Abstract
To determine the step count and self-reported activity levels for obese and nonobese pediatric patients following concussion and predict self-reported symptoms, quality of life, and psychological health over time. Participants completed the Post-Concussion Symptom Scale (PCSS), Pediatric Quality of Life (PedsQL), and Behavioral Symptom Inventory-18 (BSI-18) at an initial visit (<72hours), 3-5days postinjury, 10-18days postinjury, and 1 and 2months postinjury. Physical activity data (eg, step count) were collected via a commercial actigraph. Participants were categorized into obese and nonobese body mass index (BMI) groups based on age- and sex-adjusted growth standards. Mann-Whitney U tests compared groups while nonparametric series regression models examined the effect of obese BMI and average daily step count on PCSS, PedsQL, and BSI-18 outcomes at 1 and 2 months postinjury. One hundred ninety-four participants were included: 153 (78.9%; M=14.6±2.4years; 50% female) in the nonobese group and 41 (21.1%; M=14.2±2.0years; 44% female) in the obese group. The obese group had a 22.8% lower average daily step count in the week postinjury (P=.02). At 2 months, there was a significant association between obese BMI and worse PCSS total score (P=.042), PedsQL (P=.017), and BSI-18 anxiety (P=.046). Average daily step count in the first week postinjury was associated with a higher PCSS total score at 2months (P=.031). Pediatric patients following concussion with an obese BMI had a lower daily average step count in the week after injury and exhibited worse concussion symptoms, quality of life, and anxiety at 2months compared with those with a nonobese BMI. Active Injury Management (AIM) after Pediatric Concussion: NCT03869970.
Published Version
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