Factors associated with variability in recovery after mild traumatic brain injury among adults referred to outpatient concussion clinics.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Brain Impairment Pub Date : 2026-09-24 DOI:10.1071/IB26011

Deborah Snell, Jonathan Williman, Josh Faulkner, Noah D Silverberg, Alice Theadom, Lois Surgenor, Richard Siegert

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引用次数: 0

Abstract

Background: To understand factors associated with symptom and disability recovery trajectories among adults referred to outpatient clinics after mild traumatic brain injury.

Methods: Adults (n = 110; mean age 39 years, 36% men), were assessed at clinic intake (baseline mean 6.5 weeks), and monthly thereafter for 6 months. Validated questionnaires assessed distress, fear avoidance and catastrophising at baseline, and mild traumatic brain injury symptoms and disability. Using correlations and linear mixed modelling, we explored associations between demographic characteristics (age, gender), baseline psychological factors and recovery as a function of time.

Results: The models predicted improvement in symptoms (R2 = 0.22) and disability (R2 = 0.37). After adjusting for baseline severity of symptoms and disability, higher distress was associated with slower recovery and greater variability for symptoms (P = 0.06) and disability (P < 0.01). Higher baseline catastrophising predicted less symptom improvement (P = 0.02). Those with higher fear avoidance behaviour at baseline showed greater variability in disability outcomes (P = 0.02), even when other psychological variables were accounted for.

Conclusions: Participants showed improvements on average, in both symptoms and disability. Variability and rates of recovery were associated with distress, catastrophising and fear avoidance. Clinicians can target such psychological factors in treatment and anticipate recovery fluctuations, normalising these while maintaining cautiously optimistic messaging regarding expected good prognosis after mild traumatic brain injury.

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与成人轻度创伤性脑损伤后恢复变异性相关的因素涉及门诊脑震荡诊所。

背景：了解轻度创伤性脑损伤后转诊到门诊的成人症状和残疾恢复轨迹的相关因素。方法：对110名成年人（n = 110，平均年龄39岁，36%为男性）进行临床摄入评估（基线平均6.5周），此后每月评估一次，持续6个月。有效的问卷评估了痛苦、恐惧回避和灾难基线，以及轻度创伤性脑损伤症状和残疾。利用相关性和线性混合模型，我们探索了人口统计学特征（年龄、性别）、基线心理因素和恢复之间的关系。结果：模型预测症状改善（R2 = 0.22）和残疾改善（R2 = 0.37）。在调整了基线症状和残疾的严重程度后，较高的焦虑程度与较慢的恢复和较大的症状变异性（P = 0.06）和残疾（P < 0.01）相关。较高的基线灾变预测较少的症状改善（P = 0.02）。即使考虑到其他心理变量，那些在基线时有较高恐惧回避行为的人在残疾结果上也表现出更大的变异性（P = 0.02）。结论：参与者在症状和残疾方面均有改善。可变性和恢复率与痛苦、灾难和恐惧回避有关。临床医生可以在治疗中针对这些心理因素，并预测恢复波动，使这些因素正常化，同时对轻度创伤性脑损伤后预期的良好预后保持谨慎乐观的信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Impairment CLINICAL NEUROLOGY-NEUROSCIENCES

CiteScore

1.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The journal addresses topics related to the aetiology, epidemiology, treatment and outcomes of brain impairment with a particular focus on the implications for functional status, participation, rehabilitation and quality of life. Disciplines reflect a broad multidisciplinary scope and include neuroscience, neurology, neuropsychology, psychiatry, clinical psychology, occupational therapy, physiotherapy, speech pathology, social work, and nursing. Submissions are welcome across the full range of conditions that affect brain function (stroke, tumour, progressive neurological illnesses, dementia, traumatic brain injury, epilepsy, etc.) throughout the lifespan.