Objectives Approximately 30% of children experience persistent post-concussive symptoms (pPCS) beyond 1-month postinjury. Research into the treatment of pPCS has mostly employed unimodal approaches. The primary aim of this study was to evaluate the feasibility and effectiveness of a multimodal intervention to accelerate recovery.

Design Pilot of active intervention arm of a symptom-targeted, multimodal treatment, Concussion Essentials (CE) to reduce pPCS.

Setting Royal Children’s Hospital (RCH), Melbourne.

Participants Families were recruited from the RCH emergency department (ED). Thirteen children completed the pilot trial and provided 3 and 6 month follow-up data.

Interventions Participants received weekly individualised, 1-hour intervention sessions for up to 8-weeks, or until symptom resolution. The intervention included education, physiotherapy and psychology modules. Up to two of these modules were delivered each week. The PCSI was administered weekly, and modules targeted to the most severe pPCS.

Outcome Measures Primary outcome: PCSI. Secondary outcomes: Return to normal activities, physical, psychological, cognitive, fatigue, sleep, and quality of life domains.

Main Results PCSI baseline mean symptom count was 13.30, reducing to 4.30 post-intervention and maintained at 6-months post-injury (M=3.30). PCSI total symptom severity improved from M=39.40, to 3.50 and 2.90 at post-intervention and 6 months.

Conclusions Results highlight the potential efficacy of an individualised multi-modal intervention to improve outcomes for children and adolescents with pPCS. Importantly, this intervention has the potential to transform clinical management of children and adolescents with pPCS in the community.