Abstract
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 the initial clinic visit.
Setting
Three military treatment facilities.
Participants
Study participants included active duty Service members diagnosed with a concussion
(N=111; median age, 24 y). Individuals with previous history of concussion within
12 months of study enrollment were excluded.
Intervention
Not applicable.
Main Outcome Measures
Activity questionnaire and the Neurobehavioral Symptom Inventory assessed within 72
hours of concussion; at 1 week; and at 1, 3, and 6 month(s) postinjury.
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 postconcussive
symptoms should consider patient knowledge and/or 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.
Keywords
List of abbreviations:
CI (confidence interval), MLM (multilevel modeling)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 28, 2020
Footnotes
Supported by the Defense Health Program 6.7 (award no. D6.7_14_C2_I_14_J9_1077) and the Defense and Veterans Brain Injury Center. The views expressed in this manuscript are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other United States government agency. This work is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available for any work of the U.S. Government. For more information, please contact [email protected]
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
