The identification and comparison of factors impacting musculoskeletal and concussion injury disclosure

Abstract

Context Despite increased risk of Musculoskeletal (MSK) injury following a concussion, little is known about the determinants of such risk. Moreover, previous reports of increased risk of MSK injury following a concussion have neglected to account for the high level of undisclosed concussions. Objective This study explored the association between intention to disclose a possible concussion and intention to disclose MSK injuries. Design Cross-sectional Setting Online survey Patients or Other Participants One hundred and seven NCAA Division 1 athletes (79% Female, age=19.4±1.4) Main Outcome Measure(s) Online survey exploring determinants such as injury knowledge, attitudes, perceived social norms, and perceived behavioral control surrounding concussive and musculoskeletal injury disclosure. Results A significant association between high intention to disclose a concussion and high intention to disclose a MSK injury (χ2=19.276, p<0.001, Cramer's V=0.482) was observed. Spearman rank correlations suggested no correlation between the behavior of concussion non-disclosure (25%) and MSK injury non-disclosure (52%). Multivariate binomial regressions indicated perceived social norms were the strongest determinant (β =1.365, p= .002) of high intention to disclose concussion, while attitudes toward MSK injury (β =1.067, p=.005) and perceived social norms (β = 1.099, p=.013) were the strongest determinants of high intention to report MSK injury. Conclusions Individuals with high intention to report concussion symptoms also demonstrated high intention to report MSK injury. Strong positive associations were observed between known determinants of intention to disclose concussion and adapted versions of those same determinant domains in MSK injury disclosure intention. As those with high intention to disclose concussion also demonstrated high intention to disclose MSK injury, intention to disclose injuries generally may play a role in explaining the increase in MSK injury following a concussion.