Research Reports - Sedentary behavior predicts headache pain following mild traumatic brain injury

Christopher Carey; Kelly M. Naugle; Jonathan Saxe; Fletcher A. White

Medicine & Science in Sports & Exercise. 50(5S):827, MAY 2018

The acute management of mild traumatic brain injury (mTBI), particularly in athletes, typically includes a period of physical rest during symptom resolution. However, evidence for the use of rest versus physical activity to aid in mTBI recovery is mixed and may depend on symptom type and severity. Post-traumatic headaches (PTH) are one of the most common and long-lasting symptoms of mTBI. While physical activity is often used in the non-pharmacological management of primary headache disorders, the relationship between PTH’s and physical activity behavior in the first month post-injury remains poorly understood.
PURPOSE: To determine if self-reported physical activity behavior predicts headache pain in mTBI patients within 1 month of head injury, and whether psychological factors mediate this relationship.
METHODS: Twenty-seven mTBI patients recruited from Emergency Departments completed study sessions at 1-2 weeks and 1-month post head injury. The McGill Pain Questionnaire (MPQ) provided a quantitative evaluation of the patient’s headache pain experience. The International Physical Activity Questionnaire - short form assessed the amount of time in the past week participants spent on vigorous and moderate intensity activity, walking, and sitting. Participants also completed the Pain Catastrophizing Scale, which assesses negative mental responses to anticipated or actual pain. Simple and multiple linear regressions were used to test whether physical activity behavior and pain catastrophizing predicted headache pain at 1 month post injury, and whether pain catastrophizing mediated this relationship.
RESULTS: Separate simple regression analyses indicated the following: 1) time sitting at 2 weeks post-injury predicted pain on the MPQ at 1 month (B=.41, p=.035), 2) time sitting at 2 weeks predicted pain catastrophizing at 1 month (B=.38, p=.049), 3) pain catastrophizing predicted pain on the MPQ at 1 month (B=.53, p=.003). When pain catastrophizing and time sitting were both entered as predictors into the same regression model, pain catastrophizing was the only significant predictor of pain on the MPQ.
CONCLUSIONS: Results suggest that increased sitting in the acute stage of mTBI predicted greater headache pain in the subacute stage of injury, and this relationship was mediated by pain catastrophizing.

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