A. J. Zynda, C. Perry, A. Reed, M. Collins, A. Kontos, A. Trbovich
{"title":"A - 41 成人脑震荡后恐惧规避行为、临床结果和康复时间之间的关系","authors":"A. J. Zynda, C. Perry, A. Reed, M. Collins, A. Kontos, A. Trbovich","doi":"10.1093/arclin/acae052.41","DOIUrl":null,"url":null,"abstract":"\n \n \n To examine the relationship between fear-avoidance behavior, clinical outcomes, and recovery time in adults following concussion.\n \n \n \n This prospective study included patients aged 18–50 years who presented to a specialty clinic 5–30 days post-concussion. Participants completed a clinical intake (e.g., demographics/medical history), multidomain clinical assessment (Clinical Profile Screen [CP-Screen], Immediate Post-concussion Cognitive Testing [ImPACT], Vestibular/Ocular Motor Screen [VOMS], Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7]), and the Fear-Avoidance Components Scale (FACS). Recovery time was ascertained at a subsequent visit(s). Fear-avoidant (FA) and non-fear-avoidant (NFA) groups were classified using cutoffs from the FACS (FA = 41–100; NFA = 0–40) and compared using independent samples t-tests, X2 tests, and analyses of covariance.\n \n \n \n Seventy-two participants (M = 28.7¬ ± 8.5 years, 69.4% female) were included: 37 (51.4%) in the FA and 35 (48.6%) in the NFA group. Groups did not differ on demographics, medical history, injury characteristics, or CP-Screen. A greater proportion of the FA group had the anxiety/mood profile (62.2% vs 31.4%, p < 0.01). The FA group had worse ImPACT reaction time (t(68) = −2.7, p < 0.01, d = −0.7), VOMS visual motion sensitivity (t(67) = −2.3, p = 0.03, d = −0.5), GAD-7 (t(70) = −3.9, p < 0.01, d = −0.9), and PHQ-9 (t(69) = −2.8, p < 0.01, d = −0.7) scores, and longer recovery (t(24) = −2.8, p = 0.01, d = −0.9), even when controlling for age and time to clinic (F[1, 22] = 4.6, p = 0.04, ηp2 = 0.17).\n \n \n \n Adults who reported high fear-avoidance (e.g., avoiding activity, catastrophizing) had worse clinical outcomes and longer recovery following concussion compared to non-fear-avoidant adults, despite no differences in demographics, medical history, injury characteristics, or symptoms. Clinicians should screen for and counsel adults post-concussion against engaging in fear-avoidance behaviors to improve recovery outcomes.\n","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":" 9","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A - 41 Relationship between Fear-Avoidance Behavior, Clinical Outcomes, and Recovery Time in Adults Following Concussion\",\"authors\":\"A. J. Zynda, C. Perry, A. Reed, M. Collins, A. Kontos, A. Trbovich\",\"doi\":\"10.1093/arclin/acae052.41\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n \\n To examine the relationship between fear-avoidance behavior, clinical outcomes, and recovery time in adults following concussion.\\n \\n \\n \\n This prospective study included patients aged 18–50 years who presented to a specialty clinic 5–30 days post-concussion. Participants completed a clinical intake (e.g., demographics/medical history), multidomain clinical assessment (Clinical Profile Screen [CP-Screen], Immediate Post-concussion Cognitive Testing [ImPACT], Vestibular/Ocular Motor Screen [VOMS], Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7]), and the Fear-Avoidance Components Scale (FACS). Recovery time was ascertained at a subsequent visit(s). Fear-avoidant (FA) and non-fear-avoidant (NFA) groups were classified using cutoffs from the FACS (FA = 41–100; NFA = 0–40) and compared using independent samples t-tests, X2 tests, and analyses of covariance.\\n \\n \\n \\n Seventy-two participants (M = 28.7¬ ± 8.5 years, 69.4% female) were included: 37 (51.4%) in the FA and 35 (48.6%) in the NFA group. Groups did not differ on demographics, medical history, injury characteristics, or CP-Screen. A greater proportion of the FA group had the anxiety/mood profile (62.2% vs 31.4%, p < 0.01). The FA group had worse ImPACT reaction time (t(68) = −2.7, p < 0.01, d = −0.7), VOMS visual motion sensitivity (t(67) = −2.3, p = 0.03, d = −0.5), GAD-7 (t(70) = −3.9, p < 0.01, d = −0.9), and PHQ-9 (t(69) = −2.8, p < 0.01, d = −0.7) scores, and longer recovery (t(24) = −2.8, p = 0.01, d = −0.9), even when controlling for age and time to clinic (F[1, 22] = 4.6, p = 0.04, ηp2 = 0.17).\\n \\n \\n \\n Adults who reported high fear-avoidance (e.g., avoiding activity, catastrophizing) had worse clinical outcomes and longer recovery following concussion compared to non-fear-avoidant adults, despite no differences in demographics, medical history, injury characteristics, or symptoms. 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A - 41 Relationship between Fear-Avoidance Behavior, Clinical Outcomes, and Recovery Time in Adults Following Concussion
To examine the relationship between fear-avoidance behavior, clinical outcomes, and recovery time in adults following concussion.
This prospective study included patients aged 18–50 years who presented to a specialty clinic 5–30 days post-concussion. Participants completed a clinical intake (e.g., demographics/medical history), multidomain clinical assessment (Clinical Profile Screen [CP-Screen], Immediate Post-concussion Cognitive Testing [ImPACT], Vestibular/Ocular Motor Screen [VOMS], Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7]), and the Fear-Avoidance Components Scale (FACS). Recovery time was ascertained at a subsequent visit(s). Fear-avoidant (FA) and non-fear-avoidant (NFA) groups were classified using cutoffs from the FACS (FA = 41–100; NFA = 0–40) and compared using independent samples t-tests, X2 tests, and analyses of covariance.
Seventy-two participants (M = 28.7¬ ± 8.5 years, 69.4% female) were included: 37 (51.4%) in the FA and 35 (48.6%) in the NFA group. Groups did not differ on demographics, medical history, injury characteristics, or CP-Screen. A greater proportion of the FA group had the anxiety/mood profile (62.2% vs 31.4%, p < 0.01). The FA group had worse ImPACT reaction time (t(68) = −2.7, p < 0.01, d = −0.7), VOMS visual motion sensitivity (t(67) = −2.3, p = 0.03, d = −0.5), GAD-7 (t(70) = −3.9, p < 0.01, d = −0.9), and PHQ-9 (t(69) = −2.8, p < 0.01, d = −0.7) scores, and longer recovery (t(24) = −2.8, p = 0.01, d = −0.9), even when controlling for age and time to clinic (F[1, 22] = 4.6, p = 0.04, ηp2 = 0.17).
Adults who reported high fear-avoidance (e.g., avoiding activity, catastrophizing) had worse clinical outcomes and longer recovery following concussion compared to non-fear-avoidant adults, despite no differences in demographics, medical history, injury characteristics, or symptoms. Clinicians should screen for and counsel adults post-concussion against engaging in fear-avoidance behaviors to improve recovery outcomes.
期刊介绍:
ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications.
The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.