For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
29
views
125
references
 Top references
cited by
156
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      473
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Predictors of clinical recovery from concussion: a systematic review

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          A systematic review of factors that might be associated with, or influence, clinical recovery from sport-related concussion. Clinical recovery was defined functionally as a return to normal activities, including school and sports, following injury.

          Design

          Systematic review.

          Data sources

          PubMed, PsycINFO, MEDLINE, CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus and Web of Science.

          Eligibility criteria for selecting studies

          Studies published by June of 2016 that addressed clinical recovery from concussion.

          Results

          A total of 7617 articles were identified using the search strategy, and 101 articles were included. There are major methodological differences across the studies. Many different clinical outcomes were measured, such as symptoms, cognition, balance, return to school and return to sports, although symptom outcomes were the most frequently measured. The most consistent predictor of slower recovery from concussion is the severity of a person’s acute and subacute symptoms. The development of subacute problems with headaches or depression is likely a risk factor for persistent symptoms lasting greater than a month. Those with a preinjury history of mental health problems appear to be at greater risk for having persistent symptoms. Those with attention deficit hyperactivity disorder (ADHD) or learning disabilities do not appear to be at substantially greater risk. There is some evidence that the teenage years, particularly high school, might be the most vulnerable time period for having persistent symptoms—with greater risk for girls than boys.

          Conclusion

          The literature on clinical recovery from sport-related concussion has grown dramatically, is mostly mixed, but some factors have emerged as being related to outcome.

          Related collections

          Most cited references125

          • Record: found
          • Abstract: found
          • Article: not found

          Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED.

          Roger Zemek, Nick Barrowman, Stephen B. Freedman … (2016)
          Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist.
          Article 0 comments Cited 204 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes.

            Robin Lovell-Badge, Melvin Field, Joseph C. Maroon … (2003)
            To evaluate symptoms and neurocognitive recovery patterns after sports-related concussion in high school and college athletes. College athletes (n = 371) and high school athletes (n = 183) underwent baseline neuropsychological evaluation between 1997 and 2000. Individuals who received a concussion during athletic competition (n = 54) underwent serial neuropsychologic evaluation after injury and were compared with a noninjured within-sample control group (n = 38). Main outcome measures included structured interview, four memory measures, and Concussion Symptom Scale ratings. Baseline to postinjury change scores and multiple analyses of variance were used to compare recovery curves within and between groups. High school athletes with concussion had prolonged memory dysfunction compared with college athletes with concussion. High school athletes performed significantly worse than age-matched control subjects at 7 days after injury (F = 2.90; P <.005). College athletes, despite having more severe in-season concussions, displayed commensurate performance with matched control subjects by day 3 after concussion. Self-report of postconcussion symptoms by student athletes was not predictive of poor performance on neuropsychologic testing. Caution and systematic evaluation should be undertaken before returning athletes with concussion to competition. Sole reliance on the self-report of the athlete may be inadequate. Preliminary data may suggest a more protracted recovery from concussion in high school athletes.
            Article 0 comments Cited 132 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The role of age and sex in symptoms, neurocognitive performance, and postural stability in athletes after concussion.

              Tracey Covassin, R.J. Elbin, William Harris … (2012)
              Researchers have begun to focus on age and sex differences in concussion outcomes. Results suggest that younger athletes and female athletes may take longer to recover from a concussion. However, little is known about the interactive effects of age and sex on symptoms, neurocognitive testing (NCT), and postural stability. The purpose of the study was to examine sex and age differences in symptoms, NCT, and postural stability following concussion. We hypothesized that high school and female athletes would have worse symptoms, NCT, and postural stability than college and male athletes, respectively. Cohort study; Level of evidence, 2. A total of 296 concussed athletes from a multistate, 2-year study were enrolled in this study. Participants completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) and Post-Concussion Symptom Scale (PCSS) at baseline and again at 2, 7, and 14 days after concussion. Participants completed the Balance Error Scoring System (BESS) at 1, 2, and 3 days after concussion. Female athletes performed worse than male athletes on visual memory (mean, 65.1% and 70.1%, respectively; P = .049) and reported more symptoms (mean, 14.4 and 10.1, respectively) after concussion (P = .035). High school athletes performed worse than college athletes on verbal (mean, 78.8% and 82.7%, respectively; P = .001) and visual (mean, 65.8% and 69.4%, respectively; P = .01) memory. High school athletes were still impaired on verbal memory 7 days after concussion compared with collegiate athletes (P = .001). High school male athletes scored worse on the BESS than college male athletes (mean, 18.8 and 13.0, respectively; P = .001). College female athletes scored worse on the BESS than high school female athletes (mean, 21.1 and 16.9, respectively; P = .001). The results of the current study supported age differences in memory and sex differences in memory and symptoms and an interaction between age and sex on postural stability after concussion that warrant consideration from clinicians and researchers when interpreting symptoms, specific components of NCT, and postural stability tests. Future research should develop and assess interventions tailored to age and sex differences and include younger (<14 years) participants.
              Article 0 comments Cited 117 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Br J Sports Med
                Journal ID (iso-abbrev): Br J Sports Med
                Journal ID (hwp): bjsports
                Journal ID (publisher-id): bjsm
                Title: British Journal of Sports Medicine
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 0306-3674
                ISSN (Electronic): 1473-0480
                Publication date (Print): June 2017
                Publication date (Electronic): 31 May 2017
                Volume: 51
                Issue: 12
                Pages: 941-948
                Affiliations
                [1 ]departmentDepartment of Physical Medicine and Rehabilitation , Harvard Medical School , Charlestown, Massachusetts, USA
                [2 ]departmentSport Concussion Program , MassGeneral Hospital for Children , Boston, Massachusetts, USA
                [3 ]departmentCentre for Stroke and Brain Injury, School of Medicine and Public Health , University of Newcastle , Newcastle, New South Wales, Australia
                [4 ]departmentSchool of Psychological Sciences , Monash University , Melbourne, Australia
                [5 ]departmentDepartment of Neurological Surgery , Vanderbilt University Medical Center , Nashville, Tennessee, USA
                [6 ]departmentDepartment of Psychiatry & Neurobehavioral Sciences , University of Virginia , Charlottesville, Virginia, USA
                [7 ]departmentDepartments of Neurological Surgery, Orthopaedic Surgery & Rehabilitation, and Psychiatry & Behavioral Sciences , Vanderbilt University School of Medicine , Nashville, Tennessee, USA
                Author notes
                [Correspondence to ] Dr Grant L Iverson, Center for Health and Rehabilitation Research, Department of Physical Medicine and Rehabilitation, 79/96 Thirteenth Street, Charlestown Navy Yard, Charlestown, MA, 02129, USA; giverson@ 123456mgh.harvard.edu
                Article
                Publisher ID: bjsports-2017-097729
                DOI: 10.1136/bjsports-2017-097729
                PMC ID: 5466929
                PubMed ID: 28566342
                SO-VID: 0725786e-4865-4851-afa2-d17c8ef05338
                Copyright © © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date accepted : 10 March 2017
                Categories
                Subject: Review
                Subject: 1506
                Custom metadata
                special-feature unlocked

                ScienceOpen disciplines: Sports medicine
                Keywords: concussion,sex differences,outcome,moderators,age,sports
                Data availability:
                ScienceOpen disciplines: Sports medicine
                Keywords: concussion, sex differences, outcome, moderators, age, sports

                Comments

                Comment on this article

                scite_

                Similar content473

                See all similar

                Cited by213

                See all cited by

                Most referenced authors1,031

                See all reference authors