Suzanne Bock1, Rod Grim2, Todd F Barron3,4, Andrew Wagenheim5, Yaowen Eliot Hu6,7,8, Matthew Hendell3, John Deitch9, Ellen Deibert3,10. 1. WellSpan Health, Emig Research Center, York Hospital, 1001 S. George Street, York, PA, 17405, USA. markbock@comcast.net. 2. WellSpan Health, Emig Research Center, York Hospital, 1001 S. George Street, York, PA, 17405, USA. 3. WellSpan Neurosciences, 228 St Charles Way, York, PA, 17402, USA. 4. Pennsylvania College of Medicine, 500 University Drive, Hershey, PA, 17033, USA. 5. Pinnacle Health, Spine and Sports Medicine, 2005 Technology Parkway, Suite 100, Mechanicsburg, PA, 17050, USA. 6. VCU-Fairfax Family Practice Sports Medicine Fellowship, Richmond, VA, USA. 7. Team Physician, George Mason University, Fairfax, VA, USA. 8. Team Physician, Herndon High School, 555 Herndon Parkway Suite 100, Herndon, VA, 20170, USA. 9. Sports Medicine WellSpan Health, 25 Monument Rd, Ste. 290, York, PA, 17403, USA. 10. Department of Neurology, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.
Abstract
PURPOSE: With the increase in knowledge and management of sport-related concussion over the last 15 years, there has been a shift from a grading scale approach to an individualized management approach. As a result, there is an increased need to better understand the factors involved in delayed recovery of concussion. The purpose of this retrospective study was to examine factors that may be associated with recovery from sport-related concussion in student athletes aged 11 to 18 years old. METHODS: Of the 366 patients who met the inclusion criteria, 361 were included in our analysis. The primary dependent variable included days until athlete was able to return to play (RTP). Independent variables of interest included age, gender, academic performance, comorbid factors, sports, on-field markers, days until initial neurological evaluation, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) scores, acute headache rescue medications, chronic headache medication, sleep medication, and referral to concussion rehabilitation program. RESULTS: Variables associated with longer median RTP were being female (35 days), having a referral to concussion rehabilitation program (53 days), being prescribed acute headache rescue therapy (34 days), and having chronic headache treatment (53 days) (all p < 0.05). Variables associated with shorter RTP were on-field marker of headache (23 days) and evaluation within 1 week of concussion by a concussion specialist (16 days) (Both p < 0.05). CONCLUSION: This study supports the need for a concussed athlete to have access to a provider trained in concussion management in a timely fashion in order to prevent delayed recovery and return to play.
PURPOSE: With the increase in knowledge and management of sport-related concussion over the last 15 years, there has been a shift from a grading scale approach to an individualized management approach. As a result, there is an increased need to better understand the factors involved in delayed recovery of concussion. The purpose of this retrospective study was to examine factors that may be associated with recovery from sport-related concussion in student athletes aged 11 to 18 years old. METHODS: Of the 366 patients who met the inclusion criteria, 361 were included in our analysis. The primary dependent variable included days until athlete was able to return to play (RTP). Independent variables of interest included age, gender, academic performance, comorbid factors, sports, on-field markers, days until initial neurological evaluation, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) scores, acute headache rescue medications, chronic headache medication, sleep medication, and referral to concussion rehabilitation program. RESULTS: Variables associated with longer median RTP were being female (35 days), having a referral to concussion rehabilitation program (53 days), being prescribed acute headache rescue therapy (34 days), and having chronic headache treatment (53 days) (all p < 0.05). Variables associated with shorter RTP were on-field marker of headache (23 days) and evaluation within 1 week of concussion by a concussion specialist (16 days) (Both p < 0.05). CONCLUSION: This study supports the need for a concussed athlete to have access to a provider trained in concussion management in a timely fashion in order to prevent delayed recovery and return to play.
Authors: Ryan T Tierney; Michael R Sitler; C Buz Swanik; Kathleen A Swanik; Michael Higgins; Joseph Torg Journal: Med Sci Sports Exerc Date: 2005-02 Impact factor: 5.411
Authors: Derk A Van Kampen; Mark R Lovell; Jamie E Pardini; Michael W Collins; Freddie H Fu Journal: Am J Sports Med Date: 2006-06-30 Impact factor: 6.202
Authors: Paul McCrory; Willem H Meeuwisse; Mark Aubry; Bob Cantu; Jirí Dvorák; Ruben J Echemendia; Lars Engebretsen; Karen Johnston; Jeffrey S Kutcher; Martin Raftery; Allen Sills; Brian W Benson; Gavin A Davis; Richard G Ellenbogen; Kevin Guskiewicz; Stanley A Herring; Grant L Iverson; Barry D Jordan; James Kissick; Michael McCrea; Andrew S McIntosh; David Maddocks; Michael Makdissi; Laura Purcell; Margot Putukian; Kathryn Schneider; Charles H Tator; Michael Turner Journal: Br J Sports Med Date: 2013-04 Impact factor: 13.800
Authors: Donna K Broshek; Tanya Kaushik; Jason R Freeman; David Erlanger; Frank Webbe; Jeffrey T Barth Journal: J Neurosurg Date: 2005-05 Impact factor: 5.115
Authors: Scott L Zuckerman; Benjamin L Brett; Aaron S Jeckell; Aaron M Yengo-Kahn; Gary S Solomon Journal: Curr Neurol Neurosci Rep Date: 2018-11-05 Impact factor: 5.081
Authors: Elizabeth F Teel; Stephen W Marshall; Viswanathan Shankar; Michael McCrea; Kevin M Guskiewicz Journal: J Athl Train Date: 2017-03 Impact factor: 2.860
Authors: Grant L Iverson; Andrew J Gardner; Douglas P Terry; Jennie L Ponsford; Allen K Sills; Donna K Broshek; Gary S Solomon Journal: Br J Sports Med Date: 2017-06 Impact factor: 13.800
Authors: Philip E Rosenbaum; Christopher Locandro; Sara P D Chrisman; Meeryo C Choe; Rachel Richards; Christina Pacchia; Lawrence J Cook; Frederick P Rivara; Gerard A Gioia; Christopher C Giza Journal: JAMA Netw Open Date: 2020-11-02