Concussion-Recovery Trajectories Among Tactical Athletes: Results From the CARE Consortium

Assessments of the duration of concussion recovery have primarily been limited to sport-related concussions and male contact sports. Furthermore, whereas durations of symptoms and return-to-activity (RTA) protocols encompass total recovery, the trajectory of each duration has not been examined separ...

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Bibliographic Details
Published in:Journal of athletic training 2020-07, Vol.55 (7), p.658-665
Main Authors: Van Pelt, Kathryn L, Allred, C Dain, Brodeur, Rachel, Cameron, Kenneth L, Campbell, Darren E, D'Lauro, Christopher J, He, Xuming, Houston, Megan N, Johnson, Brian R, Kelly, Tim F, McGinty, Gerald, Meehan, Sean K, O'Donnell, Patrick G, Peck, Karen Y, Svoboda, Steven J, Pasquina, Paul, McAllister, Thomas, McCrea, Michael, Broglio, Steven P
Format: Article
Language:English
Subjects:
Adult
Asymptomatic
Athletic Coaches
Athletic Injuries - complications
Athletic Injuries - epidemiology
Brain
Brain Concussion - diagnosis
Brain Concussion - etiology
Brain Concussion - rehabilitation
Clinical Protocols - standards
Cohort Studies
Concussion
Consortia
Departments
Duration of Therapy
Environmental Influences
Female
Headaches
Humans
Individual Characteristics
Injuries
Male
Medical Evaluation
Military Health Services - statistics & numerical data
Military service
Military Training
Participant Characteristics
Physical Activities
Physical Education
Physical Fitness
Recovery (Medical)
Recovery of Function
Return to Sport - statistics & numerical data
Statistical Analysis
Survival analysis
Symptom Assessment - methods
Symptom Assessment - statistics & numerical data
Symptoms (Individual Disorders)
United States - epidemiology
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Summary:Assessments of the duration of concussion recovery have primarily been limited to sport-related concussions and male contact sports. Furthermore, whereas durations of symptoms and return-to-activity (RTA) protocols encompass total recovery, the trajectory of each duration has not been examined separately. To identify individual (eg, demographics, medical history), initial concussion injury (eg, symptoms), and external (eg, site) factors associated with symptom duration and RTA-protocol duration after concussion. Cohort study. Three US military service academies. A total of 10 604 cadets at participating US military service academies enrolled in the study and completed a baseline evaluation and up to 5 postinjury evaluations. A total of 726 cadets (451 men, 275 women) sustained concussions during the study period. Number of days from injury (1) until the participant became asymptomatic and (2) to complete the RTA protocol. Varsity athlete cadets took less time than nonvarsity cadets to become asymptomatic (hazard ratio [HR] = 1.75, 95% confidence interval = 1.38, 2.23). Cadets who reported less symptom severity on the Sport Concussion Assessment Tool, third edition (SCAT3), within 48 hours of concussion had 1.45 to 3.77 times shorter symptom-recovery durations than those with more symptom severity. Similar to symptom duration, varsity status was associated with a shorter RTA-protocol duration (HR = 1.74, 95% confidence interval = 1.34, 2.25), and less symptom severity on the SCAT3 was associated with a shorter RTA-protocol duration (HR range = 1.31 to 1.47). The academy that the cadet attended was associated with the RTA-protocol duration (P < .05). The initial total number of symptoms reported and varsity athlete status were strongly associated with symptom and RTA-protocol durations. These findings suggested that external (varsity status and academy) and injury (symptom burden) factors influenced the time until RTA.
ISSN:1062-6050
1938-162X
DOI:10.4085/1062-6050-10-19