Faculty Collaboration Database

The Role of Body Mass Index on Physical Activity, Symptoms, and Related Outcomes Following Pediatric Concussion. J Pediatr 2025 Feb;277:114386

Date

11/04/2024

Pubmed ID

39489284

DOI

10.1016/j.jpeds.2024.114386

Scopus ID

2-s2.0-85210073576 (requires institutional sign-in at Scopus site)

Abstract

OBJECTIVE: To determine the step count and self-reported activity levels for obese and nonobese pediatric patients following concussion and predict self-reported symptoms, quality of life, and psychological health over time.

STUDY DESIGN: Participants completed the Post-Concussion Symptom Scale (PCSS), Pediatric Quality of Life (PedsQL), and Behavioral Symptom Inventory-18 (BSI-18) at an initial visit (<72 hours), 3-5 days postinjury, 10-18 days postinjury, and 1 and 2 months postinjury. Physical activity data (eg, step count) were collected via a commercial actigraph. Participants were categorized into obese and nonobese body mass index (BMI) groups based on age- and sex-adjusted growth standards. Mann-Whitney U tests compared groups while nonparametric series regression models examined the effect of obese BMI and average daily step count on PCSS, PedsQL, and BSI-18 outcomes at 1 and 2 months postinjury.

RESULTS: One hundred ninety-four participants were included: 153 (78.9%; M = 14.6 ± 2.4 years; 50% female) in the nonobese group and 41 (21.1%; M = 14.2 ± 2.0 years; 44% female) in the obese group. The obese group had a 22.8% lower average daily step count in the week postinjury (P = .02). At 2 months, there was a significant association between obese BMI and worse PCSS total score (P = .042), PedsQL (P = .017), and BSI-18 anxiety (P = .046). Average daily step count in the first week postinjury was associated with a higher PCSS total score at 2 months (P = .031).

CONCLUSIONS: Pediatric patients following concussion with an obese BMI had a lower daily average step count in the week after injury and exhibited worse concussion symptoms, quality of life, and anxiety at 2 months compared with those with a nonobese BMI.

TRIAL REGISTRATION: Active Injury Management (AIM) after Pediatric Concussion: NCT03869970.

Author List

Eagle SR, Zynda AJ, Sandulli L, Hickey RW, Kegel NE, Nelson L, McCrea M, Collins MW, Okonkwo DO, Thomas DG, Kontos AP

Authors

Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Lindsay D. Nelson PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Danny G. Thomas MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Body Mass Index
Brain Concussion
Child
Exercise
Female
Humans
Male
Pediatric Obesity
Post-Concussion Syndrome
Quality of Life
Self Report