Clinical Mental Health Measures and Prediction of Postconcussion Musculoskeletal Injury.

ACHILLES tendon injuries; LEG injuries; QUADRICEPS muscle injuries; SPORTS injuries risk factors; MUSCULOSKELETAL system diseases; SPORTS participation; COLLEGE athletes; ANALYSIS of variance; SELF-evaluation; MENTAL health; CASE-control method; PHYSICAL training & conditioning; SATISFACTION; SPRAINS; BRUISES; JOINT dislocations; POSTCONCUSSION syndrome; RISK assessment; PSYCHOLOGICAL tests; T-test (Statistics); ANKLE injuries; PSYCHOSOCIAL factors; QUESTIONNAIRES; REPEATED measures design; MENTAL depression; HAMSTRING muscle; FOOT; BRIEF Symptom Inventory; ANXIETY; LOGISTIC regression analysis; PREDICTION models; KNEE injuries; MENISCUS injuries; BONE fractures; DISEASE risk factors

The rate of lower extremity musculoskeletal injury (LE MSK) is elevated after concussion; however, the underlying mechanism has not been elucidated. Physical characteristics have been investigated despite poorer mental health being a common postconcussion complaint and linked to MSKs. To evaluate the role of mental health as a predictor of postconcussion LE MSK. Case-control study. Intercollegiate athletic training facility. A total of 67 National Collegiate Athletic Association Division I student-athletes (n = 39 females) who had been diagnosed with a sport-related concussion. The Brief Symptom Inventory-18, Hospital Anxiety and Depression Scale, and Satisfaction With Life Scale (SWLS) measures were completed at baseline (preseason) and on the day participants were cleared for unrestricted return to play (RTP) after a concussion. Two binary logistic regressions were used to predict postconcussion LE MSK within a year, one for the baseline time point and the second for the RTP time point. A 2 (group: LE MSK, no LE MSK)-by-2 (time: baseline, RTP) repeated-measures analysis of variance compared performance between baseline and RTP. Subsequent LE MSKs were sustained by 44 participants (65.7%). The only significant predictor of postconcussion LE MSK was the SWLS score at RTP, with Exp(B) = 0.64, indicating that an increased (improved) SWLS score was associated with a lower LE MSK rate. No significant interactions were present between mental health measures and subsequent MSK (P values =.105–.885). Limited associations were evident between postconcussion LE MSK and scores on commonly used measures of anxiety, depression, and satisfaction with life. Reported increased satisfaction with life was associated with a decreased injury risk, which warrants further attention. Our results suggest that these measures of anxiety, depression, and satisfaction with life have limited value in assisting sports medicine clinicians with determining which student-athletes are at elevated risk of postconcussion LE MSK. [ABSTRACT FROM AUTHOR]

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