years After ACL Reconstruction in Young Men

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092326 ◽  
Author(s):  
Iftach Hetsroni ◽  
Yohay Wiener ◽  
David Ben-Sira ◽  
Antonio Dello Iacono ◽  
Niv Marom ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Young Men ◽  
Sports Participation ◽  
Level Of Evidence ◽  
Eccentric Load ◽  
Cross Sectional ◽  
Successful Recovery

Background: Long-term maintenance of sports participation is important for young men undergoing anterior cruciate ligament (ACL) reconstruction. Identifying biomechanical characteristics in patients who achieve this goal can assist in elaborating rehabilitation programs and in identifying successful recovery, but this has rarely been investigated. Purpose: To test the association between maintenance of sports participation at 5 to 10 years after ACL reconstruction and measures of force production and landing biomechanics in men. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 30 men who underwent isolated ACL reconstruction were examined. At 5- to 10-year follow-up, associations were tested between reported outcomes of sports maintenance and objective biomechanical measures. The biomechanical tests included isokinetic knee torque and lower limb kinetics and kinematics during landing tasks. Measurements for each limb were conducted separately, and side-to-side symmetry indices (SI) were calculated. Subgroups included SI greater than +10% (ie, extreme positive), SI lower than –10% (ie, extreme negative), and SI between –10% and +10% (ie, symmetric). Results: At follow-up, concentric knee torque in the operated limb correlated with Tegner and Marx scores ( r = 0.42-0.47; P ≤ .05). Regarding the SI of knee torque, the highest Tegner, Marx, and KOOS (Knee injury and Osteoarthritis Outcome Score) results were associated with symmetry, as opposed to patients with extreme positive or extreme negative SIs ( P < .05). As for landing kinematics, Tegner score negatively correlated with knee range of motion (ROM) in the operated limb ( r = –0.38; P ≤ .05). With regard to SI, hip and knee ROM correlated with Tegner, IKDC, and KOOS scores ( r = 0.41-0.51; P ≤ .05). Specifically, the highest sports participation levels were associated with achieving symmetric hip and knee ROM but also with extreme positive SIs, as opposed to patients with extreme negative SIs ( P < .03), indicating substantially higher ROM in the uninjured limb as compared with the operated limb. Conclusion: At 5 to 10 years after ACL reconstruction, maintenance of sports participation was associated with symmetric side-to-side concentric knee torque and with producing greater attenuation of hip and knee ROM during the drop jump landing in the operated limb. Therefore, eccentric load programs that can improve attenuation-phase kinematics during landing tasks may be valuable in addition to concentric training and may facilitate enhanced long-term outcomes.

Return to Sport and Performance After Hip Arthroscopy for Femoroacetabular Impingement in 18- to 30-Year-Old Athletes: A Cross-sectional Cohort Study of 189 Athletes

2018 ◽  
Vol 46 (11) ◽  
pp. 2578-2587 ◽  
Author(s):  
Lasse Ishøi ◽  
Kristian Thorborg ◽  
Otto Kraemer ◽  
Per Hölmich
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Return To Sport ◽  
Sports Participation ◽  
Impingement Syndrome ◽  
Sports Performance ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Femoroacetabular Impingement Syndrome

Background: A recent systematic review found that 87% of athletes return to sport after hip surgery for femoroacetabular impingement syndrome. However, the proportion of athletes returning to preinjury sport at their preinjury level of sport is less clear. Purpose: The main purpose of this study was to determine the rate of athletes returning to preinjury sport at preinjury level including their associated sports performance after hip arthroscopy for femoroacetabular impingement syndrome. Furthermore, self-reported hip and groin function was investigated. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Eligible subjects were identified in the Danish Hip Arthroscopy Registry. A self-reported return to sport questionnaire was used to collect data after hip arthroscopy. If athletes reported they were engaged in preinjury sport at their preinjury level, the associated sports performance and participation were assessed as either (1) optimal sports performance including full sports participation; (2) impaired sports performance, but full sports participation; or (3) impaired sports performance including restricted sports participation. Self-reported hip and groin function was assessed for all athletes by use of the Copenhagen Hip and Groin Outcome Score. Results: The study included 189 athletes (mean ± SD age at follow-up, 26.9 ± 3.4 years) at a mean ± SD follow-up of 33.1 ± 16.3 months after surgery. At follow-up, 108 athletes (57.1%) were playing preinjury sport at preinjury level, whereas the remaining 81 athletes (42.9%) failed to return to preinjury sport at preinjury level. Of the 108 athletes engaged in their preinjury sport at preinjury level at follow-up, 32 athletes (29.6%) reported optimal sports performance including full sports participation, corresponding to 16.9% of the study sample. Better self-reported hip and groin function was observed in athletes who were engaged in preinjury sport at preinjury level compared with athletes who were not. Conclusion: Fifty-seven percent of athletes returned to preinjury sport at their preinjury level. This is considerably lower than a previously reported return to sport rate of 87% and may reflect that the present study used a clear and strict definition of return to sport. Of note, only one-third of athletes who returned to preinjury sport at preinjury level reported their sports performance to be optimal, corresponding to 16.9% of the study sample. Better self-reported hip and groin function was observed in athletes who were playing preinjury sport at preinjury level compared with athletes who were not.

scholarly journals Effect of knee arthroplasty on sports participation and activity levels: a systematic review and meta-analysis

2020 ◽  
Vol 6 (1) ◽  
pp. e000729
Author(s):  
Marco J Konings ◽  
Henri De Vroey ◽  
Ive Weygers ◽  
Kurt Claeys
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Sport Participation ◽  
Meta Analysis ◽  
Sports Participation ◽  
Activity Level ◽  
Outcome Variable ◽  
Activity Levels ◽  
Post Surgery ◽  
Sport Activities

ObjectiveDesires and expectations of patients in regard to resume participation in sport activities after knee arthroplasty strongly increased in recent years. Therefore, this review systematically reviewed the available scientific literature on the effect of knee arthroplasty on sports participation and activity levels.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, SPORTDiscus and reference lists were searched in February 2019.Studies eligibility criteriaInclusion of knee osteoarthritis patients who underwent total knee arthroplasty (TKA) and/or unicondylar knee arthroplasty. Studies had to include at least one preoperative and one postoperative measure (≥1 year post surgery) of an outcome variable of interest (ie, activity level: University of California, Los Angeles and/or Lower Extremity Activity Scale; sport participation: type of sport activity survey).ResultsNineteen studies were included, consisting data from 4074 patients. Knee arthroplasty has in general a positive effect on activity level and sport participation. Most patients who have stopped participating in sport activities in the year prior to surgery, however, do not seem to reinitiate their sport activities after surgery, in particular after a TKA. In contrast, patients who continue to participate in sport activities until surgery appear to become even more active in low-impact and medium-impact sports than before the onset of restricting symptoms.ConclusionsKnee arthroplasty is an effective treatment in resuming sports participation and physical activity levels. However, to achieve the full benefits from knee arthroplasty, strategies and guidelines aimed to keep patients capable and motivated to participate in (low-impact or medium-impact) sport activities until close before surgery are warranted.

Younger age and greater preoperative function predict compliance with 2-year follow-up visits after ACL reconstruction: an analysis of the PIVOT multicentre trial

2018 ◽  
Vol 3 (5) ◽  
pp. 251-257 ◽  
Author(s):  
Jayson Lian ◽  
João Victor Novaretti ◽  
Neel K Patel ◽  
Adam C Popchak ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Rating Scale ◽  
Cruciate Ligament ◽  
Univariate Analysis ◽  
International Knee Documentation Committee ◽  
Activity Level ◽  
Level Of Evidence ◽  
Younger Age ◽  
Patient Reported ◽  
The Usa

ObjectivesThe purpose of this investigation was to identify clinical and demographic variables that may predict compliance, defined as patient follow-up at 1-year and 2-year postoperative appointments, after anterior cruciate ligament reconstruction (ACLR).MethodsA total of 107 patients undergoing primary ACLR across four centres were prospectively followed for 2 years. Demographic and clinical data were recorded preoperatively and postoperatively, including patient-reported outcomes such as the Marx Activity Rating Scale, Cincinnati Occupational Rating Scale (CORS), International Knee Documentation Committee Subjective Knee Evaluation Form and Activities of Daily Living Scale (ADLS). Compliance was retrospectively defined using the presence or lack of outcome measures at 1-year and 2-year postoperative visits. Univariate analysis was done to compare demographic and clinical variables between compliant and non-compliant patients at 1-year and 2-year follow-up. Significant variables were entered into a logistic regression model. Significance was set at p<0.05.ResultsThe overall rate of compliance at 1-year and 2-year postoperative appointments was 83.2% (89/107) and 57.0% (61/107), respectively. Regression analysis showed that residence in Kobe, Japan compared with Pittsburgh, USA (OR 10.28; 95% CI 1.0003 to 105.28), and ‘very strenuous’ (OR 16.74; 95% CI 3.21 to 87.43) and ‘strenuous’ (OR 18.78; 95% CI 2.01 to 175.78) preinjury activity level were independent factors associated with compliance at 1-year follow-up. At 2 years follow-up, younger age (OR 0.95; 95% CI 0.91 to 0.997), and greater preoperative score on CORS (OR 1.03; 95% CI 1.01 to 1.06) and on ADLS (OR 1.04; 95% CI 1.01 to 1.07) were independently associated with compliance.ConclusionWhile patients with greater level of strenuous activity were more likely to follow-up after ACL surgery at 1 year, patients who were younger and had higher preoperative function measured by CORS and ADLS were more likely to follow-up at 2 years. Differences in follow-up rates among the USA, Italy, Sweden and Japan may highlight important cultural, socioeconomic and infrastructural differences across international healthcare systems. Orthopaedic surgeons may consider the results of this study during preoperative discussion with their patients and design of future ACL clinical research trials.Level of evidenceLevel III, prospective cohort.

Return to Work and Sport After Distal Femoral Osteotomy: A Systematic Review

2021 ◽  
pp. 194173812110410
Author(s):  
Jaspal S. Bassi ◽  
Justin P. Chan ◽  
Tyler Johnston ◽  
Dean Wang
Keyword(s):  
Systematic Review ◽  
Return To Work ◽  
Operation Time ◽  
Femoral Osteotomy ◽  
Activity Level ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Distal Femoral Osteotomy ◽  
Number Of Patients

Context: Distal femoral osteotomy (DFO) is a joint preservation procedure that corrects genu valgum deformities and patellofemoral maltracking, thereby restoring kinematics and unloading contact pressures in the lateral tibiofemoral and patellofemoral compartments. Objective: To evaluate the rates of return to work (RTW) and return to sport (RTS) after DFO for valgus malalignment and lateral compartment osteoarthritis through a systematic review of the literature. Data Sources: A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on the PubMed, Cochrane, and Embase databases. Study Selection: The search terms femoral osteotomy AND ( sports OR work) were used. Studies in which patients underwent concomitant total knee arthroplasty were excluded. Study Design: Systematic review. Level of Evidence: Level 4 (systematic review of level 4 studies). Data Extraction: Data included the number of patients, age, gender, laterality of operation, time to follow-up, rate of RTW and RTS, time to RTS, activity level on return, and activity level scores (Tegner, Marx, Lysholm, and the International Knee Documentation Committee). Risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Results: Seven articles with 194 patients were included. The average age ranged from 19 to 49 years with a mean postoperative follow-up range of 36 to 90 months. RTW data were available for 125 patients, of whom 42.1% to 91.3% returned by final follow-up. Data on RTS were available for 149 patients, of whom 70% to 100% returned at a range of 8.3 to 16.9 months postoperatively, and 41.6% to 100% returned to the same or greater level of sports activity. The Tegner and Marx activity level scores ranged from 3 to 4 and from 5 to 11, respectively, at final follow-up. Conclusion: Patients treated with DFO reported high rates of RTW and RTS, with most patients being able to return to recreational sport after surgery.

scholarly journals Minimum 10-Year Clinical Outcome of Lateral Collagen Meniscal Implants for the Replacement of Partial Lateral Meniscal Defects: Further Results From a Prospective Multicenter Study

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712199491
Author(s):  
Alberto Grassi ◽  
Gian Andrea Lucidi ◽  
Giuseppe Filardo ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
...  
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Final Analysis ◽  
Activity Level ◽  
Long Term Results ◽  
Level Of Evidence ◽  
Unicompartmental Knee Arthroplasties ◽  
Tegner Score

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.

scholarly journals Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199455
Author(s):  
Nicola Maffulli ◽  
Francesco Oliva ◽  
Gayle D. Maffulli ◽  
Filippo Migliorini
Keyword(s):  
Surgical Management ◽  
Revision Surgery ◽  
Case Series ◽  
Sports Participation ◽  
Patellar Tendinopathy ◽  
Symptom Duration ◽  
Level Of Evidence ◽  
Training Time ◽  
The Mean

Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis

2015 ◽  
Vol 41 (3) ◽  
pp. 322-327 ◽  
Author(s):  
J. K. Thillemann ◽  
T. M. Thillemann ◽  
B. Munk ◽  
K. Krøner
Keyword(s):  
Rating Scale ◽  
Revision Rate ◽  
Numerical Rating Scale ◽  
Elevated Serum ◽  
Consecutive Series ◽  
Dash Score ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Thumb Carpometacarpal

We retrospectively evaluated a consecutive series of 42 Motec thumb carpometacarpal total joint arthroplasties. The primary endpoint was revision with implant removal and trapeziectomy. At follow-up the disability of the arm shoulder and hand (DASH) score, pain on numerical rating scale at rest and with activity and serum chrome and cobalt concentrations were assessed for both unrevised and revised patients. At a mean follow-up of 26 months, 17 patients had been revised. The 2 year cumulative revision rate was 42% (95% CI, 28–60%). The DASH score and pain scores at rest and with activity were comparable between the patients whose thumbs remained unrevised and those revised. Patients with elevated serum chrome and cobalt levels had significantly higher DASH and pain scores, but elevated levels were not associated with revision. The revision rate in this study is unacceptably high. However, pain and DASH scores after revision are acceptable and comparable with patients with non-revised implants. Level of evidence: IV

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals Assessing the health impacts of adults’ participation in sports: investigating the role of accessibility to sport facilities

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Theodora Pouliou ◽  
Sarah Lowe ◽  
Gary Higgs
Keyword(s):  
Sport Participation ◽  
Positive Association ◽  
Sports Participation ◽  
Individual Characteristics ◽  
Data Sets ◽  
Potential Association ◽  
Sport Activities ◽  
Sporting Activities ◽  
Sport Facilities ◽  
Self Assessed Health

The health benefits of individual and group participation in sports are well-known. While a positive association between participation in sport and self-assessed health has been reported for England and Scotland, research has been limited in Wales. In addition, research examining the relationship between levels of physical activity and the accessibility of sport facilities give inconsistent findings. This research project proposes to explore the potential association between the accessibility of sports facilities, sport participation and health. In particular, we will examine whether: Accessibility to sport facilities contributes to participation in sporting activities. Sports participation mediates the association between accessibility to sport facilities and health outcomes (as recorded in routine-health-records). The association between participation in sports and health is independent of individual characteristics such as gender, socio-economic characteristics. The data-sets used were: the Welsh Demographic Service Data (WDSD), the Patient Episode Database for Wales (PEDW), the Sport Wales Active Adults Survey (AAS) and Enhanced Recreational Database (ERD). Accessibility measures were derived from the SWERD, while the Charlson Comorbidity Index (CCI) was estimated as an indicator of general health based on PEDW data. The AAS was then linked to PEDW and the ERD. Appropriate regression analysis was applied based on the type of outcome explored. Preliminary results showed that 72% of the adults participated in sports in the 4 weeks prior to interview and 39% of them participated 3 or more times. Accessibility to sport facilities was significantly associated with outdoor sport activities rather than indoor activities. Distance to a sports hall was significantly associated with sport participation. Adults with a chronic condition based on CCI were less likely to participate in sports. The study provided a unique opportunity to explore the benefits of analysing linked administrative and survey data, therefore contributing to current research on sport participation/accessibility and health.

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