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Prospective observational cohort of paediatricpediatric sport-related concussion
  1. Neil Dilworth,
  2. Siobhan Karam,
  3. Ryan Eardley,
  4. Sari Kraft,
  5. Hemen Shukla,
  6. Mark Leung,
  7. Ira Smith
  1. Women’s College Hospital, University of Toronto, Toronto, Canada

Abstract

Objective To determine the symptom duration, and time to return to school and sport after sport-related concussion in paediatric population aged 12–18 years. Symptom duration was hypothesised to be >7–10 days.

Design Prospective observational cohort study.

Setting Large urban community primary care sports medicine clinic.

Paticipants 30 participants age 12–18 years (Male: n=27;Female: n=3) presenting to clinic ≤14 days with sport-related concussion. 100% completed study. Exclusion criteria: age <12 and >18 years, presentation ≥15 days, non-sport related concussion.

Independent variable(s)/modifiers Sport, SCAT3 score, past medical and concussion history, objective assessment variables (oculomotor, near-point convergence, vestibular, cognitive, cervical dysfunction).

Outcome measures Symptom duration, return to sport, return to school (days)

Main results Most concussions occurred playing ice-hockey (53%), followed by Canadian football and basketball. Mean intake SCAT3 symptom number was 10 and symptom score was 22. Patient characteristics included prior concussion (50%), prior neurological conditions (40%), and pre-existing psychological diagnosis (20%). The mean initial exam findings included near point convergence=6.5 cm and Balance Error Scoring System=26.1/30. Vestibular dysfunction (46.7%), cervical pain (53.3%), and abnormal coordination in (43.3%) were present. Mean duration of symptoms was 30.6 days; return to school was 23.9 days. 73.3% of patients would return to sport within 3 months (mean=34.6 days).

Conclusions Sport-related concussion symptoms resolved ≥30 days after injury confirming prolonged symptoms in an adolescent population, affecting return to school and sport. Future larger similar prospective studies may identify associations between past medical history or clinical exam findings and symptom duration, return to school and sport.

Competing interests None.

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