Skip to main content

Advertisement

SpringerLink
Log in

Factors associated with delayed recovery in athletes with concussion treated at a pediatric neurology concussion clinic

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. CDC (2007) CDC announces updated information to help physicians recognize and manage concussions early. CDC http://www.cdc.gov/media/pressrel/2007/r070607.htm. Accessed 7 June 2007

  2. Gordon KE, Dooley JM, Wood EP (2006) Descriptive epidemiology of concussion. Pediatr Neuorol 34:376–378

    Article  Google Scholar 

  3. McCrory P, Meeuwisse W, Aubry M, Cantu B, Dvorak J, Echemendia RJ, Engebretsen L, Johnston K, Kutcher JS, Raftery M, Sills A, Benson BW, Davis GA, Ellenbogen RG, Guskiewicz K, Herring SA, Iverson GL, Jordan BD, Kissick J, McCrea M, McIntosh AS, Maddocks D, Mskdissi M, Purcell L, Putukian M, Schneider K, Tator CH, Turner M (2013) Consensus statement on concussion in sport: the 4th international conference on concussion in sport held in Zurich, November 2012. Br J Sports Med 47:250–258

    Article  PubMed  Google Scholar 

  4. Report of the Quality Standards Subcommittee (1997) Practice parameter: the management of concussion in sports (summary statement). Neurology 48:581–585

    Article  Google Scholar 

  5. Lovell MR, Collins MW, Iverson GL, Johnston KM, Bradley JP (2004) Grade 1 or “ding” concussions in high school athletes. Am J Sports Med 32:1–8

    Article  Google Scholar 

  6. Giza CC, Kutcher JS, Ashwal S, Barth J, Getchius TS, Gioia GA, Gronseth GA, Guskiewicz K, Mandel G, McKeag DB, Thurman DJ, Zafonte R (2013) Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the guideline development subcommittee of the American Academy of Neurology. Neurology 80:2250–2257

    Article  PubMed Central  PubMed  Google Scholar 

  7. McCrea M, Guskiewicz K, Randolph C, Barr WB, Hammeke TA, Marshall SW, Powell MR, Ahn KW, Wang Y, Kelly JP (2012) Incidence, clinical course, and predictors of prolonged recovery time following sport-related concussion in high school and college athletes. J Int Neuropsychol Soc 18:1–12

    Article  Google Scholar 

  8. McCarthy M, O’Hara R (2010) How physicians are managing concussions in Connecticut. Conn Med 74:485–487

    PubMed  Google Scholar 

  9. McCrory P, Johnston K, Meeuwisse W, Aubry M, Cantu R, Dvorak J, Graf-Baumann T, Kelly J, Lovell M, Schamasch P (2005) Summary and agreement statement of the 2nd international conference on concussion in sport, Prague 2004. Clin Sports Med 15:48–55

    Article  Google Scholar 

  10. Carl RL, Kinsella SB (2014) Pediatricians’ knowledge of current sports concussion legislation and guidelines and comfort with sports concussion management: a cross-sectional study. Clin Pediatr 53:689–697

    Article  Google Scholar 

  11. Van Kampen DA, Lovell MR, Pardini JE, Collins MW, Fu FH (2006) The “value added” of neurocognitive testing after sports-related concussion. Am J Sports Med 10:1630–1635

    Article  Google Scholar 

  12. Chrisman SP, Quitquit C, Rivara F (2013) Qualitative study of barriers to concussive symptom reporting in high school athletes. J Adolescent Health 52:330–335

    Article  Google Scholar 

  13. Broshek DK, Kaushik T, Freeman J, Erlanger D, Webbe F, Barth J (2005) Sex differences in outcome following sports-related concussion. J Neurosurg 102:856–863

    Article  PubMed  Google Scholar 

  14. Lovell M (2009) The management of sports-related concussion: current status and future trends. Clin Sports Med 28:95–111

    Article  PubMed  Google Scholar 

  15. Tierney RT, Sitler MR, Swanik CB, Swanik KA, Higgins M, Torg J (2005) Gender differences in head-neck segment dynamic stabilization during head acceleration. Med Sci Sports Exerc 37(2):272–279

    Article  PubMed  Google Scholar 

  16. Guskiewicz KM, Weaver NL, Padua DA, Garrett WE (2000) Epidemiology of concussion in collegiate and high school football players. Am J Sports Med 28:643–650

    CAS  PubMed  Google Scholar 

  17. Seifert TD (2013) Sports concussion and associated post-traumatic headache. Headache 53:726–736. doi:10.1111/head.12087

    Article  PubMed  Google Scholar 

  18. Francisco GE, Walker WC, Zasler ND, Nouffard MH (2007) Pharmacological management of neurobehavioural sequelae of traumatic brain injury: a survey of current physiatric practice. Brain Inj 21:1007–1014

    Article  PubMed  Google Scholar 

  19. Kinnaman KA, Mannix RC, Comstock DR, Meehan WP (2013) Management strategies and medication use for the treating paediatric patients with concussions. Acta Paediatr 102:424–428

    Article  Google Scholar 

  20. Iverson GL, Gaetz M, Lovell MR, Collins MW (2004) Relation between subjective fogginess and neuropsychological testing following concussion. J Int Neuropsychol Soc 10:904–906

    Article  PubMed  Google Scholar 

  21. Lau B, Lovell MR, Collins MW, Pardini J (2009) Neurocognitive and symptom predictors of recovery in high school athletes. Clin J Sport Med 19(3):216–221

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no competing interest.

Author information

Authors and Affiliations

  1. WellSpan Health, Emig Research Center, York Hospital, 1001 S. George Street, York, PA, 17405, USA

    Suzanne Bock & Rod Grim

  2. WellSpan Neurosciences, 228 St Charles Way, York, PA, 17402, USA

    Todd F. Barron, Matthew Hendell & Ellen Deibert

  3. Pinnacle Health, Spine and Sports Medicine, 2005 Technology Parkway, Suite 100, Mechanicsburg, PA, 17050, USA

    Andrew Wagenheim

  4. VCU-Fairfax Family Practice Sports Medicine Fellowship, Richmond, VA, USA

    Yaowen Eliot Hu

  5. Team Physician, George Mason University, Fairfax, VA, USA

    Yaowen Eliot Hu

  6. Team Physician, Herndon High School, 555 Herndon Parkway Suite 100, Herndon, VA, 20170, USA

    Yaowen Eliot Hu

  7. Sports Medicine WellSpan Health, 25 Monument Rd, Ste. 290, York, PA, 17403, USA

    John Deitch

  8. Department of Neurology, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA

    Ellen Deibert

  9. Pennsylvania College of Medicine, 500 University Drive, Hershey, PA, 17033, USA

    Todd F. Barron

Authors
  1. Suzanne Bock
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rod Grim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Todd F. Barron
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew Wagenheim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yaowen Eliot Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Matthew Hendell
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. John Deitch
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ellen Deibert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Suzanne Bock.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bock, S., Grim, R., Barron, T.F. et al. Factors associated with delayed recovery in athletes with concussion treated at a pediatric neurology concussion clinic. Childs Nerv Syst 31, 2111–2116 (2015). https://doi.org/10.1007/s00381-015-2846-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-015-2846-8

Keywords

Search

Navigation