Abstract

INTRODUCTION: Academic performance upon return-to-learn (RTL) following sport-related concussion (SRC) in adolescent athletes is an understudied yet important topic in the concussion literature. METHODS: A retrospective, cohort study was conducted of athletes 12-24-years-old who were treated for a SRC at a regional sports concussion center between 11/2017-04/2022. Athletes/parents were interviewed via phone regarding grades following concussion. Outcome variables included worsening of grades (yes/no) upon RTL to school and delayed time-to-normalization-of-grades (dichotomized: 0-90 days vs. >90 days). Independent variables include demographics, personal/family medical history, injury characteristics, school factors (type [private/public], accommodations received [yes/no], presence of concussion specialist/athletic trainer at school [yes/no], participant rating of teacher/school’s concussion knowledge [1-10]), and recovery (return-to-learn [RTL], symptom resolution, return-to-play). Univariate logistic regressions were performed. RESULTS: A total of 94 participants (60.4% male, 16.6 ± 2.6 years-old) were interviewed at a median time of 286 days (IQR: 247-420) post-concussion. The mean RTL of the cohort was 9.0 ± 13.2 days. Of all participants, 30/94 (31.9%) endorsed having worsening of grades upon RTL, and of those, 17/30 (43.6%) reported delayed time-to-normalization-of-grades (>90 days). Univariate analysis revealed no statistically significant predictors for worsening of grades; however, marginal significance was obtained as such that those with worse initial concussion symptoms were more likely to endorse feeling their grades worsened (OR = 1.02, p = .08, 95% CI 0.99, 1.04). No statistically significant predictors of delayed time-to-normalization-of-grades were found. CONCLUSIONS: In a cohort of adolescents with SRC, approximately 1 in 3 athletes reported worsening of grades, and 18% reported their grades did not normalize for >3 months. Marginal significance was obtained supporting the notion that those with worse initial symptoms were more likely to report worsened grades.

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