Anxiety, pain, and fear of pain: predictors of postural stability after concussion.

IF 2 4区 医学 Q2 SPORT SCIENCES International journal of sports medicine Pub Date : 2025-03-13 DOI:10.1055/a-2558-7690
Madison L Brna, Katherine L Smulligan, Mathew J Wingerson, Samantha N Magliato, Lindsay E Kemp, Julie Wilson, David R Howell
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Abstract

Concussion can lead to anxiety, pain, kinesiophobia, and/or postural control deficits. We conducted a cross-sectional study evaluating adolescents with a recent concussion. We hypothesized that those reporting higher levels of anxiety, pain-interference, and kinesiophobia would perform worse on postural control tests. Participants completed anxiety, pain-interference, and kinesiophobia ratings, and postural control tests (single/dual-task tandem gait [TG], modified balance error scoring system [mBESS]). Using multivariable linear regression model, we evaluated the relationship between anxiety, pain-interference, and kinesiophobia (predictors) with postural control measures (TG and mBESS, outcomes), adjusting for sex and anxiety history. We enrolled 128 participants (53% female, age=15.4±1.7 years, 9.3±4.0 days post-concussion). Higher anxiety was weakly correlated with slower dual-task TG time (r=0.31; p=0.001) and more mBESS errors (r=0.22; p=0.01). Multivariable modeling indicated that a higher post-concussion anxiety rating was associated with slower dual-task TG time (β=0.21, 95% CI=0.01, 0.41; p=0.04). Female sex was associated with slower single-task tandem gait (β=-3.01, 95% CI= -6.01, -0.01; p=0.049). Adolescents with higher anxiety post-concussion performed worse on dual-task tandem gait assessments, while pain-interference and kinesiophobia were not associated with postural control. Anxiety and impaired postural control are independently associated with poor concussion outcomes; thus, this association may inform individualized concussion care strategies.

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来源期刊
CiteScore
4.80
自引率
4.00%
发文量
111
审稿时长
3-8 weeks
期刊介绍: The IJSM provides a forum for the publication of papers dealing with both basic and applied information that advance the field of sports medicine and exercise science, and offer a better understanding of biomedicine. The journal publishes original papers, reviews, short communications, and letters to the Editors.
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