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 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 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 Preliminary Evidence-Based Recommendations for Return to Learn: a novel pilot study tracking concussion recovery in college students

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S33.3-S34
Author(s):  
Zachary Bevilacqua ◽  
Mary Kerby ◽  
David Fletcher ◽  
Zhongxue Chen ◽  
Becca Merritt ◽  
...  
Keyword(s):  
Physical Activity ◽  
Longitudinal Design ◽  
Text Messages ◽  
Return To Play ◽  
Evidence Based ◽  
Full Time ◽  
Symptom Resolution ◽  
Phone Calls ◽  
Return To Learn ◽  
Concussion Recovery

ObjectiveInvestigate the potential factors influencing resolution of chief concussion symptoms in a longitudinal design. Second, assess subjects’ perception of their concussion recovery and what types of activities and accommodations appeared beneficial.BackgroundAthletes re-entering the academic setting after a concussion is commonly referred as return-to-learn (RTL), which has appeared secondary to the abundantly researched return-to-play protocols implemented ubiquitously. Importantly, every concussed collegiate, adolescent, and pediatric athlete is first and foremost a student-athlete, with “student” holding the emphasis. To date, very few studies have examined the RTL aspect of concussion recovery, and the effects premature classroom attendance may cause.Design/MethodsNine concussed, college aged (18-26 years), full-time students were monitored longitudinally throughout their recovery from diagnosis to full symptom-free academic participation. Symptom severity for five prevalent symptoms were recorded 4 times per day, along with a daily phone call to report participant’s diet, duration of screen-time usage and music listened to, physical activity participation, and types of classes attended.ResultsResponse rates to text messages and phone calls yielded a mean 92% and 93% respectively across the nine subjects. Additionally, five variables were significantly associated with symptom resolution (music, sleep, physical activity, water, and time) (p = 0.0004 to p = 0.036). Lastly, subjects reported math and computer-oriented courses as the most difficult (33% and 44% respectively). Additional time on assignments/exams and reducing screen brightness were the most beneficial accommodations (66% and 56% respectively).ConclusionsOur findings introduce a novel and robust approach to monitoring concussed students throughout their recovery. Furthermore, this methodology is the first to produce holistic evidence-based results concerning re-integrating students to the classroom. Lastly, it appears that dietary and social behaviors can indeed influence symptom resolution.

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 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 More Physical Activity after Concussion Is Associated with Faster Return to Play among Adolescents

2021 ◽  
Vol 18 (14) ◽  
pp. 7373
Author(s):  
Corrine N. Seehusen ◽  
Julie C. Wilson ◽  
Gregory A. Walker ◽  
Sarah E. Reinking ◽  
David R. Howell
Keyword(s):  
Physical Activity ◽  
Return To Play ◽  
Post Injury ◽  
Exercise Frequency ◽  
Early Introduction ◽  
Youth Athletes ◽  
Concussion Management ◽  
Concussion History ◽  
Concussion Recovery ◽  
Optimal Quantity

Concussion management has evolved to de-emphasize rest in favor of early introduction of post-injury physical activity. However, the optimal quantity, frequency and intensity of physical activity are unclear. Our objective was to examine the association between objective physical activity metrics and clinical recovery after concussion. We prospectively enrolled a cohort of 32 youth athletes with concussion, evaluated within 14 days of injury and after return-to-play (RTP) clearance. For two weeks after enrollment, we quantified steps/day and exercise frequency, duration, and intensity via wrist-worn actigraphy. We grouped participants by RTP clearance timing (<28 days vs. ≥28 days). Seventeen (53%) participants required ≥28 days post-concussion for RTP clearance. Groups were similar in age (14.9 ± 1.9 vs. 15.4 ± 1.5 years; p = 0.38), proportion of females (47% vs. 40%; p = 0.69), and concussion history (59% vs. 47%; p = 0.49). During the study period, the RTP ≥ 28 days group took fewer steps/day (8158 ± 651 vs. 11,147 ± 4013; p = 0.02), exercised fewer days/week (2.9 ± 2.4 vs. 5.0 ± 1.9 days/week; p = 0.01), and exercised fewer total minutes/week (117 ± 122 vs. 261 ± 219 min/week; p = 0.03). Furthermore, we observed ≥10,251 average steps/day, ≥4 exercise sessions/week, and exercising ≥134 total minutes/week were optimal cutpoints to distinguish between groups. These findings support the benefit of physical activity during concussion recovery.

scholarly journals A-42 Incremental Utility of Visual Assessment in Predicting Concussion Recovery Time Among Adolescents

2020 ◽  
Vol 35 (5) ◽  
pp. 638-638
Author(s):  
J Sterling ◽  
D Pardini ◽  
J Pardini ◽  
M Docherty ◽  
J Mattis
Keyword(s):  
Test Performance ◽  
Symptom Severity ◽  
Visual Memory ◽  
Recovery Time ◽  
Return To Play ◽  
Prior History ◽  
Post Injury ◽  
Neurocognitive Test ◽  
The Impact ◽  
Vision Function

Abstract Objective Sports-related concussions (SRC) often affect vision function and cognition, two components frequently assessed as part of a multimodal post-injury evaluation. The purpose of the study was to examine contributions of measures of vision function and cognition toward understanding recovery time. Method Participants were 593 (37.6% female) adolescents ages 10–18 (M = 14.7, SD = 1.7) who were evaluated and diagnosed with a concussion within 10 days of injury. Participants were administered the King-Devick (KD) test via KD cards to assess rapid number naming speed and the ImPACT test to assess post-concussion symptoms and neurocognitive test performance. The primary outcome was number of weeks (M = 3.2, SD = 1.9) until participants were cleared to return to play by the treating physician based on a standardized protocol. Results Poorer performance on the King-Devick test was significantly correlated with higher symptom severity (r = .41, p &lt; .001), and poorer performance on ImPACT Verbal Memory (r = −.46, p &lt; .001), Visual Memory (r = −.39, p &lt; .001), Visual Motor Speed (r = −55, p &lt; .001), and Reaction Time (r = .47, p &lt; .001) composites. Poorer KD scores were also significantly correlated with a longer time to recovery (r = .23, p &lt; .001). Importantly, poorer KD scores continued to significantly predict protracted recovery time after controlling for age, gender, time to initial physician evaluation, prior history of concussion, post-concussion symptom severity, and neurocognitive test performance (β = .12, p &lt; .05). Conclusions Performance on King-Devick testing predicted recovery time, even after controlling for important demographic/injury characteristics and cognitive testing. Evaluation of vision function is an important component of post-injury assessment for SRC.

Recovery of ectomycorrhizal fungi after exposure to subfreezing temperatures

1979 ◽  
Vol 57 (17) ◽  
pp. 1845-1848 ◽  
Author(s):  
R. C. France ◽  
M. L. Cline ◽  
C. P. P. Reid
Keyword(s):  
Growth Rate ◽  
Ectomycorrhizal Fungi ◽  
Recovery Time ◽  
Growth Form ◽  
Rapid Recovery ◽  
Active Growth ◽  
Growth Recovery ◽  
Recovery Times

Seventy-three isolates of eighteen ectomycorrhizal fungi were examined for their growth recovery after a 48-h exposure to −10 °C. Survival of all isolates was 97%. Recovery time to active growth varied between species and within species. Of surviving isolates, 72% initiated growth in less than 2 weeks after thawing. Growth rate was not affected for isolates exhibiting rapid recovery but was significantly lowered for isolates with recovery times of more than 5 weeks. Variation in growth form occurred with some species of Suillus and Xerocomus.

Investigation of Aerobic and Muscular Fitness and Concussion Among Service Academy Cadets at the United States Air Force Academy: Results from the CARE Consortium

2021 ◽  
Author(s):  
Kathryn L Van Pelt ◽  
Laura Wolff ◽  
Darren E Campbell ◽  
Gerald McGinty ◽  
Michael Zupan ◽  
...  
Keyword(s):  
Physical Fitness ◽  
Aerobic Fitness ◽  
Recovery Time ◽  
The United States ◽  
Physical Fitness Test ◽  
Fitness Test ◽  
Recovery Duration ◽  
Concussion Recovery ◽  
Service Academy ◽  
The Relationship

ABSTRACT Introduction Concussion has become the signature injury facing the U.S. military. However, little is understood about the relationship between military fitness and concussion recovery. The current study examined the recoveries of cadets at a U.S. Service Academy to determine whether preinjury physical fitness improved recovery and whether recovery was associated with post-injury physical fitness measures. Methods Participants were enrolled in a longitudinal study of concussion. Aerobic Fitness Test (AFT) and Physical Fitness Test (PFT) data were used to estimate cadet fitness. Survival analysis evaluated significant estimators of concussion recovery time. Linear regression models were used to explore the relationship between recovery duration and change in physical fitness scores. Results Between 2014 and 2017, 307 (n = 70; 22.80% Women) cadets who had sustained a concussion were enrolled. Preinjury physical fitness was not significantly associated with recovery duration (P &gt; .05). Men and intercollegiate cadets took fewer days to reach recovery milestones. Compared to women, men had greater decrements in the Aerobic Fitness Test total score (P &lt; .05) and increased 1.5-mile time postconcussion (P &lt; .05). Women had greater decreases in push-ups postconcussion compared to males (P &lt; .05). There was a trend for a negative association between days until asymptomatic and change in the Physical Fitness Test score (P = .07). Conclusion Preconcussion physical fitness levels do not appear to impact concussion recovery time among a highly physically fit cohort. Possible methods to reduce the effect of symptom duration on strength-related physical fitness should be investigated along with evaluating reductions in strength as a possible mechanism for postconcussion injury risk.

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