The Variability of Recovery From Pediatric Concussion Using Multimodal Clinical Definitions
BACKGROUND: While concussions are common pediatric injuries, a lack of agreement on a standard definition of recovery creates multiple challenges for clinicians and researchers alike.
HYPOTHESIS: The percentage of concussed youth deemed recovered as part of a prospective cohort study will differ depending on the recovery definition.
STUDY DESIGN: Descriptive epidemiologic study of a prospectively enrolled observational cohort.
LEVEL OF EVIDENCE: Level 3.
METHODS: Participants aged 11 to 18 years were enrolled from the concussion program of a tertiary care academic center. Data were collected from initial and follow-up clinical visits ≤12 weeks from injury. A total of 10 recovery definitions were assessed: (1) cleared to full return to sports; (2) return to full school; (3) self-reported return to normal; (4) self-reported full return to school; (5) self-reported full return to exercise; (6) symptom return to preinjury state; (7) complete symptom resolution; (8) symptoms below standardized threshold; (9) no abnormal visio-vestibular examination (VVE) elements; and (10) ≤1 abnormal VVE assessments.
RESULTS: In total, 174 participants were enrolled. By week 4, 63.8% met at least 1 recovery definition versus 78.2% by week 8 versus 88.5% by week 12. For individual measures of recovery at week 4, percent recovered ranged from 5% by self-reported full return to exercise to 45% for ≤1 VVE abnormality (similar trends at 8 and 12 weeks).
CONCLUSION: There is wide variability in the proportion of youth considered recovered at various points following concussion depending on the definition of recovery, with higher proportions using physiologic examination-based measures and lower proportions using patient-reported measures.
CLINICAL RELEVANCE: These results further emphasize the need for a multimodal assessment of recovery by clinicians as a single and standardized definition of recovery that captures the broad impact of concussion on a given patient continues to be elusive.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Sports health - 16(2024), 1 vom: 29. Jan., Seite 79-88 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Corwin, Daniel J [VerfasserIn] |
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| Links: |
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| Themen: |
Concussion recovery |
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| Anmerkungen: |
Date Completed 20.12.2023 Date Revised 12.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/19417381231152448 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: While concussions are common pediatric injuries, a lack of agreement on a standard definition of recovery creates multiple challenges for clinicians and researchers alike | ||
| 520 | |a HYPOTHESIS: The percentage of concussed youth deemed recovered as part of a prospective cohort study will differ depending on the recovery definition | ||
| 520 | |a STUDY DESIGN: Descriptive epidemiologic study of a prospectively enrolled observational cohort | ||
| 520 | |a LEVEL OF EVIDENCE: Level 3 | ||
| 520 | |a METHODS: Participants aged 11 to 18 years were enrolled from the concussion program of a tertiary care academic center. Data were collected from initial and follow-up clinical visits ≤12 weeks from injury. A total of 10 recovery definitions were assessed: (1) cleared to full return to sports; (2) return to full school; (3) self-reported return to normal; (4) self-reported full return to school; (5) self-reported full return to exercise; (6) symptom return to preinjury state; (7) complete symptom resolution; (8) symptoms below standardized threshold; (9) no abnormal visio-vestibular examination (VVE) elements; and (10) ≤1 abnormal VVE assessments | ||
| 520 | |a RESULTS: In total, 174 participants were enrolled. By week 4, 63.8% met at least 1 recovery definition versus 78.2% by week 8 versus 88.5% by week 12. For individual measures of recovery at week 4, percent recovered ranged from 5% by self-reported full return to exercise to 45% for ≤1 VVE abnormality (similar trends at 8 and 12 weeks) | ||
| 520 | |a CONCLUSION: There is wide variability in the proportion of youth considered recovered at various points following concussion depending on the definition of recovery, with higher proportions using physiologic examination-based measures and lower proportions using patient-reported measures | ||
| 520 | |a CLINICAL RELEVANCE: These results further emphasize the need for a multimodal assessment of recovery by clinicians as a single and standardized definition of recovery that captures the broad impact of concussion on a given patient continues to be elusive | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a concussion recovery | |
| 650 | 4 | |a pediatric concussion | |
| 650 | 4 | |a postconcussion symptom inventory | |
| 650 | 4 | |a sport concussion assessment tool | |
| 650 | 4 | |a visio-vestibular examination | |
| 700 | 1 | |a Metzger, Kristina B |e verfasserin |4 aut | |
| 700 | 1 | |a McDonald, Catherine C |e verfasserin |4 aut | |
| 700 | 1 | |a Pfeiffer, Melissa R |e verfasserin |4 aut | |
| 700 | 1 | |a Arbogast, Kristy B |e verfasserin |4 aut | |
| 700 | 1 | |a Master, Christina L |e verfasserin |4 aut | |
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