Concussion Outcomes 3 Months after an Intervention for Young Adults with Co-Occurring Anxiety: A Randomized Controlled Trial

Background: We recently developed and established the feasibility of the first mind-body program aiming to prevent persistent concussion symptoms among young adults with anxiety – the Toolkit for Optimal Recovery after Concussion (TOR-C) and an active health education control (HE-C). Both interventions demonstrated preliminary improvements between baseline and post-intervention in outcomes including post-concussion symptoms, physical function, and anxiety. Here, we report on these outcomes 3 months post-intervention. Methods: Fifty young adults (ages 18–35) with a recent concussion (3–10 weeks) and anxiety (≥5 on GAD-7) were randomized to TOR-C (n = 25) or HE-C (n = 25). Participants completed measures of concussion symptoms (PCSS), anxiety (GAD-7), and physical function (WHODAS 2.0) at baseline (pre-randomization), post-intervention, and 3 months post-intervention. We used mixed-model ANOVA with a shared baseline to adjust for baseline differences and assessed within-group changes in these outcomes from baseline to 3 months. Results: Preliminary improvements in concussion symptoms from baseline to 3 months post-intervention were statistically significant in both groups, but clinically meaningful (i.e., exceeding the Minimal Clinically Important Difference) only for TOR-C. Baseline versus 3-month follow-up improvements in physical function and anxiety were statistically significant and clinically meaningful for both groups. Conclusions: Findings provide preliminary evidence that TOR-C may help improve post-concussion recovery, and support a future fully-powered trial to establish the efficacy and sustained effects of TOR-C versus HE-C.