Background Sport and active recreation are important avenues for health enhancing physical activity. These health benefits can however be negated by injury. The impact of sport and active recreation injury on long term physical activity levels has yet to be investigated.

Objective To evaluate the impact of serious sport and active recreation injury on patients' long-term physical activity levels.

Design Prospective cohort study with 12-month follow-up.

Setting Two Level 1 trauma centres and one regional hospital in Victoria, Australia.

Participants Adults admitted to hospital with orthopaedic sport and active recreation injuries and captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited from the two Level 1 trauma centres and one regional hospital over a 12-month time period. A total of 324 patients entered the study and 98% were followed up at 12-months post-injury.

Assessment of risk factors Independent variables used in the analyses were sporting group, age, sex, education level, major trauma classification (Injury Severity Score>15), injury patterns and disability at 12-months post-injury.

Main outcome measurement The International Physical Activity Questionnaire.

Results At 12-months post-injury participants reported significant reductions in physical activity levels (p<0.001) with median levels reduced by two thirds. Those reporting no disability as measured by the Extended Glasgow Outcomes Scale at 12-months, still reported significant reductions in physical activity (p<0.001) with median levels reduced by more than half and vigorous activity being performed half as frequently. Multivariate regression analysis found no significant predictors of physical activity levels at 12-months.

Conclusion Sport and active recreation injuries lead to significant reductions in physical activity levels, with potential negative health impacts in the future. The importance of sports injury prevention in maintaining population physical activity and the need to better understand why patients do not return to pre-injury activity levels is highlighted.