A Longitudinal Investigation of Symptom Recovery following Concussion in Youth Soccer

Abstract

To prospectively evaluate symptom outcomes after youth soccer-related concussion. Using a prospective cohort design, we enrolled male and female competitive soccer players age 8-17years into 3 groups: concussed (n=23), matched control (n=23), and orthopedic injury (n=24). Postconcussive symptoms were monitored serially via both athlete and parent report at days 1-2, 4, 7, 10, 30, and90. Repeated-measures analyses revealed a significant time by group interaction (F [12, 402]=19.91, P<.001). In the initial days postinjury, the concussed group reported greater symptoms than the comparison groups, with more symptoms reported by athletes on average than parents. By 10days, concussed athletes did not differ from the matched controls by either rater's report, but they did differ from the orthopedic injury group by parent report. At 30days, no differences were apparent among groups. At 30days, 100% of concussed youth and 91% of parents rated symptoms as back to preinjury levels using reliable change indices. At 30days, 86% of athletes had been cleared to return to full game play. The natural clinical history of concussion symptoms in youth competitive soccer players was similar to that seen in older athletes, with resolution in days to a few weeks. Additional study will be required to investigate which factors best predict symptom outcomes for individual athletes and how symptom report relates to performance-based outcome measures and underlying neurophysiologic recovery.