Clinical predictors of post-concussion kinesiophobia severity among adolescents

Kinesiophobia is a common post-concussion comorbidity. Identifying factors associated with post-concussion kinesiophobia may be clinically useful to guide effective treatment plans.

To identify patient-level factors associated with kinesiophobia among adolescents after concussion.

Sixty-six participants (age = 15.3, SD = 1.8 years; 59% female) were evaluated at two visits: Visit 1 (mean = 9.9, SD = 4.3 days post-concussion) and Visit 2 (mean = 43.9, SD = 15.9 days post-concussion). They completed the Post-Concussion Symptom Inventory (PCSI) and Tampa Scale of Kinesiophobia (TSK-17) questionnaires. In addition, we collected age, sex, concussion history, and musculoskeletal injury history variables to include as covariates.

At Visit 1, higher PCSI ratings were significantly associated with higher TSK ratings (β = 0.07, 95% CI = 0.02, 0.13, p = 0.006). Higher TSK ratings at Visit 1 were significantly associated with higher TSK ratings at Visit 2 (β = 0.65, 95% CI = 0.41, 0.89, p < 0.001). History of musculoskeletal injury was significantly associated with lower TSK ratings at Visit 2 (β = -2.86, 95% CI = -5.53, -0.20, p = 0.03).

We observed an association between post-concussion kinesiophobia with symptom severity initially post-injury and previous musculoskeletal injury at later stages of recovery. Clinicians may consider the time since injury, overlap with concussion symptoms, and past injury history to help contextualize pathways to reduce post-concussion kinesiophobia.