Self-perceived Mobility And Fatigue As Predictors Of Time Spent In Moderate-to-vigorous Physical Activity After Concussion

Adolescents who participate in higher volumes of moderate-to-vigorous physical activity (MVPA) following concussion demonstrate faster recovery, though engagement in MVPA soon after injury may be limited by various factors. Self-perceived mobility and fatigue may influence the amount of MVPA performed during concussion recovery, however this relationship remains unclear. PURPOSE: To determine the association between self-reported mobility and fatigue ratings after concussion, and if either predict subsequent MVPA. METHODS: Adolescents within 18 days of concussion reported demographics, medical history, injury characteristics, and symptom severity. Fatigue and mobility were assessed using the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric global 25 fatigue and mobility domain scales. Raw scores were calculated and converted to a standardized T-score. Higher fatigue scores indicate more severe fatigue, and higher mobility scores indicate more severe mobility impairment. Average MVPA/day over the 2 weeks following initial assessment was quantified via wrist-worn actigraphy. Pearson r correlation assessed the relationship between fatigue and mobility; linear regression tested fatigue and mobility as predictors of subsequent MVPA, adjusting for covariates of sex, time since injury, actigraphy compliance, and initial post-concussion symptom severity. RESULTS: We enrolled 70 adolescents after concussion. Of those, 58 wore their actigraphy device over the subsequent two weeks (83% adherence rate) and were included in the current analysis. Average MVPA/day was 31.6 ± 27.9 (range = 2.3-159.6) minutes. More severe fatigue and mobility impairment were moderately correlated after concussion (Pearson r = 0.68, p < 0.001). After adjusting for covariates, neither fatigue (β = -0.15, 95% confidence interval [CI] = -0.88, 0.58; p = 0.67) or mobility (β = 0.78, 95% CI = -0.24, 1.80; p = 0.13) significantly predicted time spent in MVPA/day over the 2 weeks following initial assessment. CONCLUSIONS: Fatigue and mobility are associated after adolescent concussion, but neither of these factors significantly predicted MVPA during the subsequent 2 weeks of recovery. Further work evaluating barriers to MVPA after concussion should be considered. Tai Foundation; MINDSOURCE