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Abstract
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OBJECTIVE: To assess the association between the Brief Symptom Inventory 18 (BSI-18) response at post-concussion return to play (RTP) and subsequent lower extremity musculoskeletal injury (LE-MSI).
BACKGROUND: Concussion evaluation includes a multifaceted neurologic assessment at baseline and post-injury. Despite emotional sequelae after concussion, psychological assessments have received limited attention thus athletes may RTP despite persistent psychological distress post-concussion. Recent evidence has suggested an ∼2x elevated rate of post-concussion LE-MSI in collegiate athletes; however there is limited understanding of potential mechanisms. As psychological distress has been associated with MSI, the purpose of this study was to assess BSI-18 as a potential predictor of subsequent MSI.
DESIGN/METHODS: This analysis utilized a cross-sectional design of 67 NCAA intercollegiate students-athletes with a diagnosed concussion (59.7% female, age: 19.7 ± 1.4 years). Participants completed the BSI-18, an 18-item questionnaire based on a 5-point Likert scale (0-4) used to measure psychological distress at the RTP clinical time-point. Outcome measures were the Global Severity Index (GSI) which is the total score of symptoms (0-72) with higher scores representing greater psychological distress and subsequent MSI (yes or no) collected retrospectively through an electronic medical record in the year following diagnosed concussion. Binary logistic regression was used to assess the predictive capabilities of BSI-18 GSI and subsequent LE-MSI.
RESULTS: The BSI-18 GSI did not significantly predict subsequent LE-MSI (p = 0.095, Exp(B) = 2.436, Nagelkerke R2 = 0.181).
CONCLUSIONS: The BSI-18 GSI at RTP did not predict post-concussion subsequent LE-MSI. While the underlying mechanism for post-concussion MSI remains to be fully elucidated, results suggest that psychological health, as measured by the BSI-18 GSI, at RTP is not associated with subsequent LE-MSI. If MSI risk can be predicted then targeted, established, and clinically feasible injury prevention programs can be implemented to reduce injury risk.
Language: en |