Abstract
ObjectivesThe objectives were 1) to compare the effects of adolescent sport-related concussion (SRC) and sport-related extremity fracture (SRF) on academic outcomes including change in school grades and school attendance; and 2) to determine which specific academic accommodations were most helpful during recovery from these injuries.MethodsA prospective cohort study was conducted to compare changes in school grades, school attendance and academic accommodations among students (grades 8–12) with an SRC or SRF. School grades were extracted from student immediate pre- and post-injury report cards. Students completed attendance log books and an exit interview to determine which accommodations were helpful and how accommodating they perceived their school to be during their recovery.ResultsOverall, 124 students (92 with SRC and 32 with SRF) submitted both pre- and post-injury report cards. Students who sustained an SRC or SRF experienced similar decreases in grades post-injury (SRC: -1.0%; 95% CI: -2.1, 0.1 and SRF: -0.9%: 95% CI: -2.1, 0.3). Students with an SRC missed significantly more days of school compared to those with an SRF (median of 4 days [IQR: 1, 7] versus 1 day [IQR: 0, 4], p<0.0001). In total, 60/113 (53.1%) SRC students reported their school to be very accommodating while only 31/77 (40.3%) SRF students reported their school to be very accommodating (p = 0.082).ConclusionsStudents who sustain an SRC miss significantly more days of school but demonstrate similar changes in school grades post-injury compared to those with an SRF. Future studies are needed to identify the pre- and post-injury factors associated with poor academic functioning following concussion and identify measures that can be taken to help optimize academic outcomes in these patients.
Highlights
Concussion is the most common form of traumatic brain injury (TBI) and is associated with a rapid onset of neurological symptoms that typically resolve spontaneously [1]
Students who sustained an SRC or SRF experienced similar decreases in grades post-injury (SRC: -1.0%; 95% CI: -2.1, 0.1 and SRF: -0.9%: 95% CI: -2.1, 0.3)
The objectives of this study were 1) to compare the effects of adolescent SRC and sport-related extremity fracture (SRF) on academic outcomes including change in school grades and school attendance; and 2) to determine which specific academic accommodations were most helpful during recovery from these injuries
Summary
Concussion is the most common form of traumatic brain injury (TBI) and is associated with a rapid onset of neurological symptoms that typically resolve spontaneously [1]. Persistent post-concussion symptoms can manifest as headaches, dizziness, visual disturbance, or difficulties with memory and concentration that can have a negative impact on patient functioning and health-related quality of life [4,5,6]. These symptoms can negatively impact school performance. Returning to school can be associated with increased concussion symptoms [8]. Students who return to school with ongoing symptoms reported greater concerns about the impact of their concussion on school performance and more schoolrelated problems that those who have achieved symptomatic recovery [9]. In Canada, the Canadian Pediatric Society has released several Return to Learn recommendations, such as a gradual return to school with increasing time in the classroom providing that symptoms do not worsen, extra time to write exams, and not making up missed assignments and tests [10]
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