The Nocebo Effect and Pediatric Concussion

Kirkwood, Michael W.; Howell, David R.; Brooks, Brian L.; Wilson, Julie C.; Meehan, William P.

doi:10.1123/jsr.2020-0519

Cited by 8 publications

(3 citation statements)

References 67 publications

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“…"Nocebo effects" occur when an individual has negative expectations of outcomes that are associated with prolonged recovery or worsened symptoms. 57 Because much online information about concussion is not from reliable sources and may be inaccurate, 58,59 some parents and adolescents in the study may have experienced "nocebo effects," prolonging recovery. Parent and player distress and recovery expectations likely reflect messaging by both clinicians and scientists, who should aim to provide accurate, up-to-date information regarding the outcomes of concussion.…”

Section: Discussionmentioning

confidence: 99%

“…Clinicians and scientists should help to dispel concussion misinformation and aim to support more accurate expectations to aid in recovery. 57 Providing accurate information about recovery has been recommended for pediatric concussion management, 50 and future studies should investigate whether doing so affects recovery expectations. Because more peer problems were associated with increased time, promoting positive peer relationships also might help facilitate faster recovery.…”

Section: Discussionmentioning

confidence: 99%

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Psychosocial Factors Associated With Time to Recovery After Concussion in Adolescent Ice Hockey Players

Luszawski,

Plourde,

Sick

et al. 2023

Clinical Journal of Sport Medicine

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Objective: To investigate the association between psychosocial factors and physician clearance to return to play (RTP) in youth ice hockey players after sport-related concussion. Design: Prospective cohort study, Safe to Play (2013-2018). Setting: Youth hockey leagues in Alberta and British Columbia, Canada. Participants: Three hundred fifty-three ice hockey players (aged 11-18 years) who sustained a total of 397 physician-diagnosed concussions. Independent Variables: Psychosocial variables. Main Outcome Measures: Players and parents completed psychosocial questionnaires preinjury. Players with a suspected concussion were referred for a study physician visit, during which they completed the Sport Concussion Assessment Tool (SCAT3/SCAT5) and single question ratings of distress and expectations of recovery. Time to recovery (TTR) was measured as days between concussion and physician clearance to RTP. Accelerated failure time models estimated the association of psychosocial factors with TTR, summarized with time ratios (TRs). Covariates included age, sex, body checking policy, days from concussion to the initial physician visit, and symptom severity at the initial physician visit. Results: Self-report of increased peer-related problems on the Strengths and Difficulties Questionnaire (TR, 1.10 [95% CI, 1.02-1.19]), higher ratings of distress about concussion outcomes by participants (TR, 1.06 [95% CI, 1.01-1.11]) and parents (TR, 1.05 [95% CI, 1.01-1.09]), and higher parent ratings of distress about their child's well-being at the time of injury (TR, 1.06 [95% CI, 1.02-1.09]) were associated with longer recovery. Conclusions: Greater pre-existing peer-related problems and acute distress about concussion outcomes and youth well-being predicted longer TTR. Treatment targeting these psychosocial factors after concussion may promote recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychosocial Factors Associated With Time to Recovery After Concussion in Adolescent Ice Hockey Players

Luszawski,

Plourde,

Sick

et al. 2023

Clinical Journal of Sport Medicine

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“…This needs to be seriously considered when communicating with concussion patients and their families during rehabilitation. More clear, accurate, and well-balanced messaging to the community about concussion recovery is also vital [92,93], especially given that both preinjury and postconcussion somatisation have been identified as risk factors for delayed recovery [94][95][96].…”

Section: Beliefs and Self-efficacymentioning

confidence: 99%

Concussion Rehabilitation and the Application of Ten Movement Training Principles

McLoughlin

2023

Cureus

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Concussion awareness continues to grow in all aspects of healthcare, including the areas of prevention, acute care, and ongoing rehabilitation. Most of the concussion research to date has focussed on the challenges around screening and diagnosing what can be a complex mix of brain impairments that overlay with additional pre-existing comorbidities. While we expect further progress in concussion diagnosis, progress also continues to be made around proactive rehabilitation, with the emergence of interventions that can enhance the recovery process, maximise function and independence with a return to study, work, and play. Traditionally, optimal multimodal assessments of concussion have treated the physical, cognitive, and psychological domains of brain injury separately, which supports diagnosis, and informs appropriate follow-up care. Due to the complex nature of brain injury, multimodal assessments direct care toward professionals from many different disciplines including medicine, physiotherapy, psychology, neuropsychology, ophthalmology, and exercise physiology. In addition, these professionals may work in different fields such as sports, neurorehabilitation, vestibular, musculoskeletal, community, vocational, and general practice clinical settings. Rehabilitation interventions for concussions employed in practice are also likely to use a blend of theoretical principles from motor control, cognitive, and psychological sciences. This scale of diversity can make information dissemination, collaboration, and innovation challenging. The Ten Movement Training Principles (MTPs) have been proposed as a usable and relevant concept to guide and support clinical reasoning in neurorehabilitation. When applied to concussion rehabilitation, these same 10 principles provide a comprehensive overview of key rehabilitation strategies for current and future practice. Future collaborations can use these training principles to support clinical and research innovations including the rapid rise of technologies in this growing field of rehabilitation practice.

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Mental Health and Sport-Related Concussion

Jeckell

2022

Mental Health Care for Elite Athletes

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The Nocebo Effect and Pediatric Concussion

Cited by 8 publications

References 67 publications

Psychosocial Factors Associated With Time to Recovery After Concussion in Adolescent Ice Hockey Players

Psychosocial Factors Associated With Time to Recovery After Concussion in Adolescent Ice Hockey Players

Concussion Rehabilitation and the Application of Ten Movement Training Principles

Mental Health and Sport-Related Concussion

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