Department of Psychology, University of British Columbia, and Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada (Drs Cairncross and Silverberg); Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada (Dr Debert); Head Injury Clinic, Trauma & Neurosurgery Program, St Michael's Hospital, Toronto Canada (Dr Hunt); Hull-Ellis Concussion and Research Clinic, Toronto Rehabilitation Institute, University Health Network-KITE Research Institute, Toronto, Canada (Drs Bayley and Comper and Ms Chandra); Faculty of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada (Dr Bayley); and Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada (Dr Comper).
J Head Trauma Rehabil. 2021;36(5):E355-E362. doi: 10.1097/HTR.0000000000000669.
Fear avoidance behavior after a concussion or mild traumatic brain injury (mTBI) is associated with a number of adverse outcomes, such as higher symptom burden, emotional distress, and disability. The Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire (FAB-TBI) is a recently developed and validated self-report measure of fear avoidance after mTBI. The objective of this study was to derive clinical normative data for the FAB-TBI. To determine whether demographic stratification was necessary and to further support clinical interpretation, we also explored associations between fear avoidance behavior and demographic and injury variables.
Five concussion clinics in Canada.
Adults who sustained an mTBI (N = 563).
Cross-sectional.
Participants completed the Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire (FAB-TBI) and measures of postconcussion symptom burden (Rivermead Postconcussion Symptoms Questionnaire, Sport Concussion Assessment Tool-5) at clinic intake.
Generalized linear modeling revealed that females reported more fear avoidance than males (95% CI = 0.66 to 2.75), indicating that FAB-TBI normative data should be stratified by sex. Differences between recruitment sites on FAB-TBI scores were reduced but not eliminated by controlling for potential confounds. Loss of consciousness (95% CI =0.61 to 2.76) and higher postconcussion symptom burden (95% CI = 0.79 to 1.03) were also associated with higher FAB-TBI scores, but time since injury was not (95% = CI -0.4 to 0.03). Tables to convert FAB-TBI raw scores to Rasch scores to percentiles are presented.
These findings support clinical interpretation of the FAB-TBI and further study of fear avoidance after mTBI.
脑震荡或轻度创伤性脑损伤（mTBI）后出现的恐惧回避行为与许多不良后果相关，如更高的症状负担、情绪困扰和残疾。创伤性脑损伤后恐惧回避行为问卷（FAB-TBI）是一种最近开发和验证的 mTBI 后恐惧回避的自我报告测量工具。本研究的目的是为 FAB-TBI 制定临床规范数据。为了确定是否需要进行人口统计学分层，并进一步支持临床解释，我们还探讨了恐惧回避行为与人口统计学和损伤变量之间的关系。
加拿大的 5 个脑震荡诊所。
患有 mTBI 的成年人（N=563）。
横断面研究。
参与者在诊所就诊时完成了创伤性脑损伤后恐惧回避行为问卷（FAB-TBI）和脑震荡后症状负担的测量（Rivermead 脑震荡后症状问卷、运动性脑震荡评估工具-5）。
广义线性模型显示，女性比男性报告更多的恐惧回避（95%CI=0.66 至 2.75），表明 FAB-TBI 规范数据应按性别分层。通过控制潜在的混杂因素，减少了但并未消除招募地点对 FAB-TBI 评分的差异。意识丧失（95%CI=0.61 至 2.76）和更高的脑震荡后症状负担（95%CI=0.79 至 1.03）也与更高的 FAB-TBI 评分相关，但损伤后时间与 FAB-TBI 评分无关（95%CI=-0.4 至 0.03）。呈现了将 FAB-TBI 原始分数转换为 Rasch 分数和百分位数的表格。
这些发现支持了对 FAB-TBI 的临床解释，并进一步研究了 mTBI 后的恐惧回避。
