Investigator(s)
| Submitter |
Dophu Tshering Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan. MPT student at Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India Dophu Tshering 
|
| Principal Investigator |
Dophu Tshering Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan. MPT student at Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India Dophu Tshering
|
| Co-Investigator(s) |
Ganesh M. Batellyan Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India. Ganesh M. Batellyan
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| Co-Investigator(s) |
Dr. Radhika Aditya Jadhav Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India. Dr. Radhika Aditya Jadhav
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| Co-Investigator(s) |
Jigme Dorji Central Regional Referral Hospital, Gelephu, Bhutan Jigme Dorji
|
Title(s) and abstract
| Scientific title | Knowledge, Attitude, and Practice regarding Anterior Cruciate Ligament Injury Prevention and Rehabilitation among Football Players in Bhutan: A Cross-Sectional Study |
| Public title | Knowledge, Attitude, and Practice regarding Anterior Cruciate Ligament Injury Prevention and Rehabilitation among Football Players in Bhutan: A Cross-Sectional Study |
| Background | INTRODUCTION: The Anterior Cruciate Ligament (ACL) of the knee is an important joint stabilizer, and it is one of the most injured structures among football players worldwide. ACL injuries leads to reduced performance, loss of game time, and sometimes career-ending consequences among footballers. Globally, the frequency of ACL injury in football players differs widely. The annual injury incidence is as high as 1.42% in elite male football players of the top 8 European leagues. The incidence of ACL injury among professional Asian footballers is twice that of the UEFA report. South Asian data on ACL injury in football are limited but epidemiological studies from a tertiary care centre in India and Nepal stated that football accounted from 30.8% to 83% of the sports-related ACL injuries. These findings highlight higher injury rates among lower levels of football. In Bhutan, football is among the most participated sports, institutional and anecdotal reports suggest a rising trend. Introducing ACL reconstruction surgery in 2021 within country further supports the growing health burden. Large proportion of ACL injuries can be prevented through prevention strategies. Higher Adherence to ACL injury prevention programs can reduce the injury rate by more than 50%. Similarly a large proportion of reinjury and contralateral ACL injury can be prevented with adequate rehabilitation. However, the effectiveness of those preventive strategies and rehabilitative interventions depends mainly on players' knowledge and attitudes, and their actual practice. Most of the existing knowledge, Attitude and Practice (KAP) studies on ACL injury prevention among footballers are done in developed nations, particularly in European countries where structured training programs are high and access to sports medicine and rehabilitation are the highest. While few KAP studies have been done in South Asia for general injury prevention in football or ACL injury among athletes, football-specific ACL KAP is under-researched. |
| Objectives | To assess the level of knowledge, attitude, practice regarding anterior cruciate ligament injury prevention and rehabilitation among football players in Bhutan using an adapted questionnaire. |
| Study Methods | Study design: The research study will be a cross-sectional study. Study setting: The study setting will be in Bhutan; an online medium of survey will be used. Study population: The study population will be football players in Bhutan. Data collection: The data will be collected via an online survey questionnaire from March 2026 to October 2026, or until the required sample size of 385 participants is achieved, whichever occurs earlier. Sample size: 385 Calculated using the Cochran Formula [Zα2 P (1-P)] / (d) 2 Where Zα=1.96, d=0.05 (5% precision), P=O.32 (knowledge of football players previous study by Monthuley et al,), Sample size =335, No response 15%= 50, Total sample size = 385 Tools used: Instruments used in the study: Questionnaire on Knowledge, Attitude, and Practice regarding ACL injury prevention from a previous study by Monthuley et al (2025) is adapted and modified according to the study’s objective. Although it’s published in an open-access journal, permission was obtained through an email from the corresponding author for adaptation. An online Google survey link for the questionnaire will be created. The study approval from the Institutional Research Committee (IRC), Manipal College of Health Professions, Manipal, will be obtained. Adaptation of the survey questionnaire, followed by expert opinion and content validation, will be done. Duel Ethics Clearance; Institutional Ethics Committee (IEC), Kasturba Hospital, Manipal, and Research Ethics Board of Health (REBH), Ministry of Health, Bhutan, clearance will be sought. The study will be registered in the Clinical Trials Registry India. Additional administration clearance from the relevant agency will be obtained for data collection. Data collection will be carried out using an online questionnaire. The survey link will be disseminated through convenience and snowballing sampling, initially shared with colleagues who are in contact with professional football players and recreational players in Bhutan. To ensure representation across different levels of football play |
| Expected outcomes and use of results | Outcome measured: Knowledge, Attitude, and Practice of football players. The conclusion drawn from this study will provide a generic description on existing awareness and attitude regarding ACL injury prevention and rehabilitation among football players in Bhutan. The findings may identify gaps in current prevention and rehabilitation practices. It might serve as a foundation for developing targeted injury prevention strategies within Bhutan’s football community. Thereby reducing the long-term impact on the individual and cost on the healthcare system. |
| Keywords | Anterior Cruciate Ligament, Injury, Prevention, Rehabilitation, Knowledge, Attitude, Practice |
Research Details
| Student research | Yes |
| Institution: Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India | |
| Academic degree: Master | |
| Supervisor of the student(s) | |
| Full Name and title: Ganesh M Batellyan | |
| Email: ganesh.bm@manipal.edu | |
| Start Date | 01-Mar-2026 |
| End Date | 31-Oct-2026 |
| Key Implementing Institution | |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Accidents and Injuries |
| Involves human subjects | Yes |
| Population-Based Survey | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | Approved |