Abstract
ObjectivesTo estimate the times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion, and to estimate the proportion of athletes who were participating at their pre-injury level of sport competition six months and one-year following sport-related concussion. DesignProspective cohort study. MethodsAmateur, adult athletes (16–38 years old) were diagnosed with sport-related concussion at a university-affiliated hospital emergency department. Participants were assessed within one-week, upon medical clearance to return to sporting activity, two weeks following return to sporting activity, six months, and 12 months following sport-related concussion. We assessed sex-, age-, and activity-matched non-injured, control participants at matched time-points. Participants were asked during each study assessment whether they were participating in any sport, in a different sport than before their sport-related concussion, in the same sport but at a lower level of competition than before their sport-related concussion, or in the same sport at the same level of competition than before their sport-related concussion. ResultsFifty concussed participants and 50 non-injured, control participants completed the study. The median times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion were 13 days (95%CI=12,16) and 31 days (95%CI=28,32), respectively. One-year following sport-related concussion, 52% of participants reported that they were no longer participating in the same sport and at the same level of competition as they were before their sport-related concussion, compared with only 24% of participants in the non-injured, control group (p=0.003). ConclusionsA greater percentage of athletes in the concussion group were not participating at their perceived pre-injury level of sport competition one-year following sport-related concussion compared with a non-injured control group. Factors that explain the lower proportion of amateur athletes participating at their pre-injury level of sport competition one-year after sport-related concussion are likely multifaceted and should be considered in future investigations.
Highlights
Many recreational, amateur, and elite athletes who sustain significant orthopedic injuries struggle to return to their pre-injury level of sport competition.[1,2] For example, one out of every three recreational and competitive-level athletes do not return to their pre-injury level of sport competition following anterior cruciate ligament (ACL) injury.[2]
We prospectively investigated the time taken to receive clearance to RTA and the time taken to return to pre-injury level of sport competition amongst amateur athletes who presented to a university-affiliated hospital emergency department following sport-related concussion
Amateur athletes who presented to a university-affiliated hospital emergency department following sport-related concussion received clearance to return to sporting activity, and returned to their pre-injury level of sport competition, on average, 13 and 31 days after injury, respectively
Summary
Amateur, and elite athletes who sustain significant orthopedic injuries struggle to return to their pre-injury level of sport competition.[1,2] For example, one out of every three recreational and competitive-level athletes do not return to their pre-injury level of sport competition following anterior cruciate ligament (ACL) injury.[2]. 75% of collegiate and professional athletes are deemed ready to return-to-sport within two weeks following concussive injury.[4,5] upon returnto-play some professional athletes have temporarily impaired sporting performance (e.g., adjusted plus-minus National Hockey League [NHL] scores and lower batting averages and decreased on-base percentages in Major League Baseball [MLB]) up to six weeks after sport-related concussion.[6,7] Many factors (e.g., psychological responses, medical care, and social support)[8,9,10] may influence athletes’ time taken to return to their pre-injury level of sport competition, and their sustained participation at pre-injury levels of sport competition after they have returned, following sport-related concussion. Examining the time taken by athletes to return to their pre-injury level of sport competition following concussion and estimating the proportion of athletes who, after returning to sport, are no longer participating at their pre-injury level of sport competition one-year following concussion, is an important step to inform strategies that may prevent post-injury attrition from sport
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