Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Variations in Time to Recovery from Pediatric Concussion Based on Differing Outcomes of Interest
Clinical Examination Tools
P1 - Poster Session 1 (7:00 AM-3:15 PM)
009

Pediatric concussion studies are hindered by a common significant limitation: lack of agreement on a standard definition of “recovery.” A variety of clinical outcomes of interest utilized across studies, including symptom self-report, neurocognitive testing results, self-reported return to activity, and physician clearance for activity, leads to challenges for both research, as well as clinical concussion management.

To quantify variability in pediatric concussion recovery across multiple outcomes of interest

We enrolled concussed youth, ages 11-18 years, from a specialty sports medicine clinic ≤28 days of injury. Patients were followed as part of clinical care for concussion for up to 13 weeks. At each visit, participants completed questionnaires and a battery of clinical measures. From these data, we constructed 10 potential definitions of recovery:  3 based on self-reported symptoms (change from pre-injury, no symptoms, below pre-determined thresholds), 2 based on visio-vestibular examination (VVE) deficits (none, ≤1), 2 based on physician clearance (for return to school/sport), and 3 based on self-assessment ( “back to normal”, return to school/exercise). 

174 concussed youth were enrolled (median age: 15 years, 54.6% female) with a median time from injury to initial visit of 12 days (IQR: 7, 20). Median number of visits was 2 (range: 1, 5). We observed a wide variation in the proportion of participants recovered across the 10 definitions. Depending on definition, between 4% and 45% were considered recovered within 4 weeks, and between 10% and 80% were considered recovered at the end of follow-up. The VVE-based definition (≤1 deficit) consistently had the highest proportion recovered at all time points, while self-reported return to exercise had the lowest proportion.

Recovery from concussion is not a single unitary point in time.  These results will provide valuable guidance to clinicians in managing concussion and researchers in designing future observational and interventional trials of pediatric concussion.
Authors/Disclosures
Christina Master, MD, FAAP, CAQSM (Children's Hospital of Philadelphia)
PRESENTER
The institution of Dr. Master has received research support from NIH. The institution of Dr. Master has received research support from DoD. The institution of Dr. Master has received research support from AMSSM. The institution of Dr. Master has received research support from PA Department of Health.
No disclosure on file
Daniel Corwin Mr. Corwin has nothing to disclose.
No disclosure on file
No disclosure on file
Kristy Arbogast The institution of Kristy Arbogast has received research support from NIH. The institution of Kristy Arbogast has received research support from Pennsylvania Department of Health. The institution of Kristy Arbogast has received research support from Football Research Inc.