Mood, Psychological, and Behavioral Factors of Health-Related Quality of Life throughout Recovery from Sport Concussion

Samuel R. Walton, Donna K. Broshek, Sibylle Kranz, Steven K. Malin, Jay Hertel, Jacob E. Resch

Research output: Contribution to journalArticlepeer-review


Objective: To measure alterations in mood, psychological, and behavioral factors in collegiate athletes throughout recovery from sport concussion (SC) compared with matched controls. Setting: University research laboratory. Participants: Twenty (55% female) division I collegiate athletes with SC (19.3 ± 1.08 years old, 1.77 ± 0.11 m, 79.6 ± 23.37 kg) and 20 (55% female) uninjured matched controls (20.8 ± 2.17 years old, 1.77 ± 0.10 m, 81.9 ± 23.45 kg). Design: Longitudinal case control. Main Measures: Self-reported concussion-related symptoms, anxiety, resilience, stigma, sleep disturbance, fatigue, and appetite were assessed at 3 time points in the SC group: T1(≤72 hours of SC), T2(7 days after T1), and TF(after symptom resolution). Control participants were evaluated at similar intervals. Group and group-by-sex differences were assessed using repeated-measures analyses of variance. Post hoc analyses were performed with Tukey's honestly significant difference (HSD) and paired-sample t tests. Results: The SC group had greater sleep disturbance than controls at T1(P =.001; d = 1.21) and endorsed greater stigma at all time points (P ≤.03; d ≥ 0.80). Stigma (F(2)= 3.68; P = 0.03; η2p= 0.12), sleep disturbance (F(2)= 5.27; P =.008; η2p= 0.15), and fatigue (F(2)= 3.46; P =.04; η2p= 0.11) improved throughout recovery in those with SC only. No differences were observed between males and females (P >.05). Conclusion: Sleep disturbance and stigma were negatively affected by SC, highlighting potential areas for clinical interventions to maximize recovery in males and females.

Original languageEnglish (US)
Pages (from-to)128-136
Number of pages9
JournalJournal of Head Trauma Rehabilitation
Issue number2
StatePublished - Mar 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology


  • anxiety
  • appetite
  • concussion
  • fatigue
  • health-related quality of life
  • resilience
  • sleep disturbance
  • stigma


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