Smulligan Katherine L, Wingerson Mathew J, Magliato Samantha N, Rademacher Jacob G, Wilson Julie C, Howell David R
Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO.
Med Sci Sports Exerc. 2024 May 1;56(5):790-795. doi: 10.1249/MSS.0000000000003368. Epub 2023 Dec 27.
This study aimed to examine how moderate-to-vigorous physical activity (MVPA) during concussion recovery influences self-reported anxiety symptoms at follow-up assessment. We hypothesized that more MVPA after concussion would be associated with lower anxiety rating at follow-up.
We performed a prospective study of participants aged 13-18 yr initially assessed within 14 d of diagnosed concussion. Participants rated concussion symptoms using the Post-Concussion Symptom Inventory and were provided a wrist-worn actigraphy device to track activity for 1 wk after assessment. At follow-up assessment, participants rated anxiety symptoms using the four-question Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety subscale. Each question ranged from 1 (never) to 5 (almost always), with an overall score range of 4-20. For univariable analysis, we calculated correlation coefficients between MVPA and PROMIS anxiety subscale scores. We then created a multiple linear regression model with follow-up PROMIS anxiety subscale score as the outcome and MVPA, sex, initial symptom severity, and preconcussion anxiety as predictors.
We enrolled and initially tested 55 participants, and 48 were included in the final analysis (age, 14.6±2.7 yr; 56% female; initial assessment, 7.3± 3.1 d; follow-up assessment, 42.0±29.7 d). We observed an inverse and low correlation between MVPA and follow-up PROMIS anxiety subscale T-scores ( r = -0.30, P = 0.04). Multivariable regression results indicated that MVPA ( β = -5.30; 95% confidence interval (CI), -10.58 to -0.01), initial Post-Concussion Symptom Inventory score ( β = 0.11; 95% CI, 0.03 to 0.19), and preconcussion anxiety ( β = 5.56; 95% CI, 0.12 to 11.0), but not sex ( β = -2.60; 95% CI, -7.14, to 1.94), were associated with follow-up PROMIS anxiety subscale T-scores.
After adjusting for covariates, more MVPA early after concussion predicted lower PROMIS anxiety subscale scores at follow-up. Although initial concussion symptom severity and preconcussion anxiety were also associated with follow-up PROMIS anxiety subscale score, MVPA represents a modifiable factor that may contribute to lower anxiety symptoms.
本研究旨在探讨脑震荡恢复期间的中等到剧烈身体活动(MVPA)如何影响随访评估时自我报告的焦虑症状。我们假设脑震荡后更多的MVPA与随访时较低的焦虑评分相关。
我们对年龄在13 - 18岁的参与者进行了一项前瞻性研究,这些参与者在被诊断为脑震荡后的14天内进行了初始评估。参与者使用脑震荡后症状量表对脑震荡症状进行评分,并在评估后被提供了一个腕部佩戴的活动记录仪,以跟踪1周的活动情况。在随访评估时,参与者使用包含四个问题的患者报告结局测量信息系统(PROMIS)焦虑子量表对焦虑症状进行评分。每个问题的评分范围为1(从不)到5(几乎总是),总分范围为4 - 20。对于单变量分析,我们计算了MVPA与PROMIS焦虑子量表评分之间的相关系数。然后,我们创建了一个多元线性回归模型,将随访时的PROMIS焦虑子量表评分作为结果,将MVPA、性别、初始症状严重程度和脑震荡前焦虑作为预测因素。
我们招募并初步测试了55名参与者,最终分析纳入了48名(年龄,14.6±2.7岁;56%为女性;初始评估,7.3±3.1天;随访评估,42.0±29.7天)。我们观察到MVPA与随访时PROMIS焦虑子量表T评分之间存在负向且较低的相关性(r = -0.30,P = 0.04)。多变量回归结果表明,MVPA(β = -5.30;95%置信区间(CI),-10.58至-0.01)、初始脑震荡后症状量表评分(β = 0.11;95%CI,0.03至0.19)和脑震荡前焦虑(β = 5.56;95%CI,0.12至11.0),而非性别(β = -2.60;95%CI,-7.14至1.94),与随访时PROMIS焦虑子量表T评分相关。
在对协变量进行调整后,脑震荡后早期更多的MVPA预测了随访时较低的PROMIS焦虑子量表评分。尽管初始脑震荡症状严重程度和脑震荡前焦虑也与随访时PROMIS焦虑子量表评分相关,但MVPA是一个可改变的因素,可能有助于降低焦虑症状。