JMIR Publications

ABSTRACT

Background:

Concussions are common, particularly among young adults, and often are associated with persistent, debilitating and hard-to-treat symptoms. Anxiety plays a key role in symptom persistence. We developed the Toolkit for Optimal Recovery after Concussion (TOR-C), the first mind-body program tailored for young adults with a recent concussion who are experiencing anxiety aiming to prevent persistent concussion symptoms.

Objective:

We conducted an open pilot of TOR-C to test preliminary feasibility, signal of change in measures, and treatment perceptions.

Methods:

Participants (N=5) attended four weekly live-video sessions with qualitative exit interviews and completed questionnaires measuring treatment targets (i.e., pain catastrophizing, mindfulness, fear-avoidance, limiting behaviors, all-or-nothing behavior) and outcomes (i.e., post-concussive symptoms, physical function, anxiety, depression, pain) at baseline, immediately post program, and 3 months post program

Results:

Feasibility markers were excellent for credibility, expectancy, client satisfaction, therapist adherence, acceptability of treatment, adherence to homework, and feasibility of assessments. Feasibility of recruitment was good. There were preliminary signals of improvements from pre-post comparisons in treatment targets (d=.72-2.20) and outcomes (d=.41-1.38), which were sustained after 3 months (d=.38-2.74 and d=.71-1.63 respectively). Exit interviews indicated overall positive perceptions of skills, and highlighted barriers (e.g., busyness) and facilitators (e.g., accountability) to engagement.

Conclusions:

Overall, TOR-C shows preliminary feasibility and has potential to support recovery from concussion. Findings inform preparations for an upcoming randomize-controlled trial.