Sunday, April 14, 2024

1… 2… 3… Prior Concussions Predict Persistent Postconcussion Signs in Youth


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

https://journals.lww.com/cjsportsmed/Summary/2022/11000/Association_of_Concussion_History_and_Prolonged.19.aspx

Take-House Message

Athletes with three or extra prior concussions have 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 youngsters, 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. Nevertheless, it stays unclear if that is true amongst pediatric sufferers.

Examine Targets

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 data prospectively from three sports activities drugs clinics close to Buffalo, New York. Sufferers have been between 8 and 18 years previous, identified with a concussion inside 14 days of the harm, had a documented variety of prior concussions, and have been handled till clinically recovered. The researchers outlined restoration as signs returning to regular at relaxation, regular bodily examination, and the power to train and return to high school with out symptom exacerbation. The researchers calculated restoration time because the distinction between days from harm and when individuals recovered. Physicians recorded the variety of physician-diagnosed concussions or undiagnosed concussions that they deemed dependable based mostly on a affected person’s historical past.

Outcomes

The authors recruited 284 youngsters, with 270 used within the closing evaluation. Fifteen youngsters 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 finally 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 fascinating to see if these findings could be replicated in a examine with extra individuals with 3 or extra concussions. Nevertheless, these findings could maintain up effectively as a result of they agree with earlier analysis amongst adults who’ve skilled concussions.

Scientific Implications

Clinicians ought to use this info to coach sufferers, significantly those that have sustained a number of concussions, that their restoration is extra prone to take longer than their earlier concussions. It might be useful to tell school-based clinicians and directors {that a} affected person has a historical past of a number of concussions and might have an extended time to get well and extra educational lodging.

Questions for Dialogue

  1. Do different preinjury historical past components affect a affected person’s chance of sustaining a concussion?

Written by Mitchell Barnhart
Reviewed by Jeffrey Driban

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