PROTOCOL: Fear avoidance model psychological factors as predictors for persistent post-concussion clinical outcomes: An integrative review

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Abstract
Background: Persisting symptoms after concussion (PSaC) include physical, cognitive, and psychological symptoms which contribute to rehabilitation challenges. Previous research has not thoroughly investigated the association between PSaC and pain-related psychological factors. Therefore, there is an opportunity to use current pain models, such as the Fear Avoidance Model (FAM), as a framework to explore these relationships. The goals of this integrative review are to (1) identify and describe range of evidence that explores relationships between psychological factors and clinical outcomes in patients with PSaC, and (2) develop a comprehensive understanding of FAM-specific psychological factors that have been identified as potential predictors of clinical outcomes in patients with PSaC. Methods: This review will be based on principles and stages of an integrative review which will allow for inclusion of diverse methodologies: (1) problem formulation, (2) literature search, (3) data evaluation, (4) data analysis, and (5) presentation. Methods for reporting this review will be informed by the 2020 PRISMA guidelines for systematic reviews. Discussion: The findings from this integrative review will inform healthcare professionals working in post-concussion rehabilitation settings regarding relationships between FAM psychological factors and PSaC—an area that until recently has not been thoroughly explored. Additionally, this review will inform the development of other reviews and clinical studies to further investigate relationships between FAM psychological factors and PSaC. Integrative Review Registration: OSF DOI 10.17605/OSF.IO/CNGPW.

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