Preliminary Feasibility of a Novel Mind-Body Program to Prevent Persistent Concussion Symptoms Among Young Adults With Anxiety: Nonrandomized Open Pilot Study.

Autor:	Becker ME; Psychology Department, Suffolk University, Boston, MA, United States., Stratton Levey N; Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States., Yeh GY; Harvard Medical School, Boston, MA, United States.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States., Giacino J; Spaulding Rehabilitation Hospital, Charleston, MA, United States.; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., Iverson G; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Spaulding Research Institute, Harvard Medical School, Charlestown, MA, United States.; Mass General Hospital for Children Sports Concussion Program, Boston, MA, United States.; Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, United States., Silverberg N; Department of Psychology, University of British Columbia, Vancouver, BC, Canada.; Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada., Parker RA; Harvard Medical School, Boston, MA, United States.; Biostatistics Center, Massachusetts General Hospital, Boston, MA, United States., McKinnon E; Dr Robert C Cantu Concussion Center, Emerson Hospital, Concord, MA, United States., Siravo C; Dr Robert C Cantu Concussion Center, Emerson Hospital, Concord, MA, United States., Shah P; Spaulding Rehabilitation Hospital, Charleston, MA, United States., Vranceanu AM; Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States., Greenberg J; Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States.
Jazyk:	angličtina
Zdroj:	JMIR formative research [JMIR Form Res] 2024 Nov 08; Vol. 8, pp. e64540. Date of Electronic Publication: 2024 Nov 08.
DOI:	10.2196/64540
Abstrakt:	Background: Concussions are common, particularly among young adults, and often are associated with persistent, debilitating, and hard-to-treat symptoms. Anxiety and concussion symptoms often amplify each other, and growing evidence indicates that anxiety plays a key role in symptoms persistence after concussion. Targeting anxiety early after concussion may be a promising means of helping prevent persistent concussion symptoms in this population. We developed the Toolkit for Optimal Recovery after Concussion (TOR-C), the first mind-body program tailored for young adults with a recent concussion and anxiety, aiming to prevent persistent concussion symptoms. Objective: This study aims to conduct an open pilot of TOR-C to test preliminary feasibility, signal of change in measures, and treatment perceptions. Methods: Five young adults (aged 18-24 years) attended 4 weekly one-on-one live video sessions with a clinician. Participants completed questionnaires measuring treatment targets (ie, pain catastrophizing, mindfulness, fear avoidance, limiting behaviors, and all-or-nothing behaviors) and outcomes (ie, postconcussive symptoms, physical function, anxiety, depression, and pain) at baseline, immediately following the intervention, and 3 months after intervention completion. At the conclusion of the program, participants attended a qualitative interview and provided feedback about the program to help optimize study content and procedures. Results: Feasibility markers were excellent for credibility and expectancy (5/5, 100% of participants scored above the credibility and expectancy scale midpoint), client satisfaction (4/5, 80% of participants scored above the Client Satisfaction Questionnaire midpoint), therapist adherence (97% adherence), acceptability of treatment (5/5, 100% of participants attended 3 or more sessions), adherence to homework (87% home practice completion), and feasibility of assessments (no measures fully missing). The feasibility of recruitment was good (5/7, 71% of eligible participants agreed to participate). There were preliminary signals of improvements from pre-post comparisons in treatment targets (d=0.72-2.20) and outcomes (d=0.41-1.38), which were sustained after 3 months (d=0.38-2.74 and d=0.71-1.63 respectively). Exit interviews indicated overall positive perceptions of skills and highlighted barriers (eg, busyness) and facilitators (eg, accountability) to engagement. Conclusions: TOR-C shows preliminary feasibility, is associated with a signal of improvement in treatment targets and outcomes, and has the potential to support recovery from concussion. The quantitative findings along with the qualitative feedback obtained from the exit interviews will help optimize TOR-C in preparation for an upcoming randomized controlled trial of TOR-C versus an active control condition of health education for concussion recovery. International Registered Report Identifier (irrid): RR2-10.2196/25746. (©Molly Elizabeth Becker, Nadine Stratton Levey, Gloria Y Yeh, Joseph Giacino, Grant Iverson, Noah Silverberg, Robert A Parker, Ellen McKinnon, Caitlin Siravo, Priyanca Shah, Ana-Maria Vranceanu, Jonathan Greenberg. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.11.2024.)
Databáze:	MEDLINE
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