{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:45:58Z","timestamp":1777927558322,"version":"3.51.4"},"reference-count":60,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>\n                    Vestibular\/ocular motor provocation and state anxiety are both independently linked to poor recovery outcomes following concussion. However, the relationship between these two clinical presentations and their co-occurring effects on concussion recovery outcomes is understudied. The purpose was to examine the co-occurring effects of vestibular\/ocular motor provocation and state anxiety following concussion. There were 532 participants (15\u201325 years) with concussions who completed the vestibular\/ocular motor screening (VOMS), State-Trait Anxiety Inventory, and the Post-Concussion Symptom Scale within 30 days of injury. Participants were classified into provocation (PROV) and no provocation (NO PROV) groups based on exceeding\/not exceeding VOMS cutoffs. An analysis of covariance was used to examine between-group comparisons on state anxiety scores; and logistic regressions, with adjusted odds ratios (Adj OR), were used to evaluate predictors of clinical levels of state anxiety and protracted recovery. A total of 418 participants (78.6%; age = 17.2\u2009\u00b1\u20092.6; 65% female) exceeding VOMS cutoffs were in the PROV, and 114 (21.4%; age = 16.6\u2009\u00b1\u20092.2; 53% female) participants were in the NO PROV group. The PROV group (mean [\n                    <jats:italic toggle=\"yes\">M<\/jats:italic>\n                    ]\n                    <jats:italic toggle=\"yes\">=<\/jats:italic>\n                    39.50, standard deviation [\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    ]\n                    <jats:italic toggle=\"yes\">=<\/jats:italic>\n                    12.05) exhibited significantly higher state anxiety scores than the NO PROV group (\n                    <jats:italic toggle=\"yes\">M =<\/jats:italic>\n                    32.45,\n                    <jats:italic toggle=\"yes\">SD =<\/jats:italic>\n                    10.43) (\n                    <jats:italic toggle=\"yes\">F<\/jats:italic>\n                    [1, 532] = 15.36,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001,\n                    <jats:italic toggle=\"yes\">\u03b7<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 0.03). Vestibular\/ocular motor provocation (Adj OR = 3.35,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001, 95% confidence interval [CI]: 1.42\u20133.88) was the most robust predictor of clinical state anxiety following concussion (\u03c7\n                    <jats:sup>2<\/jats:sup>\n                    [4, 532] = 86.78,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001). Participants exhibiting vestibular\/ocular motor provocation with clinical levels of state anxiety were at 2.47 times (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001, 95% CI: 1.53\u20133.99) greater odds of experiencing a protracted concussion recovery than participants with vestibular\/ocular motor provocation without clinical state anxiety. Vestibular\/ocular motor provocation is associated with increased state anxiety following concussion, and the addition of clinical state anxiety to vestibular\/ocular motor provocation increases the odds for protracted recovery. Clinicians should assess vestibular\/ocular motor function and anxiety following concussion.\n                  <\/jats:p>","DOI":"10.1089\/neu.2024.0472","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T10:27:50Z","timestamp":1734949670000},"page":"985-993","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Co-Occurrence of Vestibular\/Ocular Motor Provocation and State Anxiety in Adolescents and Young Adults with Concussion"],"prefix":"10.1177","volume":"42","author":[{"given":"Melissa N.","family":"Womble","sequence":"first","affiliation":[{"name":"Inova Sports Medicine Concussion Program, Fairfax, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kori J.","family":"Durfee","sequence":"additional","affiliation":[{"name":"Department of Health, Human Performance and Recreation\/Office for Sport Concussion Research, University of Arkansas, Fayetteville, Arkansas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Jennings","sequence":"additional","affiliation":[{"name":"Inova Sports Medicine Concussion Program, Fairfax, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheri","family":"Fedor","sequence":"additional","affiliation":[{"name":"Inova Physical Therapy Center, Fairfax, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron J.","family":"Zynda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Schatz","sequence":"additional","affiliation":[{"name":"Inova Physical Therapy Center, Fairfax, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Psychology, Saint Joseph\u2019s University, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony P.","family":"Kontos","sequence":"additional","affiliation":[{"name":"Department of Psychology, Saint Joseph\u2019s University, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.J.","family":"Elbin","sequence":"additional","affiliation":[{"name":"Department of Health, Human Performance and Recreation\/Office for Sport Concussion Research, University of Arkansas, Fayetteville, Arkansas, 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