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Acute Clinical Recovery from Sport-Related Concussion

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Abstract

Concussion is a highly prevalent injury in contact and collision sports that has historically been poorly understood. An influx of sport-concussion research in recent years has led to a dramatic improvement in our understanding of the injury’s defining characteristics and natural history of recovery. In this review, we discuss the current state of knowledge regarding the characteristic features of concussion and typical acute course of recovery, with an emphasis on the aspects of functioning most commonly assessed by clinicians and researchers (e.g., symptoms, cognitive deficits, postural stability). While prototypical clinical recovery is becoming better understood, questions remain regarding what factors (e.g., injury severity, demographic variables, history of prior concussions, psychological factors) may explain individual variability in recovery. Although research concerning individual differences in response to concussion is relatively new, and in many cases limited methodologically, we discuss the evidence about several potential moderators of concussion recovery and point out areas for future research. Finally, we describe how increased knowledge about the negative effects of and recovery following concussion has been translated into clinical guidelines for managing concussed athletes.

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Notes

  1. “Prospective” in the context of sport concussion research refers to studies that enroll athletes prior to the sports season (typically during preseason baseline testing) and prior to their period of risk exposure to SRC. Athletes are then followed during one or more sport seasons in order to capture concussions as they occur, allowing for evaluation during the acute recovery period. Because athletes may have participated in contact and collision sports prior to enrollment in a given prospective study, many have prior history of concussion. In well-designed prospective studies, a detailed history is obtained on all athletes at the time of enrollment with respect to the number, acute severity, recovery course and outcome of any concussions predating their involvement in the study, and these data can be used to match concussed and control participants or in moderation analyses. Prospective studies are also typically of a longitudinal design, including detailed evaluations of concussed athletes and matched athlete controls during the acute phase (within 24–48 h of injury) and at several time points to track athletes’ clinical recovery courses.

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Authors and Affiliations

  1. Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Lindsay D. Nelson & Michael A. McCrea

  2. Department of Psychiatry, University of Illinois at Chicago, Chicago, USA

    Julie K. Janecek

  3. Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, USA

    Michael A. McCrea

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  1. Lindsay D. Nelson
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  2. Julie K. Janecek
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  3. Michael A. McCrea
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Correspondence to Lindsay D. Nelson.

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Nelson, L.D., Janecek, J.K. & McCrea, M.A. Acute Clinical Recovery from Sport-Related Concussion. Neuropsychol Rev 23, 285–299 (2013). https://doi.org/10.1007/s11065-013-9240-7

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