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 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.

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 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.

Using Acute Performance on a Comprehensive Neurocognitive, Vestibular, and Ocular Motor Assessment Battery to Predict Recovery Duration After Sport-Related Concussions

2017 ◽  
Vol 45 (5) ◽  
pp. 1187-1194 ◽  
Author(s):  
Alicia M. Sufrinko ◽  
Gregory F. Marchetti ◽  
Paul E. Cohen ◽  
R.J. Elbin ◽  
Valentina Re ◽  
...  
Keyword(s):  
Recovery Time ◽  
Symptom Assessment ◽  
Cognitive Testing ◽  
Ocular Motor ◽  
Motor Speed ◽  
Multinomial Regression ◽  
Symptom Scale ◽  
Level Of Evidence ◽  
Recovery Times ◽  
Visual Motor

Background: A sport-related concussion (SRC) is a heterogeneous injury that requires a multifaceted and comprehensive approach for diagnosis and management, including symptom reports, vestibular/ocular motor assessments, and neurocognitive testing. Purpose: To determine which acute (eg, within 7 days) vestibular, ocular motor, neurocognitive, and symptom impairments predict the duration of recovery after an SRC. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: Sixty-nine patients with a mean age of 15.3 ± 1.9 years completed a neurocognitive, vestibular/ocular motor, and symptom assessment within 7 days of a diagnosed concussion. Patients were grouped by recovery time: ≤14 days (n = 27, 39.1%), 15-29 days (n = 25, 36.2%), and 30-90 days (n = 17, 24.6%). Multinomial regression was used to identify the best subset of predictors associated with prolonged recovery relative to ≤14 days. Results: Acute visual motor speed and cognitive-migraine-fatigue symptoms were associated with an increased likelihood of recovery times of 30-90 days and 15-29 days relative to a recovery time of ≤14 days. A model with visual motor speed and cognitive-migraine-fatigue symptoms within the first 7 days of an SRC was 87% accurate at identifying patients with a recovery time of 30-90 days. Conclusion: The current study identified cognitive-migraine-fatigue symptoms and visual motor speed as the most robust predictors of protracted recovery after an SRC according to the Post-concussion Symptom Scale, Immediate Post-concussion Assessment and Cognitive Testing, and Vestibular/Ocular Motor Screening (VOMS). While VOMS components were sensitive in identifying a concussion, they were not robust predictors for recovery. Clinicians may consider particular patterns of performance on clinical measures when providing treatment recommendations and discussing anticipated recovery with patients.

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 Effects of Different Recovery Times on Internal and External Load During Small-Sided Games in Soccer

2021 ◽  
pp. 194173812199546
Author(s):  
Luis Branquinho ◽  
Ricardo Ferraz ◽  
Bruno Travassos ◽  
Daniel A. Marinho ◽  
Mário C. Marques
Keyword(s):  
External Load ◽  
Recovery Time ◽  
Total Duration ◽  
Training Load ◽  
Maximum Speed ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Internal Load ◽  
Exercise Load ◽  
Recovery Times

Background: The ability to maintain a high intensity of exercise over several repetitions depends on recovery from previous exercises. This study aimed to identify the effects of different recovery times on internal and external load during small-sided soccer games. Hypothesis: An increase in recovery time will increase the external training load and decrease the internal exercise load, which will result in a greater physical impact of the exercise. Study Design: Cross-sectional study. Level of Evidence: Level 2. Methods: Twenty male semiprofessional soccer players participated in the present study. They performed the same exercise (5-a-side game format) continuously (1 × 18 minutes) and repeatedly/fractionated (3 × 6 minutes) with different recovery times (30 seconds, 1 minute, 1.5 minutes, and 2 minutes). Their internal load (ie, average heart rate (HR) and maximum HR) and external load (ie, total distance, maximum speed, and ratio meters) were measured using an HR band and an inertial device equipped with a global positioning system, respectively. Results: The manipulation of recovery times induced differences in the internal and external load. For the same total duration, the external and internal load indicators exhibited higher values during the fractionated method, particularly with short recovery periods. Conclusion: The application of small-sided soccer games with different recovery times induced varying responses in training load. To maintain high physical performance and high training load, the fractional method with short recovery periods (ie, 30 seconds) should be used. In contrast, to carefully manage players’ efforts and decrease response to training load, continuous or fractional methods with longer recovery periods (ie, 1-2 minutes) should be used. Clinical Relevance: The proper prescription of recovery time between exercises facilitates enhanced training efficiency and optimized performance.

The Effects of Concussion on Quantity and Quality of Sleep in Football Athletes

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S22.1-S22
Author(s):  
Taren Bone ◽  
Suzanne M. Konz ◽  
William Garrett ◽  
Charles Andrew Gilliland
Keyword(s):  
Sleep Disturbances ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Quality Of Sleep ◽  
Time In Bed ◽  
Study Results ◽  
Sleep Parameters ◽  
Concussion Recovery ◽  
Initial Measurement

ObjectiveThe objective was to observe the quantity and quality of sleep of collegiate athletes following a concussion.BackgroundPatients diagnosed with a concussion report a disruption or change in their sleep with 46% of patients still having sleep disturbances 3 months after the event. Research is lacking on the sleep disruption or sleep changes in athletes who have experienced a concussion.Design/MethodsThis IRB-approved convenient cohort study involved athletes from 2 local universities. 27 (20 non-concussed and 7 concussed) male collegiate football players (19.93 ± 1.14 years old, 1.82 ± 0.08 m, and 96.42 ± 21.26 kg) wore a Readiband device for 7–10 days or throughout concussion recovery. Concussed participants completed a symptom score sheet each day. Participants returned the Readiband device and completed the Pittsburgh Sleep Quality Index Questionnaire (PSQIQ) after 7–10 days or on return to play. The sleep parameters, and PSQIQ scores were analyzed using non-parametric & independent t-tests with the alpha level set at 0.05.ResultsThe t-tests indicated a difference between the total minutes in bed at the initial measurement (F = 11.839, df = 1, p = 0.037) between the concussed (353.29 ± 110.48 minutes) and non-concussed (471.5 ± 125.09 minutes) groups. There was also a difference between the total minutes asleep at the initial measurement (F = 12.662, df = 1, p = 0.032) between the concussed (286.43 ± 86.73) and non-concussed groups (383.7 ± 104.86). The last measurement that indicated a difference was the calculated minutes in bed at the initial measurement (F = 11.916, df = 1, p = 0.023) between the concussed (326.4 3 ± 97.01) and non-concussed groups (441.60 ± 110.55).ConclusionsThe study results indicate that concussion affects the quantity of sleep, with concussed athletes spending less time in bed and fewer minutes asleep. Changes in sleep occur post-concussion, which may delay concussion recovery.

scholarly journals The Influence of Hormonal Contraceptives on Cognitive Recovery in Concussed Collegiate Athletes: Data from the NCAA-DoD CARE Consortium

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S14.3-S15
Author(s):  
Jacob Kay ◽  
Andrew Lapointe ◽  
Thomas McAllister ◽  
Michael McCrea ◽  
Steven Broglio ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Female Athletes ◽  
Clinical Symptoms ◽  
Collegiate Athletes ◽  
Neurological Status ◽  
Return To Play ◽  
Hormonal Contraceptives ◽  
Cognitive Efficiency ◽  
Concussion Recovery ◽  
The Impact

ObjectiveTo longitudinally examine the relation between hormonal contraceptives and concussion recovery. We hypothesized that female athletes using hormonal contraceptives would exhibit faster recovery times and smaller post-injury alterations in neurological status, cognition, and clinical symptoms than female athletes not using hormonal contraceptives.BackgroundResearch indicates sex may moderate concussion outcomes, with some females experiencing protracted recovery relative to males. It is hypothesized that fluctuations of sex hormones lead to poorer outcomes in these females. Thus, female athletes taking hormonal contraceptives may exhibit better recovery than their un-medicated counterparts, as their hormone levels are artificially stabilized.Design/MethodsData from the NCAA-DOD Grand Alliance: Concussion Assessment, Research, and Education (CARE) Consortium were used to evaluate female athletes who were (n = 50) and were not (n = 50) taking hormonal contraceptives. Baseline assessments were completed prior to athletes’ sport season. Athletes were re-assessed 24–48 hours post-concussion, and again at the unrestricted return-to-play. Length of recovery was defined as days between injury and the unrestricted return-to-play. Neurological status was measured using the Standardized Assessment of Concussion (SAC). Cognitive function and clinical symptoms were measured using the ImPACT test. Participants were matched on age, sex, body mass index, sport, and concussion history.ResultsNo group differences in length of recovery were observed (p > 0.05). Across all timepoints, analyses revealed main effects of group for concentration (SAC; p = 0.04), verbal memory (ImPACT; p = 0.03), and cognitive efficiency (ImPACT; p = 0.01). No differences in change scores (relative to baseline) were observed between groups.ConclusionsThe current results suggest that hormonal contraceptives do not influence concussion recovery. However, irrespective of injury status, our findings indicate that females on hormonal contraceptives may exhibit better concentration, working memory, and cognitive efficiency.

Return to Competitive Play After Hamstring Injuries Involving Disruption of the Central Tendon

2012 ◽  
Vol 41 (1) ◽  
pp. 111-115 ◽  
Author(s):  
Jules Comin ◽  
Peter Malliaras ◽  
Peter Baquie ◽  
Tim Barbour ◽  
David Connell
Keyword(s):  
Recovery Time ◽  
Biceps Femoris ◽  
Hamstring Tendon ◽  
Hamstring Injury ◽  
Level Of Evidence ◽  
Musculotendinous Junction ◽  
Sports Teams ◽  
Hamstring Injuries ◽  
Recurrent Injury ◽  
Recovery Times

Background: The hamstring muscles are the most commonly injured muscle group in many different sports. Recovery time is often unpredictable and prolonged, and recurrent injury is common. Hypothesis: Hamstring injuries that disrupt the central tendon enclosed within the muscle belly require a longer recovery time than do injuries involving only muscle, epimysial fascia, or the musculotendinous junction. Study Design: Cohort study; Level of evidence, 3. Methods: Injury records from professional sports teams were reviewed to determine the length of recovery from each hamstring injury that occurred over a 24-month period. The integrity of the central tendon on magnetic resonance imaging (MRI) was retrospectively reviewed for each case. The association between central tendon disruption on MRI and recovery time was determined. Results: There were 62 hamstring injuries included for analysis; 45 (72%) involved the biceps femoris, 11 (18%) involved the semimembranosus, and 6 (10%) involved the semitendinosus. Central tendon disruption was identified in 12 (45%) of the biceps femoris injuries and in none of the injuries to the other 2 muscles. Three of these injuries were treated surgically, with a median recovery time of 91 days. The median (interquartile range [IQR]) recovery times for those remaining biceps femoris injuries with and without central tendon disruption were 21 days (IQR, 9-28) and 72 days (IQR, 42-109), respectively ( P < .01). Conclusion: Disruption of the central tendon in injuries to the biceps femoris results in a significantly longer recovery time than injuries that do not disrupt the central tendon. This highlights the distinction between injury to the hamstring muscle and injury to the hamstring tendon, which is underappreciated as being a distinct entity when injury involves the enclosed central portion of the tendon.

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