Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA.
Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts, USA.
PM R. 2022 Jan;14(1):30-39. doi: 10.1002/pmrj.12581. Epub 2021 May 13.
Former American style football players (ASF players) have recognized health concerns associated with prior sport participation. It remains unknown whether categorizations of current health conditions, referred to in this report as afflictions (conceptually framed as neurocognitive, cardiovascular, cardiometabolic, sleep apnea, and chronic pain) are associated with physical and mental function.
To evaluate the association of afflictions to physical and mental function. It was hypothesized that former National Football League players with any affliction would have worse function compared to unafflicted participants. It was anticipated that multiple afflictions would result in cumulative loss of function.
Cross-sectional retrospective design.
Academic medical multisite hospital system.
A total of 3913 of 15,611 former ASF players who played professionally from 1960 to 2019 (response rate 25%). Assessment of Risk Factors Self-report survey.
Each participant completed the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale and Physical Function questionnaires. Responses were used to generate two physical function and one mental function subscale scores. Raw scores were converted to T-scores categorized as impaired (T-score < 40) or unimpaired (T-score ≥ 40). Primary analyses measured the association of affliction to function (impaired or unimpaired).
After adjusting for confounders (age, race, position, number of seasons, age of first exposure to football, alcohol use, smoking history, and current body mass index), each affliction was associated with reduced physical function on the Global physical function subscale (risk ratio [RR] = 1.23-2.45, all P < .005), physical function scale (RR = 1.24-2.75, all P < .01), and mental function scale (RR = 1.34-2.87, all P < .001), except that cardiovascular affliction was not associated with mental function (RR = 1.15, P = .15). The lowest functional measures were observed in those afflicted by chronic pain. Cumulative afflictions were associated with worse function.
Afflictions are associated with cumulative reduction of function. Research evaluating how afflictions interact may help elucidate mechanisms for illness and develop interventions to optimize function.
前美式足球运动员（ASF 运动员）已经认识到与先前运动相关的健康问题。目前的健康状况分类，在本报告中称为疾病（概念上被框定为神经认知、心血管、心脏代谢、睡眠呼吸暂停和慢性疼痛）是否与身体和精神功能有关，这一点尚不清楚。
评估疾病与身体和精神功能的关系。假设任何疾病的前国家橄榄球联盟运动员的功能都比未受影响的参与者差。预计多种疾病会导致功能的累积丧失。
横断面回顾性设计。
学术医学多地点医院系统。
共有 1960 年至 2019 年期间职业比赛的 15611 名前 ASF 运动员中的 3913 名（应答率 25%）参加了风险因素自我报告调查。
每位参与者完成了患者报告的结果测量信息系统（PROMIS）全球健康量表和身体功能问卷。结果用于生成两个身体功能和一个精神功能子量表评分。原始分数转换为 T 分数，分为受损（T 分数<40）或未受损（T 分数≥40）。主要分析衡量疾病与功能（受损或未受损）的关系。
在校正混杂因素（年龄、种族、位置、季节数、首次接触足球年龄、饮酒、吸烟史和当前体重指数）后，每种疾病都与全球身体功能子量表（危险比[RR] = 1.23-2.45，所有 P<.005）、身体功能量表（RR = 1.24-2.75，所有 P<.01）和精神功能量表（RR = 1.34-2.87，所有 P<.001）的身体功能受损相关，除心血管疾病与精神功能无关（RR = 1.15，P =.15）。在患有慢性疼痛的患者中观察到最低的功能测量值。累积疾病与功能下降有关。
疾病与功能的累积减少有关。评估疾病如何相互作用的研究可能有助于阐明疾病的发病机制并开发优化功能的干预措施。
