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Abstract
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PURPOSE: Physical activity (PA) after concussion is an important aspect of appropriate clinical management. However, symptoms or functional deficits may reduce patient propensity toward PA, thereby negatively affecting recovery. Our purpose was to examine whether post-concussion dizziness, total symptom severity, or postural stability predict PA level in the two weeks after initial evaluation.
METHODS: We evaluated adolescent athletes within 14 days of concussion on assessments of symptoms, dizziness, and postural stability. Athletes were provided an activity monitor to track PA for two weeks post-evaluation. Our primary outcome was step count (mean steps/day). Potential predictor variables included sex, Post-Concussion Symptom Inventory (PCSI) total symptom severity, individual PCSI ratings of dizziness and balance impairment, and postural stability assessments (single and dual-task tandem gait, modified Balance Error Scoring System). To examine predictors of PA, we calculated correlation coefficients between steps/day and each potential predictor and included significantly correlated variables in a multivariable regression model.
RESULTS: Participants were ages 12-18 years (n = 35, 15.2 ± 1.7 years, 49% female) and initially evaluated 7.3 ± 3.0 days post-concussion. Upon univariable evaluation, PCSI dizziness rating (Pearson R = -0.49, p = 0.003) and sex (mean difference = 2449 steps/day, p = 0.05) were associated with steps/day. Within the multivariable regression analysis, PCSI dizziness rating (β = -1035; 95%CI: -191, -1880; p = 0.018), but not sex, predicted average steps/day in the two weeks following initial evaluation.
CONCLUSIONS: Self-reported dizziness, but not overall symptom severity or postural stability, assessed within 14 days of concussion predicted daily step count in the subsequent two weeks. Given the importance of PA for concussion recovery, treating acute post-concussion dizziness can potentially reduce a barrier to PA and improve recovery trajectories.
Language: en |