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Advances in concussion management
Health-related quality of life following sport-related concussion in interscholastic athletes
  1. Tamara C Valovich McLeod*,
  2. R Curtis Bay,
  3. Alison R Valier,
  4. Kenneth C Lam,
  5. John T Parsons
  1. Post-Professional Athletic Training, A.T. Still University, Mesa, Arizona, USA


    Objective To determine the impact of concussion on general, fatigue-specific, and headache-specific Health-related quality of life (HRQOL).

    Design Repeated measures.

    Setting High school athletic facilities.

    Patients Two hundred and fifty-nine adolescent athletes who sustained a concussion diagnosed by their athletic trainer (218 males, 41 females, age=15.9±1.2 years, grade=10.0±1.1).

    Interventions Participants completed the paediatric Quality of Life Inventory (PedsQL), PedsQL Multidimensional Fatigue Scale (MFS), and Headache Impact Test (HIT-6) during a preseason baseline (BL) and on days 3 (D3), 10 (D10) and 30 (D30) post-concussion.

    Main Outcome Measures Dependent variables included: 4 PedsQL subscale scores (physical (PF), emotional (EF), social (SOF), school (SCF) functioning), 3 MFS subscale scores (general (GF), sleep (SLF), cognitive (CF) fatigue), and the HIT-6 total score. Higher scores on the HIT-6 and lower scores on the PedsQL and MFS indicate lower HRQOL. Analyses were conducted using generalised estimating equations with follow-up Bonferroni corrections.

    Results All omnibus tests were significant (p<0.001). Athletes reported significantly lower HRQOL on D3 than BL for PF (D3=77.8, 95% CI 75.1 to 80.4; BL=92.9, 95% CI 91.4 to 94.4), SCF (D3=78.6, 95% CI 76.3 to 80.8; BL=83.9, 95% CI 81.8 to 86.0), CF(D3=73.2, 95% CI 70.3 to 76.1; BL=82.6, 95% CI 79.9 to 85.1), GF (D3=74.9, 95% CI 72.0 to 77.9; BL=85.1, 95% CI 82.8 to 87.4) and HIT-6 (D3=51.5, 95% CI 50.3 to 52.6; BL=45.4, 95% CI 44.5 to 46.4). All D10 and D30 subscale scores were significantly higher than BL.

    Conclusions Concussed athletes demonstrated lower general, fatigue-specific, and headache-specific HRQOL in the immediate days post-injury. These findings corroborate reports of the symptoms experienced acutely post-concussion and align with a time when athletes are often restricted from participating in physical and cognitive activities. The effects of concussion on HRQOL appear short-lived, with recovery by 10 days post-injury.

    Acknowledgements This study was funded by a grant from the National Operating Committee for Standards on Athletic Equipment (NOCSAE).

    Competing interests None.

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