Recovery progression and symptom resolution in sport-related mild traumatic brain injury

ABSTRACT

Objective: To characterize the recovery progression of a group of athletes who participated in a concussion management program based on (1) group analysis and (2) individual analysis.

Setting: Concussion management clinic.

Participants: Thirty athletes (22 males, 8 females; baseline age = 16.23 ± 2.40 years) who had undergone four assessments: one baseline and three post-injury assessments at 3, 8, 15 days post-injury.

Design: Retrospective clinical.

Main Measures: Four neurocognitive scores of the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) including verbal memory, visual memory, speed of processing and reaction time and also a total symptom score.

Results: Group-analysis showed a clear decline in verbal memory (F(3, 87) = 7.36, p < 0.000) and an increase in self-reported symptoms (χ²(3, N = 30) = 48.703, p < 0.000), 3 days post-injury. By day 8, athletes had returned to their baseline levels for verbal memory and were not experiencing symptoms. When athletes’ scores were examined individually, at 3 days post-injury, 60% of the athletes showed deficits on two or more of the ImPACT variables. This rate dropped to 23% at 8 days post-injury and remained the same (23%) 15 days post-injury.

Conclusions: In concussion recovery, variability is the rule, rather than the exception, with regard to both impaired neurocognitive functions and recovery duration.

KEYWORDS:

• Cognitive impairments
• group analysis
• individual analysis
• recovery duration
• sports-related concussion
• symptoms

Acknowledgments

The authors thank the students who assisted in data collection and the athletes who participated in this study. The authors also acknowledge the kind assistance of Dr Osama Mikhail and Dr Joao Ferreira-Pinto.

Declaration of interest

The authors report no conflicts of interest.

Funding

The data for this study were made available from the Concussion Management Clinic at the University of Texas at El Paso, through an Advanced Rehabilitation Research Training (ARRT) grant from the US Department of Education to the principal investigator, Dr Anthony P. Salvatore.

Notes

^1. First assessment = baseline or pre-injury assessment; second assessment = first post-injury assessment, on average, 3 days post-injury; third assessment = second post-injury assessment, on average, 8 days post-injury; fourth assessment = third post-injury assessment, on average, 15 days post-injury.

^2. Effect size shows the size of the significant effect. Here and with regard to the verbal memory, for example it shows a large amount of variability in verbal memory was related to variability across the assessment periods.

^3. In order to better understand the patterns in context, both Tables 4 and 6 should be reviewed.

Additional information

Funding

The data for this study were made available from the Concussion Management Clinic at the University of Texas at El Paso, through an Advanced Rehabilitation Research Training (ARRT) grant from the US Department of Education to the principal investigator, Dr Anthony P. Salvatore.