Journal of Head Trauma Rehabilitation最新文献

{"title":"Long-Term Associations of Subconcussive Blast Exposure With Brain Function and Structure.","authors":"Jared A Rowland, Benjamin T Dunkley, Jennifer R Stapleton-Kotloski, Craig A Hamilton, Mollie A McDonald, Dwayne W Godwin, Sarah L Martindale","doi":"10.1097/HTR.0000000000001169","DOIUrl":"10.1097/HTR.0000000000001169","url":null,"abstract":"<p><strong>Objective: </strong>To determine the characteristics of subconcussive blast exposure associated with differences in brain structure and brain function.</p><p><strong>Setting: </strong>Veterans Affairs Health Care System.</p><p><strong>Participants: </strong>Combat-exposed veterans (n = 107) without history of blast-related traumatic brain injury (TBI) or military TBI volunteered to participate.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Main outcomes and measures: </strong>Connectome metrics describing the functional brain connectome, the unique brain network present at rest for individuals, were measured using magnetoencephalography. Regional brain volumes were calculated from anatomical magnetic resonance imaging using FreeSurfer. The Salisbury Blast Interview evaluated lifetime blast exposure.</p><p><strong>Results: </strong>Several blast characteristics were associated with the functional connectome. The average severity of exposures was related to slowing of oscillatory communication (average pressure, parameter estimate = -4.41, P < .05 corrected). By contrast, the frequency of exposures was associated with topological differences including the number of active brain regions (number of blast exposures, parameter estimate = 0.01, P < .05 corrected) and the composition of core subnetworks (number of close-range blast exposures, parameter estimate = 0.0005, P < .05 corrected). Subconcussive blast exposure was unrelated to brain volumes.</p><p><strong>Conclusion: </strong>These results demonstrate that cumulative burden of subconcussive blast exposures is associated with long-term brain function. Independent relationships with the functional connectome were observed for both the average severity and the frequency of subconcussive blast exposures. This contrasts with previous work combining concussive and subconcussive blast demonstrating the highest severity across all exposures was most relevant to long-term brain function. A critical implication of these results is that long-term brain function may be associated with blast exposure, even in the absence of acute clinical effects or noticeable symptoms. This renders subconcussive blast exposure an invisible neurological insult with potential long-term implications for brain function. As military occupational blast exposure (MOBE) is primarily subconcussive in nature, this has direct implications for its conceptualization, regulation, and monitoring.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"e554-e562"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor: \"Assessing Task-Dependent Neurophysiology During Virtual Reality Treadmill Training in Adults With Traumatic Brain Injury: A Functional Near-Infrared Spectroscopy Feasibility Study\".","authors":"Jaclyn Stephens, Kaitlin Hays, Haylee Grove, Brandon Busch, Candace Tefertiller","doi":"10.1097/HTR.0000000000001185","DOIUrl":"10.1097/HTR.0000000000001185","url":null,"abstract":"","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"405-407"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Customized Rehabilitation Program for Adults With Post-Concussion Syndrome-A Randomized Controlled Crossover Trial.","authors":"Nicholas Moser, Milos R Popovic, Sukhvinder Kalsi-Ryan","doi":"10.1097/HTR.0000000000001144","DOIUrl":"10.1097/HTR.0000000000001144","url":null,"abstract":"<p><strong>Objective: </strong>Post-concussion syndrome is a challenging condition to assess and triage rehabilitation secondary to the heterogeneity of patients' presentations. The aim of the present study was to examine the effectiveness of a subgroup-informed customized rehabilitation (CR) program in adults with persistent concussion symptoms as compared to the current symptom-based treatment approach.</p><p><strong>Setting: </strong>Rehabilitation hospital in Toronto, Ontario, Canada.</p><p><strong>Participants: </strong>40 adults (mean age ± SD, 39.1 ± 13.6 years) with persistent post-concussion symptoms (mean symptom duration ± SD, 5 ± 3.1 months) were recruited from various head injury clinics around the greater Toronto area.</p><p><strong>Design: </strong>Participants underwent a comprehensive standardized clinical exam to subgroup the ostensible symptom generators into autonomic, cervical, or vestibulo-ocular. In a crossover design, participants were randomized to undertake either a CR program for 6 weeks followed by standard care (SC) for 6 weeks (Group A) or SC followed by CR (Group B). The CR program was tailored to the individual based on the findings of the exam. The SC program was reflective of symptom-based rehabilitative recommendations.</p><p><strong>Main measures: </strong>The primary outcome measure was the Rivermead Post-Concussion Questionnaire (RPQ-3 and RPQ-13). Secondary outcome measures included the Neck Disability Index, the Patient Health Questionnaire-9 and exercise tolerance as assessed via the Buffalo Concussion Treadmill Test.</p><p><strong>Results: </strong>Participants in Group A made a clinically meaningful and statistically significant change to the primary and secondary outcome measures at the 6-week follow-up. These changes were maintained at the 12-week follow-up. Only following the CR program did Group B demonstrate significant and clinically meaningful changes in RPQ scores, as well as significant improvements in the secondary outcome measures.</p><p><strong>Conclusions: </strong>A shift away from symptom-based management to subgroup-informed customized rehabilitation may be key to advancing patient care and improving clinical outcomes for this population.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"349-358"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Timing of Concussion in Season Affect Incidence and Recovery in Division I Collegiate Football Players? A CARE Consortium Study.","authors":"Anthony E Bishay, Samuel W Fitch, Chibuikem S Iheagwaram, Kristen L Williams, Christopher Naranjo, Tyler K Sills, Robert W Fitch, Paul F Pasquina, Thomas W McAllister, Michael A McCrea, Steven P Broglio, Douglas P Terry, Scott L Zuckerman","doi":"10.1097/HTR.0000000000001146","DOIUrl":"10.1097/HTR.0000000000001146","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether seasonality is associated with (1) concussion incidence and (2) recovery outcomes, including the time to symptom resolution (SR) and return-to-play (RTP) in Division I college football players.</p><p><strong>Setting: </strong>Multi-institution study using the CARE Consortium database composed of 30 universities investigating the natural history of concussions between 2014 and 2020.</p><p><strong>Participants: </strong>682 Division I football athletes across 21 institutions who sustained a concussion during practice or competition.</p><p><strong>Design: </strong>Prospective cohort study of NCAA Division I football players with concussion.</p><p><strong>Main measures: </strong>Concussion incidence rates across 4 season periods (preseason, early, middle, and late-season) were analyzed using chi-square tests. Time to SR and RTP were analyzed using Kaplan-Meier curves, and Cox proportional hazards regression.</p><p><strong>Results: </strong>Concussion incidence rates were highest during preseason (4.73 per 100 players) compared to early (2.19), middle (2.31), and late-season (2.17). The temporal distribution showed 41.9% of concussions occurred during preseason, with 19.2%, 20.1%, and 18.8% occurring during early, middle, and late-season, respectively (χ 2  = 104.6, P < .001). Kaplan-Meier analysis revealed significant differences in time to SR (log-rank P = .012). Early (HR = 0.582, P < .001) and late-season (HR = 0.634, P = .002) concussions had delayed SR compared to preseason. No differences in time to RTP (log-rank P = .300) were found, although early-season concussions had a lower RTP hazard (HR = 0.703, P = .040).</p><p><strong>Conclusions: </strong>In a multi-institution cohort of collegiate football players, preseason resulted in the highest incidence of concussions, while early and late-season concussions had significantly longer time to SR compared to preseason. These temporal patterns suggest that contextual factors may influence concussion outcomes and warrant mechanistic investigation to inform future management strategies.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"359-368"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Access to Cognitive Rehabilitation Referrals Among Veterans With Moderate-Severe Traumatic Brain Injury.","authors":"Adam R Kinney, Molly E Penzenik, Jeri E Forster, Frederica O'Donnell, Shannon B Juengst, Nazanin H Bahraini","doi":"10.1097/HTR.0000000000001145","DOIUrl":"10.1097/HTR.0000000000001145","url":null,"abstract":"<p><strong>Objective: </strong>Examine whether self-reported cognitive symptoms, an indicator of need, were associated with the likelihood that Veterans with moderate-severe traumatic brain injury (msTBI) received a cognitive rehabilitation referral. We also explored whether non-clinical factors modified the relationship between cognitive symptoms and receipt of a referral.</p><p><strong>Setting: </strong>Veterans Health Administration (VHA).</p><p><strong>Participants: </strong>Veterans with msTBI, determined using Comprehensive Traumatic Brain Injury Evaluation data from 2013-2023 ( n = 10 790).</p><p><strong>Design: </strong>Cross-sectional study of VHA medical record data. Modified Poisson regression modelled the likelihood of cognitive rehabilitation referral based on cognitive symptom severity and non-clinical predisposing (eg, race/ethnicity) and enabling (eg, drive time) factors. Models were specified to explain referral to occupational therapy (OT), speech-language pathology (SLP), and neuropsychology. Statistical interactions determined whether non-clinical factors modified the relationship between cognitive symptoms and referral.</p><p><strong>Main measures: </strong>Cognitive rehabilitation referrals, identified using a validated algorithm detecting key phrases in unstructured consult data. Self-reported cognitive symptom severity measuring using the Neurobehavioral Symptom Inventory.</p><p><strong>Results: </strong>Only 35% received a cognitive rehabilitation referral, with SLP services being the most common discipline (25%). Veterans with more severe self-reported cognitive symptoms were more likely to receive a referral (relative risk [RR], 1.06; 99% confidence interval [CI], 1.05-1.08), and this relationship was stable in discipline-specific models. However, many Veterans without a referral reported disabling cognitive challenges, indicating unmet need. Non-clinical factors-including drive time (RR, 0.86; 95% CI, 0.77-0.97) and rurality (RR, 0.92; 95% CI, 0.85-0.99)-were associated with receipt of a referral, though these relationships varied across discipline-specific models. Interactions did not provide support for non-clinical factors modifying the relationship between cognitive symptoms and receipt of a referral.</p><p><strong>Conclusions: </strong>While cognitive rehabilitation services tend to be allocated to those in need, results revealed gaps in access. Findings can guide development of strategies expanding access to cognitive rehabilitation among Veterans with msTBI, enhancing clinical outcomes.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"369-380"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated Status of Physical Activity Research for People With Traumatic Brain Injury.","authors":"Enrico L Quilico, Simon J Driver","doi":"10.1097/HTR.0000000000001148","DOIUrl":"10.1097/HTR.0000000000001148","url":null,"abstract":"<p><strong>Objective: </strong>To update the status of physical activity research after moderate-to-severe traumatic brain injury (msTBI) by systematically reviewing empirical studies across health-related fields with the behavioral epidemiological framework to identify evidence-based interventions and inform future recommendations. The last review of physical activity research after msTBI, including studies between 2000 and 2012, found the field was in early stages of maturation.</p><p><strong>Methods: </strong>Articles published between January 2012 and December 2024 were retrieved from PubMed, Embase, Ovid Medline, Scopus, Web of Science, Rehabilitation & Sports Medicine Source, and Google Scholar using keywords related to traumatic brain injury, physical activity, and health promotion. Two authors independently screened titles, abstracts, and full texts for peer-reviewed research about physical activity behavior for adults with msTBI. Data were abstracted from included studies by study authors and then categorized into to the framework's 5 unique stages of development.</p><p><strong>Results: </strong>A total of 958 references were imported, 129 duplicates were removed, 829 were screened with title and abstract, 165 articles underwent full-text review, and 100 final articles met the inclusion criteria. Consensus was achieved across different stages of the review through critical discussion. 40% were categorized in Phase 1 (establishing connections between behavior and health); 6% in Phase 2 (developing methods for measuring behaviors); 44% in Phase 3 (examining factors that influence behavior); 10% in Phase 4 (evaluating behavior change interventions); and 0% in Phase 5 (dissemination of health promotion programs). Many excluded full-text studies (n = 39/60) did not separate results by condition/injury severity (i.e., stroke/mild TBI).</p><p><strong>Conclusions: </strong>The greater number of studies in Phases 3 and 4 suggest the field has evolved in 12 years. The lack of progress in Phase 5 provides opportunity for implementation science efforts. Recommendations for physical activity behavior research after msTBI are discussed.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"41 5","pages":"e513-e523"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Depression on Mortality Risk After Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study.","authors":"Amanda R Rabinowitz, Brennan Hickson, Raj G Kumar, Tessa Hart, Charles H Bombardier, Flora M Hammond, Ronald Seel, Ross Zafonte, John Whyte","doi":"10.1097/HTR.0000000000001205","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001205","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether depressive symptoms at 1 year postinjury are associated with all-cause mortality among individuals with moderate-to-severe traumatic brain injury (TBI) who received inpatient rehabilitation, accounting for sociodemographic, functional, and mental health factors.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>A total of 2812 individuals enrolled in the TBI Model Systems National Database with 1-year postinjury follow-up interviews between October 1, 2007, and October 1, 2013, and a follow-up within 5 years of injury.</p><p><strong>Design: </strong>Prospective cohort study, using secondary analysis of longitudinal data.</p><p><strong>Main measures: </strong>Depression (Patient Health Questionnaire-9) and all-cause mortality.</p><p><strong>Results: </strong>The rate of high depressive symptom burden at 1-year follow-up was 28.5%, and the overall death rate was 8.8% across the study follow-up period. In age-adjusted models, higher depressive symptom burden at 1 year was associated with increased mortality risk; however, this association was progressively attenuated after adjustment for functional status and preinjury mental health variables and was no longer statistically significant in fully adjusted models. Sensitivity analyses using multiple imputation yielded similar results.</p><p><strong>Conclusion: </strong>Findings suggest that depressive symptom burden at 1 year postinjury is not independently associated with 5-year mortality after accounting for functional status and preinjury mental health history. Depression may, nonetheless, function as a clinically meaningful marker of broader vulnerability. Further research is warranted to explore whether targeting depression and functional recovery influence long-term survival after TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the Reliability and Validity of A Novel Ecological Momentary Assessment Tool in Healthy College-Aged Athletes: A Foundation for Future Concussion Research.","authors":"Allie J Tracey, Douglas J Wiebe, Kimberly S Kelly, Nicole L Hoffman, Tracey Covassin, Abigail C Bretzin","doi":"10.1097/HTR.0000000000001149","DOIUrl":"10.1097/HTR.0000000000001149","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the psychometric properties and clinical feasibility of administering a post-concussion symptom checklist and real-time assessments of psychological health-related quality of life (PHRQoL) in healthy college-aged individuals via a mobile, ecological momentary assessment text messaging platform, Recovering Concussion Update on Progression of Symptoms (ReCoUPS).</p><p><strong>Setting: </strong>University laboratory setting.</p><p><strong>Participants: </strong>Healthy college-aged athletes (n = 93; 64 female, 29 male; µ age = 21.37 ± 2.63 years) who currently play or recently (i.e., within the past year) played a sport and had not sustained a concussion within the past 6 months.</p><p><strong>Design: </strong>Test-retest reliability design.</p><p><strong>Main measures: </strong>Healthy participants enrolled in the ReCoUPS platform using their cell phone number completed daily, randomly timed text message surveys for 7 consecutive days. Each survey included 30 questions from the Sport Concussion Tool, Version 6 (SCAT6) symptom checklist and modified momentary versions of the PROMIS Emotional Distress Short Forms for Anxiety and Depression (PROMIS-SF Anxiety and PROMIS-SF Depression). Eight days after enrollment, participants completed recalled PROMIS-SF inventories (\"within the past 7 days\"). Response rates to ReCoUPS surveys were calculated to assess feasibility. Reliability and validity of momentary PROMIS-SF measures were evaluated using Cronbach's alpha, intraclass correlation coefficients (ICCs) with 95% confidence intervals (95%CI), Cohen's kappa ( κ ), and Spearman's rho correlation coefficients (r s ).</p><p><strong>Results: </strong>Most participants (n = 80, 86.0%) completed over 70% of daily ReCoUPS surveys. Momentary assessments of PROMIS-SFs demonstrated acceptable reliability (Anxiety α  = .80; Depression α  = .91) and moderate to excellent agreement with their original recalled measures (Anxiety: ICC = 0.99(95%CI, 0.99-1.00), κ  = 0.44; Expected: 51.73%, Actual: 73.12%, P < .001; Depression: ICC = 0.99(95%CI, 0.99-1.00), κ  = 0.58; Expected: 50.99%, Actual: 79.57%, P < .001). Momentary assessments of PROMIS-SFs were significantly correlated with each other, all SCAT6 symptom clusters, and total SCAT6 symptom severity (r s  = 0.28-0.92, P < .001).</p><p><strong>Conclusions: </strong>ReCoUPS performed reliably and as a feasible tool for remotely monitoring concussion symptoms and momentary PHRQoL in healthy individuals, providing a foundation for future work in a concussion population to improve stakeholders' understanding of post-concussion outcomes and optimize treatments.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"391-401"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring Adolescent Sport-Related Concussion Recovery Using Consumer-Grade Wearables: A Pilot Study.","authors":"Danielle M Ransom, Brant H Tudor, Sarah A Irani, Mohamed A Rehman, Stacy J Suskauer, Adrian M Svingos, Luis M Ahumada, P Patrick Mularoni","doi":"10.1097/HTR.0000000000001143","DOIUrl":"10.1097/HTR.0000000000001143","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether consumer-grade wearable devices (CGWDs) can detect physiological differences between adolescent athletes recovering from sport-related concussion (SRC) versus musculoskeletal (MSK) injury, and to examine whether wearable-derived physiological markers are associated with symptom burden during the acute post-injury phase.</p><p><strong>Setting: </strong>Outpatient sports medicine clinic at a pediatric academic medical center.</p><p><strong>Participants: </strong>High school student-athletes aged 14-18 years were eligible if they presented within 10 days of SRC or acute, nonsurgical MSK injury and had internet access and willingness to comply with study procedures. Thirty-eight participants were enrolled; four were excluded due to protocol deviations. The final analytic sample included 34 participants (SRC: n = 17; MSK: n = 17).</p><p><strong>Design: </strong>Prospective observational cohort study conducted from September 2021 to April 2022. All participants were issued a Fitbit Sense to passively monitor sleep, activity, and heart rate for up to 6 weeks post-injury. No randomization or blinding occurred, as this was an observational study.</p><p><strong>Main measures: </strong>The primary outcome was group differences in CGWD-derived physiological metrics (sleep patterns and architecture, physical activity, heart rate) across 3 post-enrollment time intervals (Days 1-14, 15-28, 29-42). Secondary outcomes included correlations between physiological data and symptom burden based on the Post-Concussion Symptom Inventory, Second Edition (PCSI-2).</p><p><strong>Results: </strong>Compared to MSK peers, participants with SRC showed significantly more light sleep, more nocturnal wake time, and lower daily step counts during the first 4 weeks post-injury ( P <.0038). No significant differences were observed in REM sleep, deep sleep, or heart rate. In SRC participants, greater nocturnal wake time and lower resting heart rate were modestly associated with higher cognitive symptom ratings; emotional symptoms were modestly associated with step counts. No adverse events occurred.</p><p><strong>Conclusions: </strong>CGWDs may capture recovery-specific physiological disruptions in adolescent SRC, particularly in sleep and physical activity. These findings support the potential for wearable technology to inform individualized, objective approaches to concussion monitoring in clinical practice.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"e476-e485"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"A Dual Diversity Crisis in fNIRS-Based TBI Rehabilitation Research\".","authors":"Thorsten Rudroff","doi":"10.1097/HTR.0000000000001183","DOIUrl":"10.1097/HTR.0000000000001183","url":null,"abstract":"","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"402-404"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}