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Longitudinal changes in health-related quality of life during concussion recovery among youth athletes
  1. Kelly Russell1,2,3,
  2. Erin Selci1,2,
  3. Samuel Fineblit4,
  4. Michael Ellis2,3,5
  1. 1Department of Pediatrics and Child Health, University of Manitoba, Canada
  2. 2Children’s Hospital Research Institute of Manitoba, Canada
  3. 3Canada North Concussion Network, Canada
  4. 4Faculty of Health Sciences, University of Manitoba, Canada
  5. 5Departments of Surgery and Pediatrics and Child Health, University of Manitoba, Canada


Objective Determine longitudinal changes in health-related quality of life (HRQoL) in youth during recovery from a sport-related concussion.

Design Prospective case-series.

Participants 68 youth (13–18 years; 62% male) with an acute sport-related concussion were enrolled with 5 lost to follow-up.

Intervention (or assessment of risk factors) Subsequently developing Post-Concussion Syndrome (PCS: symptomatic after 30 days), initial symptom severity (Post Concussion Symptom Scale), concussion history, sex, age, and academic accommodations during recovery.

Outcome measures PedsQL Cognitive Functioning Scale and PedsQL 4.0 measured physical, social, and emotional domains of HRQoL. They were administered before each appointment until medical clearance. Multivariable mixed modelling accounted for repeated measures within an athlete and expressed as point increase per week.

Main results Initial mean HRQoL was highest for social (non-PCS: 92.7 out of 100; PCS: 86.3), followed by emotional (non-PCS: 86.45; PCS: 69.7), physical (non-PCS: 80.95; PCS: 49.2), and cognitive domains (non-PCS: 69.1; PCS: 50.3). There was effect modification by developing PCS. Changes in HRQoL subscores were: cognitive functioning non-PCS (+9.8 points [95% CI: 6.9, 12.7]) and PCS (+4.2 points [95% CI: 2.8, 5.6]); social HRQoL non-PCS (+2.3 points [1.0, 4.0]) and PCS (+0.5 points [0.1, 1.0); emotional HRQoL non-PCS (+5.0 points [95% CI: 2.9, 7.0]) and PCS points (+2.2 [1.6, 2.9]); and physical non-PCS (+6.3 points [95% CI: [3.5, 9.2]) and PCS (+3.3 points (95% CI: 2.5, 4.2).

Conclusions HRQoL significantly improved longitudinally with greater improvement among non-PCS athletes. HRQoL impairment was most apparent in the cognitive and physical domains.

Competing interests None.

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