Association Between Fear of Pain and Sports-Related Concussion Recovery in a Pediatric Population.

Objective: To determine whether an association exists between fear of pain and recovery time from sports-related concussion in a pediatric population.
Design: Prospective observational study.
Setting: Primary outpatient sports medicine clinic of a large pediatric hospital.
Patients: One hundred twenty-eight pediatric patients aged 8 to 18 years who presented to clinic with a primary diagnosis of concussion from September 2018 to March 2020. Inclusion criteria included presentation within 2 weeks of injury and symptomatic on initial visit. Patients who sustained a concussion because of motor vehicle collisions or assault were excluded.
Independent Variables: There was no intervention. Study participants who met inclusion criteria were administered the Fear of Pain Questionnaire (FOPQ) at their initial visit.
Main Outcome Measures: Time to clinical recovery was the main outcome measure and was determined by the fellowship-trained sports medicine physician based on resolution of concussion symptoms, resumption of normal physical and cognitive daily activities, no use of accommodations or medications, and normalization of physical exam.
Results: There was a significant difference in FOPQ scores for those with prolonged recovery (M = 33.12, SD = 18.36) compared with those recovering in fewer than 28 days (M = 26.16, SD = 18.44; t [126] = -2.18, P = 0.036).
Conclusions: Consistent with the adult literature, we found that pediatric patients are more likely to have a prolonged recovery from concussion when they have higher fear of pain.
Competing Interests: The authors report no conflicts of interest.
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