Dissertations and Theses @ UNI


Dissertation (UNI Access Only)


Outcome assessment (Medical care); College athletes--Wounds and injuries--Treatment;


Evidence-based practice is embraced by nearly every healthcare discipline to improve healthcare delivery and improve patient outcomes. An appropriate health care outcome is one that is both clinically relevant and meaningful to the patient. Consequently, important patient outcomes may vary for every patient population. Therefore, as a precursor to evidence-based practice is identifying meaningful patient outcomes.

To establish meaningful patient outcomes, healthcare disciplines first learn from their patients the aspects of their health that they deem most important. The most direct approach is to talk to the patients to capture their experiences and understand what contributes to their health. Then, once the meaningful outcomes have been identified, they are organized and aligned under a new or existing and accepted outcome model so they can be applied and measured.

The most prominent model is the World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF). The ICF classifies health, disability, and functioning according to: impairments of body functions and structure, activity limitations, participation restrictions, and personal and environmental factors. For athletic training, a profession that has recently begun to embrace evidence based practice, the aspects of health that are meaningful to their patients has yet to be clearly identified. Therefore, the purpose of this study was to identify health related outcomes that are meaningful to athletic training patients following lower extremity musculoskeletal injury. A qualitative approach involving semi- structured interviews was used to identify meaningful outcomes among patients. The sample consisted of 20 college athletes (10 males, 10 females; 20.1 years +1.83) that were in the final stages of recovery following a lower extremity injury within the past year. The injury required medical attention by a certified athletic trainer or physician and prevented them from competing in their chosen sport. The interviews allowed the participants to describe their experiences and the outcomes that were most meaningful to them through the various stages of recovery, with special attention towards the later stages of recovery. Interviews were recorded and transcribed verbatim. Data saturation guided the number of participants. Data were analyzed using the Framework Approach by linking appropriate ICF second-level domains and the corresponding first-level domains.

The results revealed that patients recovering from lower extremity musculoskeletal injury identified a variety of meaningful outcomes related not only to physical benchmarks related to activities, their environment, and participation, but to psychosocial barriers linked to personal identity and mental functions as well. Furthermore, these meaningful outcomes could be classified under 63 ICF second-level domains, which corresponded to 19 ICF first-level domains. Fifteen of the 19 first-level domains were classified as major themes that identify outcomes that are meaningful to athletic training patients. Whereas most of the outcomes identified by athletic training patients overlapped those identified by patients in the general population, there were several items that were unique to athletes and represented higher levels of function and ability. These results provide a framework for classifying and ultimately documenting athletic training patient outcomes. Future research should identify items which can accurately assess these higher levels of ability and compare the identified outcomes to existing instruments to determine if they reflect the outcomes identified by patients. In addition, these results also bring the psychosocial impact of musculoskeletal injury on college athletes to the forefront as well. It is essential for healthcare professionals to consider the impact of injury on all aspects of a patient’s well-being, both the physical and the psychosocial, when addressing meaningful outcomes in college athletes during recovery.

Year of Submission


Degree Name

Doctor of Education


School of Kinesiology, Allied Health, and Human Services

First Advisor

Todd Evans

Second Advisor

Kelli Snyder

Date Original


Object Description

1 PDf file (ix, 147 pages)



File Format


Off-Campus Download