{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:46:41Z","timestamp":1777891601336,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NRE"],"published-print":{"date-parts":[[2023,9,25]]},"abstract":"<jats:p>BACKGROUND: Affective symptoms, specifically, anxiety, are often overlooked after sport-related concussion (SRC), and may contribute to prolonged recovery. OBJECTIVE: To examine the impact of anxiety during clinical recovery among adolescents (13\u201318y) enrolled in a randomized trial of aerobic exercise for SRC. METHODS: Patients at three sites were randomized into aerobic exercise or stretching arms, and enrolled in the 4-week intervention. The relationship between PROMIS Anxiety score at initial visit and time to symptom resolution was evaluated with survival analysis. The relationship between weekly PROMIS Anxiety score and Post-concussion Symptom Inventory (PCSI) score was evaluated with Linear Mixed Models. Analyses adjusted for study arm and baseline covariates. RESULTS: Among 54 adolescents (median age\u200a=\u200a15.8y, initial visit PCSI score\u200a=\u200a32, pre-injury PROMIS Anxiety score\u200a=\u200a2), median time to symptom resolution was 10 days (25th-75th percentiles: 6-24) in the Low-PROMIS Anxiety group and 12 days (25th-75th percentiles: 5-21) in the High-PROMIS Anxiety group (p\u200a=\u200a0.62). Each additional unit of PROMIS Anxiety score corresponded to a 1.52-unit higher PCSI total score (p\u200a&lt; \u200a0.01). Neither effect varied by aerobic exercise\/stretching group. CONCLUSION: Higher initial PROMIS Anxiety score was not significantly associated with delayed symptom resolution. However, over time, PROMIS Anxiety score was significantly associated with elevated PCSI score, regardless of exercise\/stretching group.<\/jats:p>","DOI":"10.3233\/nre-220221","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T10:12:21Z","timestamp":1692699141000},"page":"187-198","source":"Crossref","is-referenced-by-count":4,"title":["Relationship between anxiety and concussion symptoms among adolescents enrolled in a randomized controlled trial of aerobic exercise"],"prefix":"10.1177","volume":"53","author":[{"given":"Bernadette A.","family":"D\u2019Alonzo","sequence":"first","affiliation":[{"name":"Department of Biostatistics Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas J.","family":"Wiebe","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina L.","family":"Master","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Center for Injury Research and Prevention, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"},{"name":"Sports Medicine and Performance Center, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew C.","family":"Castellana","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry S.","family":"Willer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Leddy","sequence":"additional","affiliation":[{"name":"UBMD Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/NRE-220221_ref1","first-page":"1","article-title":"Incidence of concussion and recovery of neurocognitive dysfunction on ImPACT assessment among youth athletes with premorbid depression or anxiety taking antidepressants","author":"Ali,","year":"2021","journal-title":"J Neurosurg Pediatr"},{"key":"10.3233\/NRE-220221_ref2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1037\/0000114-004","volume-title":"Neuropsychology of sports-related concussion","author":"Arnett,","year":"2019"},{"issue":"6","key":"10.3233\/NRE-220221_ref3","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1093\/jpepsy\/jsy010","article-title":"Psychometric Evaluation of the PROMIS(R) Pediatric Psychological and Physical Stress Experiences Measures","volume":"43","author":"Bevans,","year":"2018","journal-title":"J Pediatr Psychol"},{"key":"10.3233\/NRE-220221_ref4","doi-asserted-by":"crossref","unstructured":"Champigny, C. , Roberts, S. 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