Defense and Veterans Brain Injury Center, Silver Spring, MD; Naval Medical Center San Diego, San Diego, CA; American Hospital Services Group LLC, Exton, PA.
OBJECTIVES: To evaluate relationships between beliefs about the impact of rest and the level of activities and symptoms over time among active duty Service Members sustaining concussion, and whether these relationships vary by provision of concussion education.
DESIGN: Longitudinal study using multilevel modeling to assess the relationship between beliefs about rest within 72 hours of concussion and change in activity and symptom level over time, as well as interaction by concussion education at initial clinic visit. SETTING: Three military treatment facilities. PARTICIPANTS: Study participants included 111 active duty Service Members diagnosed with a concussion, with a median age of 24 years. Individuals with prior history of concussion within 12 months of study enrollment were excluded. INTERVENTION: N/A MAIN OUTCOME MEASURE(S): Activity Questionnaire and the Neurobehavioral Symptom Inventory assessed within 72 hours of concussion, at 1 week and at 1, 3 and 6 month(s) post-injury.
RESULTS: Receipt of concussion education from providers was significantly associated with greater belief that rest influences concussion recovery. Greater belief that rest influences symptom recovery at the acute stage of concussion was associated with a greater increase in activities over time, but only among those who received education from their provider. Additionally, greater belief about the influence of rest was related to a more rapid decrease in symptoms over time.
CONCLUSIONS: Concussed Service Members who underestimate the influence of rest during acute recovery may be at risk for poorer recovery. Treatment of Service Members with post-concussive symptoms should consider patient knowledge/beliefs about rest and recovery, which may influence prognosis. Our results support the provider's use of concussion education to correct potential misconceptions that may negatively impact symptom recovery.
Activity; Attitudes; Concussion; Education; Health Beliefs; Knowledge; Mild traumatic brain injury; Military; Neurobehavioral symptoms; Rest and concussion recovery; Service Members