Abstract
Aims
The objective of this study was to compare recovery time and duration of active rehabilitation following concussion between adolescents with and without attention-deficit/hyperactivity disorder (ADHD).
Methods
A retrospective cohort study was conducted among adolescents presenting to a specialty concussion clinic. One-quarter of the eligible episodes of care were selected. The final sample included 540 adolescents (ages 13–17 years, median age 15 years; 49.8% girls), of which 65 (12.0%) had a pre-injury diagnosis of ADHD. Days to recovery and days of active rehabilitation were examined.
Results
ADHD was not associated with recovery time (ADHD: median = 49 days, IQR = 25–77; No ADHD: median = 47 days, IQR = 29–85) in univariate (Z = −0.45; p = 0.65) or multivariable analyses (Hazard Ratio: 1.17 (0.85–1.61); χ2(1) = 0.95; p = 0.33). The duration of active rehabilitation services received did not differ between youth with ADHD (median = 38.5 days, IQR = 27.5–54.5) and without ADHD (median = 37.5 days, IQR = 18.5–66) in univariate (Z = −0.19; p = 0.85) or multivariable analyses (Hazard Ratio: 1.04 (0.67–1.63); χ2(1) = 0.03; p = 0.85).
Conclusions
Our findings support accumulating evidence that ADHD, in and of itself, is not a risk factor for longer recovery or worse outcomes following pediatric concussion.
Disclosure statement
Grant Iverson serves as a scientific advisor for NanoDx™, Sway Operations, LLC, and Highmark, Inc. He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs. Drs. Cook and Teel wrote the first draft of the manuscript. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript.
Additional information
Funding
Notes on contributors
Nathan E. Cook
Nathan E. Cook, Ph.D. is an Assistant Professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. He is a Pediatric Neuropsychologist at the MassGeneral Hospital for Children Sports Concussion Program in Boston, Massachusetts, USA.
Elizabeth Teel
Elizabeth Teel, Ph.D. is a Postdoctoral Fellow in the School of Physical and Occupational Therapy at McGill University in Montreal, Quebec, Canada.
Grant L. Iverson
Grant L. Iverson, Ph.D. is a Professor in the Department of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital and Harvard Medical School. He is the Director of the Concussion Research Program for the Spaulding Research Institute. He is the Director of the MassGeneral Hospital for Children Sports Concussion Program in Boston, Massachusetts, USA.
Deborah Friedman
Deborah Friedman, BSc, pht, M Mgmt is an Associate Professor in the Departments of Pediatrics & Pediatric Surgery, an Assistant Dean of Student Affairs and Co-Director of the WELL Office in the Faculty of Medicine & Health Sciences at McGill University in Montreal Quebec. She is also the Director of Trauma and the Director of the Canadian Hospitals Injury Reporting Prevention Program at the Montreal Children’s Hospital McGill University Health Centre Trauma Centre in Montreal, Quebec.
Lisa Grilli
Lisa Grilli, MSc, pht is a trauma coordinator in the Mild Traumatic Brain Injury Clinic and Trauma Research Program at the Montreal Children’s Hospital of the McGill University Health Center in Montreal.
Isabelle Gagnon
Isabelle Gagnon, PT, PhD is an Associate Professor in the School of Physical and Occupational Therapy at McGill University. She is a clinician-scientist at the Montreal Children’s Hospital of the McGill University Health Center in Montreal, where she is also an Associate Director (Research) in the Division of Pediatric Emergency Medicine.