Comparison of Symptomology, Symptom Resolution Time, and Return to Play Time between Concussions Sustained in the Same Academic Year

Abstract

ObjectiveThe purpose of this study is to examine symptomology, symptom resolution time, and return to play (RTP) time between concussions sustained in the same academic year.BackgroundPrevious research shows that among those with a history of previous concussions, outcomes for a recurrent concussion are worse, especially when concussions occur within two weeks of each other. Despite this research, there has been little investigation into concussions that occur in the same academic year.Design/MethodsConcussion data was collected from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/10-2017/18 academic years. Concussions were reported by athletic trainers (ATs) and were included if the student-athlete sustained two concussions in the same academic year. Proportions and means of symptoms, symptom resolution time, and RTP time were calculated, and, as appropriate, McNemar’s tests and Wilcoxon sign-rank tests were used to compare these between the first and second concussions.ResultsOverall, 138 student-athletes sustained 276 concussions across 15 different sports a mean of 43 days apart (SD: 37.3). Fewer symptoms were reported in the second concussion compared to the first (4.3 vs. 5.2, respectively; p = 0.01). RTP time was, on average, five days longer for the second concussion (p = 0.01), and a larger proportion of second concussions resulted in participation restriction of ≥30 days (first: 7.3%, second: 26.8%; p < 0.01). Symptom resolution time did not differ between the first and second concussions.ConclusionsAlthough the RTP time was greater in second concussions compared to first, symptom resolution time did not differ. This suggests that there may be a difference in AT management of second concussions, with a more conservative, extended RTP progression. Further research is needed to examine the association between time between concussions and differences in concussion presentation.