ECU researchers develop new tool to evaluate fear avoidance behavior after concussion

Researchers from Edith Cowan University (ECU) have developed a new tool to evaluate fear avoidance behavior following a concussion. 

The tool, aptly named the Fear Avoidance after Concussion Tool (FACT), consists of a questionnaire that can be completed within five minutes, under the supervision of a health care provider. 

ECU Masters by Research student Mr Liam Sherwood noted that if fear avoidant behaviour could be recognised early, following a concussion, it could enable targeted management for individuals who are at risk of persisting post-concussion symptoms, such as difficulty concentrating, low moods, headaches and sleep disorders. 

Mr Sherwood noted that early support and education can make a significant difference for people experiencing persisting post-concussion symptoms. These approaches focus on helping individuals understand their condition and build confidence in managing it themselves, reducing the impact that fear avoidance can have on their recovery. 

ECU Senior Research Fellow Dr Myles Murphy said existing tools used to assess fear avoidance after a concussion were originally designed for other types of injuries, meaning many of the questions asked of patients weren't relevant to their experience. 

"The FACT was designed with input from people who had concussions from an occupational injury, motor vehicle accident, fall, or from sports. All of these perspectives, as well as those from expert healthcare professionals, were used to design something that not only makes sense to the patient, but is also relevant to their injury and recovery." 

Mr Sherwood noted that the questionnaire consists of 28 items, taking around five minutes to complete. The short nature of the questionnaire allows clinicians to use FACT during their consultation period, without concern that it would take up too much time. 

Work is now being done to use the FACT in larger, clinical populations before we can start the work on implementing this tool into clinical practice." 

Mr. Liam Sherwood, ECU Masters by Research student 

The FACT is already making waves, having received the Best Clinical Research Poster Award at the Sports Medicine Australia Conference, in Hobart, earlier this year. 

Source:
Journal reference:

Sherwood, L. J., et al. (2025). Fear Avoidance after Concussion Tool (FACT): patient-reported outcome measure development and content validation. BMJ Open Sport & Exercise Medicine. doi: 10.1136/bmjsem-2025-002811. https://bmjopensem.bmj.com/content/11/4/e002811

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