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    ACUTE EFFECTS AND RECOVERY TIME FOLLOWING CONCUSSION IN COLLEGIATE FOOTBALL PLAYERS

    McCrea M, Guskiewicz KM, Marshall SW, et al. JAMA 2003;290:2556–63
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    Background:
 There is a lack of empirical data on the recovery time following sport related concussion and this makes clinical decision about return to play difficult.

    Research question/s:
 What are the immediate effects and what is the natural recovery course (symptoms, cognitive functioning, and postural stability) following sport related concussion?

    Methodology:
 Subjects: 1631 football players from 15 colleges in the USA.

    Experimental procedure: All players underwent preseason baseline testing on concussion assessment measures in 1999, 2000, and 2001. 94 players with concussion (CONC group; based on American Academy of Neurology criteria) and 56 non-injured controls (CON group) underwent assessment of symptoms, cognitive functioning, and postural stability at 3 hours, and 1, 2, 3, 5, 7, and 90 days post injury (84% compliance).

    Measures of outcome: Scores on the Graded Symptom Checklist (GSC), Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and a neuropsychological test battery.

    Main finding/s:
 The CONC group exhibited more severe symptoms (GSC score 20.93 [95% CI 15.65 to 26.21] points higher than CON), cognitive impairment (SAC score 2.94 [95% CI 1.50 to 4.38] points lower than CON), and balance problems (BESS score 5.81 [95% CI -0.67 to 12.30] points higher than CON) immediately after concussion. Symptoms gradually resolved by day 7 (GSC mean difference 0.33; 95% CI -1.41 to 2.06), cognitive functioning improved to baseline levels within 5–7 days (day 7 SAC mean difference -0.03; 95% CI -1.33 to 1.26), and balance deficits dissipated within 3–5 days after injury (day 5 BESS mean difference -0.31; 95% CI -3.02 to 2.40).


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    Mild impairments in cognitive processing and verbal memory evident on neuropsychological testing 2 days after concussion resolved by day 7.

    There were no significant differences in symptoms or functional impairments in the CONC and CON groups 90 days after concussion.

    Conclusion/s: …

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