Abstract
Concussion is among the most common injuries in athletes. Over the past 10 years, concussion knowledge has expanded, and guidelines for management have changed. Recent changes include recommendations against strict mental and physical rest after sustaining a concussion, a better recognition of preexisting conditions predisposing protracted concussion recovery, and the addition of preliminary patient counseling and education about the expected course of concussion recovery. To assess the impact of changes in concussion management on the duration of symptoms in middle school and high school athletes after sustaining a first-time, sports-related concussion. A retrospective review was performed of medical records of athletes who sustained a concussion between 2016 and 2018 and were treated by the same primary care physician (J.M.N) using the revised approach to concussion management described. Patients were included if they were 11 to 18 years old and had a diagnosis of first-time concussion sustained while playing organized sports. Athletes who sustained a concomitant injury or sustained a concussion outside of organized sports were excluded from the study; athletes lost to follow-up or with incomplete forms were also excluded. Each athlete's length of symptomatic time from his or her concussion was calculated. This data was then compared with a previously-published data set of athletes who sustained a concussion between 2011 and 2013, with the same inclusion criteria but a different approach to concussion management. A total of 110 male and 72 female athletes (N=182) met the study's eligibility criteria. Collectively, athletes of both sexes from the 2016-2018 data set reported a higher incidence of preexisting conditions associated with prolonged concussion recovery compared with the data set of 2011-2013 athletes. However, both sexes from the 2016-2018 data setalso reported a shorter median duration of concussion symptoms compared with the 2011-2013 athletes (median duration 5 vs. 11days for male athletes and 7 vs. 28days for female athletes, respectively; p<0.001). Recent changes in concussion management have led to decreased duration of symptoms among 11- to 18-year-old athletes with first-time, sports-related concussions. These management changes include advocating for early activity, recognizing preexisting conditions, and educating athletes about the realities of concussion recovery.
Highlights
Context: Concussion is among the most common injuries in athletes
One of the major differences in sport-related concussion (SRC) management is the recommendation for athletes to undergo “strict rest” before 201319 and engage in “active rest” after new SRC guidelines were published in 2017.1 Strict rest instructs athletes to refrain from any physical or cognitive activity until concussion symptoms resolve,[6] while active rest recommends that athletes initiate low intensity physical or cognitive activity at 24 to 48 hours following an SRC.[1]
The purpose of our current study was to determine whether these changes in concussion management have hastened the resolution of symptoms in first-time sports-related concussions among middle school and high school athletes
Summary
Context: Concussion is among the most common injuries in athletes. Over the past 10 years, concussion knowledge has expanded, and guidelines for management have changed. Results: A total of 110 male and 72 female athletes (N=182) met the study’s eligibility criteria Athletes of both sexes from the 2016–2018 data set reported a higher incidence of preexisting conditions associated with prolonged concussion recovery compared with the data set of 2011–2013 athletes. Conclusion: Recent changes in concussion management have led to decreased duration of symptoms among 11- to 18-year-old athletes with first-time, sports-related concussions. These management changes include advocating for early activity, recognizing preexisting conditions, and educating athletes about the realities of concussion recovery. The purpose of our current study was to determine whether these changes in concussion management have hastened the resolution of symptoms in first-time sports-related concussions among middle school and high school athletes
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