Concussion symptom presentation and clinical recovery among pediatric athletes: comparing concussions sustained during school and summer months

Abstract

ABSTRACT Objective We examined post-concussion symptom presentation, exercise, and sleep among pediatric athletes who sustained concussion during the school year vs. summer months. Methods We evaluated athletes 6–18 years old within 21-days of concussion. They reported symptoms (Health and Behavior Inventory), with cognitive/somatic domain sub-scores calculated, and indicated if they had exercised or experienced sleep problems since injury. We grouped patients by injury season: summer months (June–August) vs. school year (September–May). Results 350 patients (14.4 ± 2.4 years old; 37% female; initial visit 8.8 ± 5.3 days post-concussion) were seen for care: 24% sustained a concussion during summer months, 76% during the school year. Lower cognitive (median = 7 [IQR = 1, 15] vs. 9.5 [4, 17]; p = 0.01), but not somatic (7 [2.5, 11] vs. 8 [4, 13]; p = 0.06), HBI scores were observed for patients injured during the summer. Groups were similar in proportion exercising (16% vs 17%) and endorsing sleep problems (29% vs 31%). After adjustments, sustaining a concussion during the summer predicted total (β=-3.43; 95%CI = −6.50, −0.36; p = 0.029) and cognitive (β = -2.29; 95%CI = −4.22, −0.36; p = 0.02), but not somatic (β=-1.46; 95%CI = −2.84, −0.08; p = 0.04), symptom severity. Conclusion Pediatric patients with concussion may present with greater cognitive symptoms during the school year, compared to summer months.