TY - JOUR
T1 - Concussion-recovery trajectories among tactical athletes
T2 - Results from the CARE consortium
AU - van Pelt, Kathryn L.
AU - Dain Allred, C.
AU - Brodeur, Rachel
AU - Cameron, Kenneth L.
AU - Campbell, Darren E.
AU - D’Lauro, Christopher J.
AU - He, Xuming
AU - Houston, Megan N.
AU - Johnson, Brian R.
AU - Kelly, Tim F.
AU - McGinty, Gerald
AU - Meehan, Sean K.
AU - O’Donnell, Patrick G.
AU - Peck, Karen Y.
AU - Svoboda, Steven J.
AU - Pasquina, Paul
AU - McAllister, Thomas
AU - McCrea, Michael
AU - Broglio, Steven P.
N1 - Publisher Copyright:
© by the National Athletic Trainers’ Association, Inc.
PY - 2020/7
Y1 - 2020/7
N2 - Context: 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. Objective: 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. Design: Cohort study. Setting: Three US military service academies. Patients or Other Participants: 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. Main Outcome Measure(s): Number of days from injury (1) until the participant became asymptomatic and (2) to complete the RTA protocol. Results: Varsity athlete cadets took less time than nonvarsity cadets to become asymptomatic (hazard ratio [HR] ¼ 1.75, 95% confidence interval ¼ 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 ¼ 1.74, 95% confidence interval ¼ 1.34, 2.25), and less symptom severity on the SCAT3 was associated with a shorter RTA-protocol duration (HR range ¼ 1.31 to 1.47). The academy that the cadet attended was associated with the RTA-protocol duration (P, .05). Conclusions: 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.
AB - Context: 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. Objective: 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. Design: Cohort study. Setting: Three US military service academies. Patients or Other Participants: 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. Main Outcome Measure(s): Number of days from injury (1) until the participant became asymptomatic and (2) to complete the RTA protocol. Results: Varsity athlete cadets took less time than nonvarsity cadets to become asymptomatic (hazard ratio [HR] ¼ 1.75, 95% confidence interval ¼ 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 ¼ 1.74, 95% confidence interval ¼ 1.34, 2.25), and less symptom severity on the SCAT3 was associated with a shorter RTA-protocol duration (HR range ¼ 1.31 to 1.47). The academy that the cadet attended was associated with the RTA-protocol duration (P, .05). Conclusions: 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.
KW - Athletes
KW - Mild traumatic brain injury
KW - Return to activity
UR - https://www.scopus.com/pages/publications/85088609539
U2 - 10.4085/1062-6050-10-19
DO - 10.4085/1062-6050-10-19
M3 - Article
C2 - 32556201
AN - SCOPUS:85088609539
SN - 1062-6050
VL - 55
SP - 658
EP - 665
JO - Journal of Athletic Training
JF - Journal of Athletic Training
IS - 7
ER -