705. Psychology, Behavior and Neurobiology - behavioral aspects of sport Scientific Abstract

3449 - Fear Of Re-injury Correlates With Concussion Symptoms And Reaction Time Among Adolescents With Concussion

Session Type
Free Communication/Poster
Session Name
F-65 - Concussion and Behavior
Session Category Text
Psychology, Behavior and Neurobiology
Disclosures
 S.E. Reinking: None.

Abstract

Background: Athletes appear to be at an increased risk of musculoskeletal injury following return to play after concussion. Underlying causes are likely multi-factorial but not well established. Fear of re-injury has been widely studied in musculoskeletal injuries, but its effect on concussion recovery is unknown.
Purpose: To examine the association of fear of re-injury with physical and self-reported measures after concussion. We hypothesized that greater fear of re-injury would be correlated with a higher symptom severity, worse sleep quality, and worse physical test performance.
Methods: Athletes (n=19; 15.0±1.8 years of age; 42% female; 7.4±3.3 days post-injury) were tested within 14 days of concussion, and underwent assessments of self-reported and physical examination measures. Self-reported measures included the Tampa Scale of Kinesiophobia (TSK)- assessing fear of re-injury, Post-Concussion Symptom Inventory (PCSI), and Pittsburgh Sleep Quality Index (PSQI). Physical examination measures included clinical reaction time, near point of convergence, single and dual-task tandem gait, and Balance Error Scoring System (BESS). We examined correlations between TSK scores and each outcome measure using Pearson correlation coefficients, adjusting for age, sex, and time from injury using linear regression models.
Results: Higher TSK scores were significantly correlated with higher symptom severity (PSCI) scores (r= 0.69; p=0.001) and slower reaction times (r= 0.53; p=0.02). TSK scores were not significantly correlated with single-task tandem gait (r= 0.23; p=0.34), dual-task tandem gait (r= 0.29; p=0.23), PSQI (r= 0.43; p=0.08), NPC (r= 0.03; p=0.91), or BESS (r= 0.23; p=0.35) scores. After adjusting for the effect of age, sex, and time from injury to examination, higher TSK scores were significantly associated with slower clinical reaction time performance (β= 2.8; 95% CI= 0.94, 4.62; p=0.006), greater symptom severity (β= 3.64; 95% CI=2.07, 5.21; p < 0.001), and worse sleep quality (β= 0.37; 95% CI= 0.05, 0.68; p=0.03).
Conclusions: In accordance with our hypothesis, higher TSK scores were correlated with higher symptom severity and slower reaction times. This suggests that assessing an athlete’s fear of re-injury may be useful following concussion and throughout recovery.
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