TY - JOUR
T1 - Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes
AU - the CARE Consortium Investigators
AU - Asken, Breton M.
AU - Bauer, Russell M.
AU - Guskiewicz, Kevin M.
AU - McCrea, Michael A.
AU - Schmidt, Julianne D.
AU - Giza, Christopher C.
AU - Snyder, Aliyah R.
AU - Houck, Zachary M.
AU - Kontos, Anthony P.
AU - McAllister, Thomas W.
AU - Broglio, Steven P.
AU - Clugston, James R.
AU - Anderson, Scott
AU - Bazarian, Jeff
AU - Brooks, Alison
AU - Buckley, Thomas
AU - Chrisman, Sara
AU - Collins, Michael
AU - DiFiori, John
AU - Duma, Stefan
AU - Dykhuizen, Brian
AU - Eckner, James T.
AU - Feigenbaum, Luis
AU - Hoy, April
AU - Kelly, Louise
AU - Langford, T. Dianne
AU - Lintner, Laura
AU - McGinty, Gerald
AU - Mihalik, Jason
AU - Miles, Christopher
AU - Ortega, Justus
AU - Port, Nicholas
AU - Putukian, Margot
AU - Rowson, Steve
AU - Svoboda, Steven
N1 - Funding Information:
One or more of the authors has declared the following potential conflict of interest or source of funding: This publication was supported in part by the Grand Alliance Concussion Assessment, Research, and Education Consortium, which receives funding from the National Collegiate Athletic Association and the Department of Defense. The US Army Medical Research Acquisition Activity is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program (award W81XWH-14-2-0151). The study was also supported by National Center for Advancing Translational Sciences (UL1 RR029890) and Veterans Health Administration Office of Research and Development (1 I21 RX001730; R.M.B.).
Publisher Copyright:
© 2018, © 2018 The Author(s).
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background: Timely removal from activity after concussion symptoms remains problematic despite heightened awareness. Previous studies indicated potential adverse effects of continuing to participate in physical activity immediately after sustaining a concussion. Hypothesis/Purpose: The purpose was to determine the effect of timing of removal from play after concussion on clinical outcomes. It was hypothesized that immediate removal from activity after sport-related concussion (SRC) would be associated with less time missed from sport, a shorter symptomatic period, and better outcomes on acute clinical measures. Study Design: Cohort study; Level of evidence, 3. Methods: Data were reported from the National Collegiate Athletic Association and Department of Defense Grand Alliance: Concussion Awareness, Research, and Education (CARE) Consortium. Participants with 506 diagnosed SRCs from 18 sports and 25 institutions and military service academies were analyzed and classified as either immediate removal from activity (I-RFA) or delayed removal from activity (D-RFA). Outcomes of interest included time missed from sport attributed to their SRC, symptom duration, and clinical assessment scores. Results: There were 322 participants (63.6%) characterized as D-RFA. I-RFA status was associated with significantly less time missed from sport (R2 change =.022-.024, P <.001 to P =.001) and shorter symptom duration (R2 change =.044-.046, P <.001 [all imputations]) while controlling for other SRC recovery modifiers. These athletes missed approximately 3 fewer days from sport participation. I-RFA athletes had significantly less severe acute SRC symptoms and were at lower risk of recovery taking ≥14 days (relative risk =.614, P <.001, small-medium effect size) and ≥21 days (relative risk =.534, P =.010, small effect size). Conclusion: I-RFA is a protective factor associated with less severe acute symptoms and shorter recovery after SRC. Conveying this message to athletes, coaches, and others involved in the care of athletes may promote timely injury reporting.
AB - Background: Timely removal from activity after concussion symptoms remains problematic despite heightened awareness. Previous studies indicated potential adverse effects of continuing to participate in physical activity immediately after sustaining a concussion. Hypothesis/Purpose: The purpose was to determine the effect of timing of removal from play after concussion on clinical outcomes. It was hypothesized that immediate removal from activity after sport-related concussion (SRC) would be associated with less time missed from sport, a shorter symptomatic period, and better outcomes on acute clinical measures. Study Design: Cohort study; Level of evidence, 3. Methods: Data were reported from the National Collegiate Athletic Association and Department of Defense Grand Alliance: Concussion Awareness, Research, and Education (CARE) Consortium. Participants with 506 diagnosed SRCs from 18 sports and 25 institutions and military service academies were analyzed and classified as either immediate removal from activity (I-RFA) or delayed removal from activity (D-RFA). Outcomes of interest included time missed from sport attributed to their SRC, symptom duration, and clinical assessment scores. Results: There were 322 participants (63.6%) characterized as D-RFA. I-RFA status was associated with significantly less time missed from sport (R2 change =.022-.024, P <.001 to P =.001) and shorter symptom duration (R2 change =.044-.046, P <.001 [all imputations]) while controlling for other SRC recovery modifiers. These athletes missed approximately 3 fewer days from sport participation. I-RFA athletes had significantly less severe acute SRC symptoms and were at lower risk of recovery taking ≥14 days (relative risk =.614, P <.001, small-medium effect size) and ≥21 days (relative risk =.534, P =.010, small effect size). Conclusion: I-RFA is a protective factor associated with less severe acute symptoms and shorter recovery after SRC. Conveying this message to athletes, coaches, and others involved in the care of athletes may promote timely injury reporting.
KW - CARE Consortium
KW - brain injury
KW - concussion reporting
KW - mTBI
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U2 - 10.1177/0363546518757984
DO - 10.1177/0363546518757984
M3 - Article
C2 - 29558195
AN - SCOPUS:85046733490
VL - 46
SP - 1465
EP - 1474
JO - The Journal of sports medicine
JF - The Journal of sports medicine
SN - 0363-5465
IS - 6
ER -