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Affiliation
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Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand. |
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Abstract
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BACKGROUND: Symptoms related to concussion are generally found to be non-specific in nature as they are also reported by non-concussed individuals. What is currently not known is whether the symptoms vary over time, and whether they are also influenced by a multitude of factors.
OBJECTIVE: To investigate the potential influence of psychological, lifestyle, and situational factors on the change in postconcussion-like symptoms reported over seven consecutive days in a cohort of normal individuals.
DESIGN: Longitudinal observational study. SETTING: Real-world context. PARTICIPANTS: Convenience sample of 180 non-concussed university students were enrolled. Of these, 110 participants only provided data for the entire period of the study.
METHODS: An experience sampling methodology was employed to document the symptoms reported over time. Stepwise multivariate linear mixed-effects modeling performed to identify the predictors that contribute to the serially reported symptoms. INDEPENDENT VARIABLES: Gender, time of the day, location, primary activity and type of interactant (person) of the participant, physical activity status, trouble sleeping, alcohol consumption, caffeine consumption, stress, anxiety, depression, mental and physical fatigue and life stressors. MAIN OUTCOME MEASURES: The key outcome measures were the change in total symptom score (TSSchange) and symptom severity score (SSSchange) reported over 7 consecutive days.
RESULTS: The predictors of location at the time of reporting, physical fatigue (Estimate = - 0.98, p<. 001) and mental fatigue (Estimate = - 0.53, p<. 001) contributed to the TSSchange. Post-hoc analysis of the variable of location at the time of reporting revealed that participants reported increased TSSchange when they were at a café/restaurant compared to flat/university.
CONCLUSIONS: A number of factors within the context of daily life influenced the postconcussion-like symptoms reported over time. These findings indicate that clinicians need to be cautious when interpreting the serially assessed symptom scores to track the recovery profile of a concussed athlete in order to make decisions on return-to-play. Additional investigation is warranted to examine the change in symptom scores reported over time by concussed individuals considering that this study was conducted in a non-concussed cohort.
Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Language: en |