Affiliation of Concussion Historical past and Extended Restoration in Youth.
Chizuk HM, Cunningham A, Horn EC, Thapar RS, Willer BS, Leddy JJ, Haider MN. Clin J Sport Med. 2022;32(6):e573-e579. doi:10.1097/JSM.0000000000001044
Take-House Message
Athletes with three or extra prior concussions had been extra prone to develop persistent postconcussive signs and take longer to get well than friends with fewer earlier concussions.
Background
Persistent postconcussive signs are outlined in adults as signs lasting longer than 10 to 14 days; in kids, it has been outlined as taking longer than one month to get well. A historical past of three or extra concussions is related to an extended restoration in adults. Nonetheless, it stays unclear if that is true amongst pediatric sufferers.
Research Objectives
The authors investigated if a larger variety of prior concussions elevated the danger of persistent postconcussive signs in pediatric sufferers.
Strategies
The authors collected affected person information prospectively from three sports activities drugs clinics close to Buffalo, New York. Sufferers had been between 8 and 18 years previous, recognized with a concussion inside 14 days of the damage, had a documented variety of prior concussions, and had been handled till clinically recovered. The researchers outlined restoration as signs returning to regular at relaxation, regular bodily examination, and the flexibility to train and return to high school with out symptom exacerbation. The researchers calculated restoration time because the distinction between days from damage and when contributors recovered. Physicians recorded the variety of physician-diagnosed concussions or undiagnosed concussions that they deemed dependable primarily based on a affected person’s historical past.
Outcomes
The authors recruited 284 kids, with 270 used within the last evaluation. Fifteen kids had three or extra prior concussions. Whereas 32 to 38% of youth with a historical past of 0 to 2 prior concussions developed persistent signs, two-thirds of these with 3 or extra concussions developed persistent signs. The researchers discovered {that a} lower level of ≥ 3 or ≥4 concussions had the very best prediction fee of who would ultimately develop persistent signs.
Viewpoints
These outcomes show that pediatric sufferers with a historical past of three or extra concussions usually tend to develop persistent signs. It will likely be attention-grabbing to see if these findings could be replicated in a examine with extra folks with 3 or extra concussions. Nonetheless, these findings might maintain up nicely as a result of they agree with earlier analysis amongst adults who’ve skilled concussions.
Medical Implications
Clinicians ought to use this info to coach sufferers, notably those that have sustained a number of concussions, that their restoration is extra prone to take longer than their earlier concussions. It could be useful to tell school-based clinicians and directors {that a} affected person has a historical past of a number of concussions and may have an extended time to get well and extra educational lodging.
Questions for Dialogue
- Do different preinjury historical past components affect a affected person’s probability of sustaining a concussion?
Written by Mitchell Barnhart
Reviewed by Jeffrey Driban
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