Wingerson MJ - Dissertation Progress

The following is a temporary placeholder while I analyize data and write my results sections. I will update periodically with new findings!

Aim 1:

To investigate the optimal volume of moderate-to-vigorous physical activity (MVPA) for post-concussion symptom resolution.

Variables:

• MVPA
• Time to symptom resolution
• Potential covariates:
  • Initial symptom severity
  • Biological Sex
  • Age
  • Time since injury
• Other considerations:
  • Weekly survey symptoms
  • Weekly survey bariers to EX
  • Type of PA being performed

Primary purpose: Find inflection point in relationship between MVPA and time to symptom resolution. This reflects optimal MVPA volume.

Secondary approaches: Use Cox PH to model time to symptom resolution. Build KM curves for high vs low MVPA groups separately (find value with best separation between groups). Or, instead use PSaC as binary outcome and identify cut-point for MVPA to predict PSaC development.

Aim 2:

To explore how Brain-Derived Neurotrophic Factor (BDNF) changes throughout concussion symptom recovery in relation to exercise behavior.

Variables:

• MVPA
• BDNF at visits 1 and 2
• Potential covariates:
  • Time to visit 1
  • Time to visit 2
  • Symptom severity at visit 1
  • Symptom severity at visit 2
  • Batch effects
• Other considerations:
  • Explore other proteins (GFAP, IL-6, etc.)
  • Explore other exercise metrics (Light PA, just moderate)
  • Think about controling for time of aquisition
  • Think about controling for time of last exercise session
  • Consider Pedi-FABS for pre-injury exercise measure

Primary purpose: Determine if BDNF changes from visit 1 to visit 2, and if the degree of change is associated with MVPA volumes in the time between injury and initial assessment. Use linear mixed effects regression.

Aim 3:

To investigate how MVPA affects psychosocial functioning in the two months after symptom resolution.

Variables:

• MVPA
• Visit 3 surveys
  • PROMIS scores
  • PSQI
  • Pedi-FABS at v3
• Visit 2 surveys
  • Time to sx resolution
  • PROMIS scores at v2
• Time to visit 1

Primary purpose: Explore relationship between post-concussion MVPA and psychosocial functioning at visit 3. Use regression to identify relationships and control for factors such as visit 2 psychosocial functioning, exercise in the time between V2 and V3 (self-report, Predi-FABS), or time to visit 1.