Clinical Mental Health Measures and Prediction of Postconcussion Musculoskeletal Injury
Date
2023-07-31
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Athletic Training
Abstract
Context
The rate of lower extremity musculoskeletal injury (LE MSK) is elevated after concussion; however, the underlying mechanism has not been elucidated. Physical characteristics have been investigated despite poorer mental health being a common postconcussion complaint and linked to MSKs.
Objective
To evaluate the role of mental health as a predictor of postconcussion LE MSK.
Design
Case-control study.
Setting
Intercollegiate athletic training facility.
Patients or Other Participants
A total of 67 National Collegiate Athletic Association Division I student-athletes (n = 39 females) who had been diagnosed with a sport-related concussion.
Main Outcome Measure(s)
The Brief Symptom Inventory-18, Hospital Anxiety and Depression Scale, and Satisfaction With Life Scale (SWLS) measures were completed at baseline (preseason) and on the day participants were cleared for unrestricted return to play (RTP) after a concussion. Two binary logistic regressions were used to predict postconcussion LE MSK within a year, one for the baseline time point and the second for the RTP time point. A 2 (group: LE MSK, no LE MSK)-by-2 (time: baseline, RTP) repeated-measures analysis of variance compared performance between baseline and RTP.
Results
Subsequent LE MSKs were sustained by 44 participants (65.7%). The only significant predictor of postconcussion LE MSK was the SWLS score at RTP, with Exp(B) = 0.64, indicating that an increased (improved) SWLS score was associated with a lower LE MSK rate. No significant interactions were present between mental health measures and subsequent MSK (P values = .105–.885).
Conclusions
Limited associations were evident between postconcussion LE MSK and scores on commonly used measures of anxiety, depression, and satisfaction with life. Reported increased satisfaction with life was associated with a decreased injury risk, which warrants further attention. Our results suggest that these measures of anxiety, depression, and satisfaction with life have limited value in assisting sports medicine clinicians with determining which student-athletes are at elevated risk of postconcussion LE MSK.
Key Points
Measures of anxiety and depressive symptoms were not predictive of elevated postconcussion lower extremity musculoskeletal injury.
Greater satisfaction with life was associated with a decreased risk of postconcussion lower extremity musculoskeletal injury.
Description
This article was originally published in Journal of Athletic Training. The version of record is available at: https://doi.org/10.4085/1062-6050-0595.21. © by the National Athletic Trainers’ Association, Inc
Keywords
mild traumatic brain injury, depression, anxiety, sport injury
Citation
Thomas A. Buckley, Kelsey N. Bryk, Alexander L. Enrique, Thomas W. Kaminski, Katherine J. Hunzinger, Jessie R. Oldham; Clinical Mental Health Measures and Prediction of Postconcussion Musculoskeletal Injury. J Athl Train 1 May 2023; 58 (5): 401–407. doi: https://doi.org/10.4085/1062-6050-0595.21