scholarly journals An Examination of Concussion Recovery Time in Athletes Ages 13–18

2019 ◽  
Vol 34 (5) ◽  
pp. 739-739
Author(s):  
S Burkhart ◽  
C Ellis ◽  
J Baggett ◽  
T Smurawa ◽  
J Polousky
Keyword(s):  
Recovery Time ◽  
Student Athletes ◽  
One Health ◽  
Athletic Trainers ◽  
Injury Surveillance ◽  
Return To Play ◽  
Rank One ◽  
Recovery Times ◽  
Concussion Recovery ◽  
Surveillance Database

Abstract Purpose The purpose of this study was to examine recovery time from concussion utilizing date of injury and date of return to play. It was hypothesized females would have longer recovery times by age and dual gender sports (baseball/softball, basketball, soccer, swimming/diving, and track/field). Methods This study used data from the Rank One Health Injury Surveillance Database (ROH ISD) between 2012–18, in student-athletes ages 13 to 18. This study examined concussion reporting by Athletic Trainers (ATCs) at both middle schools and high schools. Independent sample t-tests were performed by gender, age (13–15, 16–18), and sport with p < 0.05 being statistically significant. Results A total of 3,967 concussions with an average age of 15.34 (SD = 1.43), with a defined date of injury and date of return to play were recorded by ATCs. There was a significant effect in recovery time for gender, F(1, 3965) = 3.36, p<0.001 with females taking longer to recover than males. There was a statistically significant effect in recovery time for age, F(1, 3965) = 3.97, p<0.001 with athletes ages 13–15 taking longer to recovery than athletes ages 16–18. Females also experienced longer recovery when comparing sports, with significant differences observed in baseball/softball, soccer, swimming/diving, and track/field. Conclusion This study marks the largest examination of recovery time in student athletes ages 13–18. The findings from this study provide further evidence for longer observed recovery time in females compared to males.

scholarly journals Adolescents With ADHD Do Not Take Longer to Recover From Concussion

2021 ◽  
Vol 8 ◽  
Author(s):  
Nathan E. Cook ◽  
Grant L. Iverson ◽  
Bruce Maxwell ◽  
Ross Zafonte ◽  
Paul D. Berkner
Keyword(s):  
Recovery Time ◽  
Return To Play ◽  
Return To School ◽  
Prior History ◽  
Return To Sports ◽  
Full Time ◽  
Recovery Times ◽  
Concussion History ◽  
Concussion Recovery ◽  
Medication Status

The objective of this study was to determine whether adolescents with attention-deficit/hyperactivity disorder (ADHD) have prolonged return to school and sports following concussion compared to those without ADHD and whether medication status or concussion history is associated with recovery time. We hypothesized that having ADHD would not be associated with longer recovery time. This prospective observational cohort study, conducted between 2014 and 2019, examined concussion recovery among school sponsored athletics throughout Maine, USA. The sample included 623 adolescents, aged 14–19 years (mean = 16.3, standard deviation = 1.3 years), 43.8% girls, and 90 (14.4%) reported having ADHD. Concussions were identified by certified athletic trainers. We computed days to return to school (full time without accommodations) and days to return to sports (completed return to play protocol) following concussion. Adolescents with ADHD [median days = 7, interquartile range (IQR) = 3–13, range = 0–45] did not take longer than those without ADHD (median days = 7, IQR = 3–13, range = 0–231) to return to school (U = 22,642.0, p = 0.81, r = 0.01; log rank: χ12 = 0.059, p = 0.81). Adolescents with ADHD (median days = 14, IQR = 10–20, range = 2–80) did not take longer than those without ADHD (median days = 15, IQR = 10–21, range = 1–210) to return to sports (U = 20,295.0, p = 0.38, r = 0.04; log rank: χ12 = 0.511, p = 0.48). Medication status and concussion history were not associated with longer recovery times. Adolescents with ADHD did not take longer to functionally recover following concussion. Recovery times did not differ based on whether adolescents with ADHD reported taking medication to treat their ADHD or whether they reported a prior history of concussion.

scholarly journals Reconsidering Return-to-Play Times: A Broader Perspective on Concussion Recovery

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876085 ◽  
Author(s):  
Christopher D’Lauro ◽  
Brian R. Johnson ◽  
Gerald McGinty ◽  
C. Dain Allred ◽  
Darren E. Campbell ◽  
...  
Keyword(s):  
Recovery Time ◽  
Time Window ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Sample Population ◽  
Intercollegiate Athletes ◽  
Level Of Evidence ◽  
Athletic Status ◽  
Recovery Times ◽  
Concussion Recovery

Background: Return-to-play protocols describe stepwise, graduated recoveries for safe return from concussion; however, studies that comprehensively track return-to-play time are expensive to administer and heavily sampled from elite male contact-sport athletes. Purpose: To retrospectively assess probable recovery time for collegiate patients to return to play after concussion, especially for understudied populations, such as women and nonelite athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Medical staff at a military academy logged a total of 512 concussion medical records over 38 months. Of these, 414 records included complete return-to-play protocols with return-to-play time, sex, athletic status, cause, and other data. Results: Overall mean return to play was 29.4 days. Sex and athletic status both affected return-to-play time. Men showed significantly shorter return to play than women, taking 24.7 days (SEM, 1.5 days) versus 35.5 days (SEM, 2.7 days) ( P < .001). Intercollegiate athletes also reported quicker return-to-play times than nonintercollegiate athletes: 25.4 days (SEM, 2.6 days) versus 34.7 days (SEM, 1.6 days) ( P = .002). These variables did not significantly interact. Conclusion: Mean recovery time across all groups (29.4 days) showed considerably longer return to play than the most commonly cited concussion recovery time window (7-10 days) for collegiate athletes. Understudied groups, such as women and nonelite athletes, demonstrated notably longer recovery times. The diversity of this sample population was associated with longer return-to-play times; it is unclear how other population-specific factors may have contributed. These inclusive return-to-play windows may indicate longer recovery times outside the population of elite athletes.

scholarly journals THE RELATIONSHIP BETWEEN MENTAL HEALTH HISTORY AND SYMPTOMS, SEX, AND RECOVERY TIME IN A CONCUSSED PEDIATRIC POPULATION

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0023
Author(s):  
Richard Cameron Allred ◽  
Sara Stremlau ◽  
Richard Gerkin ◽  
Steven Erickson ◽  
Jamie Pardini
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Recovery Time ◽  
Pediatric Population ◽  
Return To Play ◽  
Depression Symptoms ◽  
Health History ◽  
Mental Health History ◽  
Recovery Times ◽  
History Of

Background: The Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire (PHQ-9) are mental health screening instruments that assess symptoms of depression and anxiety. Studies of patients with concussion suggest that history of mental illness is associated with prolonged recovery; however, little research has examined the value of these tools in a concussed pediatric population (Iverson et al., 2017). Hypothesis/Purpose: The purpose of this study was to explore the relation between anxiety and depression symptoms, mental illness history, sex, and time to recover in a concussed pediatric population. We hypothesized that mental health symptoms and history, and female sex would predict longer recoveries in the pediatric population. Methods: IRB-approved retrospective chart review was used for data collection. Demographics, self-reported mental health history, GAD-7, and PHQ-9 scores were acquired for 250 adolescents ages 12-18 (45.2% female) who presented to an outpatient concussion clinic for their initial visit. Days to recover was imputed for all patients who had been discharged by clinic physicians based on international return to play standards. Results: Mann-Whitney U tests were used for analysis of this nonnormally distributed data. Males were found to recover more quickly than females (female median = 15 days, IQR 7-27; male median = 12 days, IQR 6-23; p=.013). No significant differences were observed in days to clearance based on reported history of mental health disorder (p=.066). Individuals who scored above cutoff (see Kroenke et al., 2001; Spitzer et al., 2006) on the GAD-7 (below cutoff median = 12.00 days; above cutoff median = 21.00 days) and PHQ-9 (below cutoff median = 23.5 days; above cutoff median = 57.00 days) required longer recovery times (p <.001). Conclusion: We found longer recovery times in females versus males, and in those whose scores fell above cutoff for the PHQ-9 and GAD-7 at their initial clinic visit. Although a trend existed, there were no significant differences in recovery time for those who reported a mental health history compared to those who did not. Results suggest that the GAD-7 and PHQ-9 may be useful screening measures in a concussion clinic and may provide additional insight into potential recovery times for pediatric patients.

scholarly journals Potential factors influencing recovery from concussion in collegiate student-athletes

2017 ◽  
Vol 1 ◽  
pp. 205970021770708 ◽  
Author(s):  
Kayla P Harvey ◽  
Eric E Hall ◽  
Kirtida Patel ◽  
Kenneth P Barnes ◽  
Caroline J Ketcham
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Student Athletes ◽  
Return To Play ◽  
Hyperactivity Disorder ◽  
Previous Diagnosis ◽  
History Of ◽  
Concussion Recovery ◽  
Potential Factors

Background Factors including sex, previous diagnosis of migraines, previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder, and a history of concussion may influence the length of recovery from concussion in collegiate student-athletes. Purpose To better understand factors that may influence recovery from concussion in collegiate-student athletes. Methods A total of 91 student-athletes from a Division I NCAA University who sustained concussions from the fall of 2011 to the spring of 2015 were evaluated. They were considered recovered from their concussion when neurocognitive and symptom scores returned to baseline and they were cleared by their physician. Analyses of variance were conducted to determine if potential factors influenced concussion recovery ( p < .0125). Results No significant differences were found for sex (males = 7.4 ± 5.9; females = 8.3 ± 4.8 days; p = 0.417), previous diagnosis of migraines (diagnosis = 8.0 ± 5.7; no diagnosis = 7.8 ± 5.4 days; p = 0.926), or history of concussion (history = 8.3 ± 5.7; no history = 5.6 ± 3.4 days; p = 0.088). However, a significant difference in the length of recovery was found between those with a previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and those without (diagnosis = 13.3 ± 7.3; no diagnosis = 7.3 ± 4.9 days; p = 0.002). Conclusion Student-athletes with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder show significantly longer recovery from concussions than those without. Further investigation of this and other factors that influence recovery from concussion may help in concussion recovery and return-to-play guidelines that improve student-athlete well-being.

Moderating Effects of Gender Among Collegiate Student-Athletes Receiving a Novel Peer Concussion Education Program

2020 ◽  
pp. 109019812097712
Author(s):  
Meredith Kneavel ◽  
William Ernst ◽  
Kevin McCarthy
Keyword(s):  
Education Program ◽  
Student Athletes ◽  
National Collegiate Athletic Association ◽  
Female Athletes ◽  
Athletic Trainers ◽  
Male Student ◽  
Well Being ◽  
Return To Play ◽  
Moderating Effects ◽  
Concussion Education

Background More than 460,000 female and male student-athletes compete in college sports each year, with 5.5 concussions reported per 1,000 athlete exposures. The majority of these concussions occurred during competition and are somewhat more likely to be reported by female athletes. Aims To evaluate moderating effects of gender differences in response to a Peer Concussion Education Program (PCEP). Method A total of 1,100 male and 511 female student-athletes from 60 teams (30 experimental, 30 control) representing all National Collegiate Athletic Association divisions from high-concussive sports participated before, postintervention, and 1-month following the intervention. Participants completed assessments of symptom and return-to-play knowledge, reporting behavior, and reporting attitudes. Results The PCEP was more effective than control on all measures, females in the PCEP showed significantly greater changes than males in return to play knowledge, intention to report self and teammate, and indirect attitudes for self and teammate. PCEP females were more likely to discuss concussions with athletic trainers, peers, and teammates. In addition, females had a higher likelihood of reporting their own suspected concussion. Discussion Females had greater rates of change in understanding of some key components of the PCEP. Conclusion These findings suggest that females may learn differently in a peer environment and have different attitudes toward reporting and safety when consideration is given to the well-being of others.

Differences in sport-related concussion for female and male athletes in comparable collegiate sports: a study from the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium

2020 ◽  
pp. bjsports-2020-103316
Author(s):  
Christina L Master ◽  
Barry P Katz ◽  
Kristy B Arbogast ◽  
Michael A McCrea ◽  
Thomas W McAllister ◽  
...  
Keyword(s):  
Sex Differences ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Extrinsic Factors ◽  
Contact Sports ◽  
Recovery Times ◽  
Division Ii ◽  
Concussion Recovery ◽  
Research And Education ◽  
Assessment Research

ObjectivesTo examine sex differences in sport-related concussion (SRC) across comparable sports.MethodsProspective cohort of collegiate athletes enrolled between 2014 and 2017 in the Concussion Assessment, Research and Education Consortium study.ResultsAmong 1071 concussions (females=615; 57.4%), there was no difference in recovery (median days to full return to play) (females=13.5 (IQR 9.0, 23.1) vs males=11.8 (IQR 8.1, 19.0), p=0.96). In subgroup analyses, female recovery was longer in contact (females=12.7 days (IQR 8.8, 21.4) vs males=11.0 days (IQR 7.9, 16.2), p=0.0021), while male recovery was longer in limited contact sports (males=16.9 days (IQR 9.7, 101.7) vs females=13.8 days (IQR 9.1, 22.0), p<0.0001). There was no overall difference in recovery among Division I schools (females=13.7 (IQR 9.0, 23.1) vs males=12.2 (IQR 8.2 19.7), p=0.5), but females had longer recovery at the Division II/III levels (females=13.0 (IQR 9.2, 22.7) vs males=10.6 (IQR 8.1, 13.9), p=0.0048).ConclusionOverall, no difference in recovery between sexes across comparable women’s and men’s sports in this collegiate cohort was found. However, females in contact and males in limited contact sports experienced longer recovery times, while females had longer recovery times at the Division II/III level. These disparate outcomes indicate that, while intrinsic biological sex differences in concussion recovery may exist, important, modifiable extrinsic factors may play a role in concussion outcomes.

scholarly journals Exploring Predictors of Moral Disengagement in Collegiate Athletic Trainers

2020 ◽  
Vol 55 (1) ◽  
pp. 96-104
Author(s):  
Ross Budziszewski ◽  
Scott A. Graupensperger ◽  
Matthew Vierimaa
Keyword(s):  
Social Identity ◽  
Athletic Training ◽  
Moral Disengagement ◽  
Student Athletes ◽  
Online Survey ◽  
Athletic Trainers ◽  
Return To Play ◽  
Outcome Variable ◽  
Cluster Solution ◽  
Cross Sectional

Context Considering recent high-profile reports of malpractice and negligence by National Collegiate Athletic Association (NCAA) athletic trainers (ATs), it is prudent to investigate the psychological mechanisms that may influence ATs' ability to justify unethical behaviors. When treating injured student-athletes, ATs may undergo a cognitive process known as moral disengagement, which involves convincing oneself that ethical standards do not apply in a particular context. Objective To explore the psychological factors and traits among ATs that may predict moral disengagement pertaining to allowing athletes to play through injuries. Design Cross-sectional study. Setting Online survey. Patients or Other Participants A total of 187 Division I, II, and III ATs from 100 NCAA universities. Main Outcome Measure(s) In addition to the primary outcome variable of moral disengagement, the survey captured the AT's demographic background, sport and athletic training histories, and measures of sport ethic, contesting orientations, commitment, and social identity. Results Cluster analysis was used to identify homogeneous subgroups of participants based on these variables. A 2-cluster solution emerged, with cluster 1 (n = 94) scoring higher in the sport-ethic and sport-contesting orientations but lower in commitment and social identity compared with cluster 2 (n = 93). An independent-samples t test revealed that moral disengagement was highest (t185 = 19.59, P &lt; .001, d = 0.69) among ATs in cluster 1. Conclusions These findings advance our understanding of the psychological processes that may predict moral disengagement of ATs in allowing student-athletes to play through injury. Although additional research is needed to test whether moral disengagement influences return-to-play decisions, we provide initial evidence that ATs who conform to sport norms (eg, “no pain, no gain”) and who tend to view sport competition with a “war-like” orientation are more likely to morally disengage.

scholarly journals Concussion Recovery Timeline of High School Athletes Using A Stepwise Return-to-Play Protocol: Age and Sex Effects

2020 ◽  
Vol 55 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Kaori Tamura ◽  
Troy Furutani ◽  
Ross Oshiro ◽  
Yukiya Oba ◽  
Ayaka Ling ◽  
...  
Keyword(s):  
High School ◽  
Student Athletes ◽  
Return To Play ◽  
Return To School ◽  
High School Athletes ◽  
Cross Sectional ◽  
Adolescent Population ◽  
Management Protocol ◽  
Concussion Recovery ◽  
Age And Sex

Context Implementation of a stepwise return-to-play (RTP) protocol has become the standard management strategy for high school athletes to ensure a safe RTP after concussion. The detailed characteristics of the recovery timeline throughout the steps of an RTP protocol have not been delineated among the adolescent population. Objective To investigate the days spent in each step of the stepwise RTP protocol in an adolescent population and examine the effects of age and sex on recovery time. Design Cross-sectional study. Setting Local schools. Patients or Other Participants Student-athletes from 57 schools. Intervention(s) A total of 726 patients with concussion (age = 15.5 ± 1.2 years, males = 454, females = 272) were included. The 7-step RTP protocol consists of the following steps: (1) complete cognitive rest, (2) full return to school, (3) light exercise, (4) running progression, (5) noncontact training drills and weight training, (6) full-contact practice or training, and (7) return to game play. The data were obtained by certified athletic trainers as a part of the statewide standardized concussion-management protocol. Main Outcome Measure(s) Days spent in steps 0 to 6 as well as a breakdown of days by sex and age. Results The average total RTP days were 20.2 ± 13.9. Half of this time was spent in the return-to-school phase (steps 2–3: 10.2 ± 10.0 days). Compared with 17-year-old participants, younger participants (age = 14–16 years) took 3 or 4 days longer to start step 3 and to reach step 6 (P &lt; .05). Females took longer to reach step 6 than males (21.6 ± 15.5 versus 19.3 ± 12.7 days) because they took longer to reach step 3 (14.7 ± 11.4 days) than males (13.0 ± 10.0 days; P &lt; .05). Conclusions Our study provides an estimated stepwise concussion recovery timeline for adolescent student-athletes. Clearance to start step 3 was the benchmark for the recovery timeline, as the duration of the exercise portion of the protocol was consistent across the age and sex groups.

scholarly journals GENDER DIFFERENCES IN REPORTED RECOVERY TIME FROM SPORTS-RELATED CONCUSSION IN DUAL GENDER SPORTS FROM 2012-2017

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0013
Author(s):  
SO Burkhart ◽  
CS Ellis ◽  
CA Jones ◽  
TM Smurawa ◽  
JD Polousky
Keyword(s):  
Gender Differences ◽  
Recovery Time ◽  
Epidemiological Studies ◽  
Incidence Rates ◽  
Return To Play ◽  
Point Estimates ◽  
Significant Difference ◽  
Rank One ◽  
Males And Females ◽  
Injury Reporting

Background: Sport-related concussion (SRC) is one of the leading injuries among athletes. Previous epidemiological studies have reported incidence rates of concussion among dual gender sports in which both males and females participate including; soccer, basketball, and baseball/softball yet minimal research has been conducted on differences in recovery time following concussion in the dual gender sports mentioned above. Purpose: The purpose of this study was to examine injury reporting trends associated with recovery time from concussion in dual gender sports from 2012-2017. Methods: Athletes with a reported SRC, ages 12 to 18 participating in baseball, softball, basketball, and soccer from 2012 to 2017 were included in the current study. Injury and exposure data was extracted and analyzed from the Rank One Health Injury Surveillance Database (ROH ISD). SRC counts, percentages, and recovery time in days were reported based on extracted data. All demographic and raw data were summarized using descriptive statistics with point estimates and 95% confidence intervals calculated for all end points. Independent sample t-tests were performed at <0.05 to measure significant differences between groups. Results: 1,306 athletes (males=583, females=723) with an SRC and corresponding date of return to play recorded in the ROH ISD and participating in dual gender sports were analyzed. 242 baseball/softball SRCs (male=103, mean recovery days=17.82; female=139, mean recovery days=22.12), 458 basketball SRCs (male=187, mean recovery days=20.16; female=271, mean recovery days=23.29), and 606 soccer SRCs (male=193, mean recovery days=19.96; female=413, mean recovery days=23.71) were included. A statistically significant difference in recovery time was observed in male and female soccer SRCs ( t=2.09, p=0.02). No significant differences were observed in recovery time in baseball/softball ( t=1.59, p=0.057) and basketball ( t=1.49, p=0.068). Conclusions: This is the first study of its kind to examine gender differences in report recovery time from SRCs in dual gender sports where both males and females participate. Significant gender differences were observed in reported recovery time in soccer athletes. Sports specialization, level of play, injury education level among participants, and training regiments could all be potential causes for the observed differences. Further research is warranted to explore these gender differences and identify potential causes for these findings.

Trends in United States High School Soccer Concussion Reporting from 2012–2017

2019 ◽  
Vol 34 (5) ◽  
pp. 740-740
Author(s):  
S Burkhart ◽  
C Ellis ◽  
J Baggett ◽  
T Smurawa ◽  
J Polousky
Keyword(s):  
High School ◽  
Injury Risk ◽  
Athletic Trainers ◽  
Injury Rate ◽  
Incidence Rates ◽  
Event Type ◽  
Injury Rates ◽  
Rank One ◽  
Rate Ratios ◽  
Surveillance Database

Abstract Purpose The purpose of this study was to provide updated high school soccer concussion incidence rates by gender and event type. It was hypothesized more soccer injuries occur in females, during games, and that females would have higher injury rates and risk. Methods This study used data from the Rank One Health Injury Surveillance Database (ROH ISD) between 2012–17, from 1,999 high schools in student-athletes ages 14 to 18. This study examined high school soccer concussion incidence rate reporting by Athletic Trainers (ATCs). Injury rates per 1,000 Athletic Exposures, injury rate ratios (IRRs), and risk ratios (RR) were calculated by event type. All 95% confidence intervals (CIs) not containing 1.0 were considered statistically significant. Results A total of 6,669 concussions with an average age of 15.62 (SD=1.26) were reported by ATCs in high school soccer from 2012-17. More concussions occurred in games (4,527; 67.9%) than practices (2,142; 32.1%). During games, males (3.49/1,000 AEs) had lower rates than females (7.78/1,000 AEs). During practice, males (0.52/1,000 AEs) had lower rates than females (0/97/1,000 AEs). Injury risk ratio was higher in games than practices for males (RR=6.71; 95% CI=6.67, 6.75) and females (RR=8.11; 95% CI=8.08, 8.14). Conclusion This study marks the largest epidemiological high school soccer concussion incidence investigation to date. The findings from this study provide updated high school soccer concussion incidence rates and provide further evidence of differences in injury rates when comparing practices and games.

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