Self-Administered Relaxation Techniques Improving Postconcussive Mood Symptoms in an Appalachian Population

Area of Science:

• Neurology and Sports Medicine
• Psychiatry and Behavioral Health

Background:

• Concussions are common pediatric injuries, especially among high school athletes.
• Psychological effects of concussions are often overlooked and undertreated, particularly in rural areas.
• Limited research exists on optimizing recovery for these patients, though deep breathing exercises show promise.

Purpose of the Study:

• To evaluate the effectiveness of self-administered relaxation techniques for postconcussive mood symptoms.
• To assess these techniques in an Appalachian population, a setting with potential resource limitations.
• To compare outcomes based on patient compliance with the prescribed exercises.

Main Methods:

• Retrospective chart review of 308 patients from a rural concussion clinic (September 2020 - May 2023).
• Patients with mild to moderate depression/anxiety received education on 15-minute nightly deep breathing exercises.
• Mood symptoms (PCSS, PHQ, GAD-7) were reassessed at follow-up (average 13.5 days) and analyzed based on compliance (good vs. limited).

Main Results:

• The good compliance group showed significant improvements in depression (PHQ), anxiety (GAD), and concussion symptoms (PCSS).
• The limited compliance group showed significant improvements in anxiety (GAD) and concussion symptoms (PCSS), but not depression.
• A significant difference in anxiety improvement was observed between the good and limited compliance groups (4.19 points on GAD scale).

Conclusions:

• Self-administered deep breathing exercises are a cost-free, practical, and safe intervention for concussion recovery.
• This technique may particularly benefit patients with persistent mood symptoms in resource-limited settings like Appalachia.
• Encouraging good compliance with deep breathing exercises can maximize improvements in mood symptoms post-concussion.