Smulligan Katherine L, Wingerson Mathew J, Seehusen Corrine N, Little Casey C, Wilson Julie C, Howell David R
Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO,USA.
Sports Medicine Center, Children's Hospital of Colorado, Aurora, CO,USA.
J Sport Rehabil. 2022 Oct 11;32(2):196-202. doi: 10.1123/jsr.2022-0193. Print 2023 Feb 1.
The relationship between physical activity (PA) and fear of pain with movement (ie, kinesiophobia) during concussion recovery is unknown. Kinesiophobia may limit PA, while PA after concussion may reduce kinesiophobia. Our purpose was to examine the correlation between PA and self-reported kinesiophobia during concussion recovery for adolescents with and without persistent symptoms.
Prospective cohort study of children ages 10-18 years within 14 days of concussion.
Participants rated kinesiophobia using the Tampa Scale of Kinesiophobia (TSK) at initial (≤14 d postconcussion) and return to play (RTP) assessments, and wore activity monitors between assessments. Our primary outcome was TSK score change from initial to RTP assessments. We grouped participants based on whether they experienced persistent symptoms (symptoms ≥28 days) or not (symptoms <28 days) and calculated correlation coefficients (Pearson r for normally distributed and Spearman rho for nonnormally distributed variables) between PA variables and TSK change scores.
Among the 41 participants enrolled, 44% developed persistent symptoms (n = 18; age = 14.5 [2.0] y; 50% female; symptom duration = 57.3 [6.2] d; RTP = 66.8 [6.4] d) and 56% did not (n = 23; age = 14.9 [1.8] y; 48% female; symptom duration = 15.2 [1.5] d; RTP = 21.7 [1.9] d). For the persistent symptoms group, greater TSK change scores (mean = -2.5 [5.7] point change) were significantly and moderately correlated with higher daily step count (r = -.60, P = .008) and exercise frequency (r = -.63, P = .005), but were not correlated with exercise duration (ρ = -.12, P = .65). Among the no persistent symptoms group, TSK change scores (mean = -6.0 [5.0] point change) were not correlated with step count (r = -.18, P = .41) or exercise duration (ρ = .10, P = .67), and the correlation with frequency was low and not significant (r = -.34, P = .12).
Regular PA during concussion recovery, regardless of duration or intensity, may help reduce kinesiophobia for those experiencing persistent symptoms.
在脑震荡恢复期间，身体活动（PA）与运动时疼痛恐惧（即运动恐惧症）之间的关系尚不清楚。运动恐惧症可能会限制身体活动，而脑震荡后的身体活动可能会减轻运动恐惧症。我们的目的是研究在脑震荡恢复期间，有或没有持续症状的青少年的身体活动与自我报告的运动恐惧症之间的相关性。
对脑震荡后14天内的10 - 18岁儿童进行前瞻性队列研究。
参与者在初始评估（脑震荡后≤14天）和恢复比赛（RTP）评估时使用坦帕运动恐惧量表（TSK）对运动恐惧症进行评分，并在两次评估之间佩戴活动监测器。我们的主要结果是从初始评估到RTP评估的TSK评分变化。我们根据参与者是否经历持续症状（症状≥28天）或未经历（症状<28天）进行分组，并计算身体活动变量与TSK变化分数之间的相关系数（正态分布变量用Pearson r，非正态分布变量用Spearman rho）。
在纳入的41名参与者中，44%出现了持续症状（n = 18；年龄 = 14.5 [2.0]岁；50%为女性；症状持续时间 = 57.3 [6.2]天；RTP = 66.8 [6.4]天），56%未出现（n = 23；年龄 = 14.9 [1.8]岁；48%为女性；症状持续时间 = 15.2 [1.5]天；RTP = 21.7 [1.9]天）。对于持续症状组，TSK变化分数更高（平均变化 = -2.5 [5.7]分）与每日步数增加（r = -.60，P = .008）和运动频率增加（r = -.63，P = .005）显著且中度相关，但与运动持续时间无关（ρ = -.12，P = .65）。在无持续症状组中，TSK变化分数（平均变化 = -6.0 [5.0]分）与步数（r = -.18，P = .41）或运动持续时间（ρ = .10，P = .67）无关，与频率的相关性较低且不显著（r = -.34，P = .12）。
在脑震荡恢复期间，无论持续时间或强度如何，规律的身体活动可能有助于减轻有持续症状者的运动恐惧症。
