ArticleInternational journal of sports physical therapy2026
Psychological and Neuromechanical Recovery After Concussion: Dual-Task Stability and Kinesiophobia from Return to Play to Six Months.
Article in International journal of sports physical therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Sport-related concussion (SRC) increases the risk of subsequent musculoskeletal injury, yet the mechanisms underlying this vulnerability remain unclear. Fear of movement (kinesiophobia) may contribute to impaired motor control. Purpose: This study examined kinesiophobia and postural stability in adolescent athletes at return-to-play (RTP) after SRC and evaluated changes six months later. Design: Observational analytical study with cross-sectional (case-control) and prospective cohort components. Methods: Thirty-seven concussed athletes (15.7 ± 1.3 years, 45.9% female) and 17 matched controls (16.4 ± 2.1 years, 52.9% female) completed static single-leg stance and dynamic single-leg landing tasks under single- and dual-task (Stroop) conditions. Fear of movement was measured with the Tampa Scale for Kinesiophobia (TSK-11). A subset of 12 concussed athletes and eight controls repeated testing at six months. Postural stability was quantified using ground reaction forces; higher values indicated worse performance. Group differences at RTP were examined using independent-samples t-tests or Mann-Whitney U tests. Longitudinal changes from were examined using paired-samples t-tests or Wilcoxon signed-rank tests. Effect sizes and exact p-values were reported, with α set at .05. Results: At RTP, concussed athletes reported higher TSK-11 scores than controls (18.6 ± 4.2 vs. 15.6 ± 3.9, p = 0.013, d = 0.74). No significant group differences were observed for static or dynamic postural stability under single- or dual-task conditions (all p > 0.12). Within the concussion group, those with higher TSK-11 scores consistently showed poorer stability, although this difference was not statistically significant. At six months, concussed athletes demonstrated moderate improvements in TSK-11 (17.0 ± 3.9 to 13.4 ± 6.9) and dual-task dynamic stability, but changes did not reach statistical significance. Conclusions: Adolescents cleared for RTP after SRC exhibited elevated kinesiophobia, despite having balance performance comparable to controls. Screening for fear of movement may help identify athletes at risk for delayed recovery or reinjury, complementing standard postural stability assessments. Level of Evidence: 3.
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