Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes

Breton M Asken; Russell M Bauer; Kevin M Guskiewicz; Michael A McCrea; Julianne D Schmidt; Christopher C Giza; Aliyah R Snyder; Zachary M Houck; Anthony P Kontos; Thomas W McAllister; Steven P Broglio; James R Clugston; Scott Anderson; Jeff Bazarian; Alison Brooks; Thomas Buckley; Sara Chrisman; Michael Collins; John DiFiori; Stefan Duma; Brian Dykhuizen; James T Eckner; Luis Feigenbaum; April Hoy; Louise Kelly; T Dianne Langford; Laura Lintner; Gerald McGinty; Jason Mihalik; Christopher Miles; Justus Ortega; Nicholas Port; Margot Putukian; Steve Rowson; Steven Svoboda

doi:10.1177/0363546518757984

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Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes

Journal article

Open access

Peer reviewed

Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes

Breton M Asken, Russell M Bauer, Kevin M Guskiewicz, Michael A McCrea, Julianne D Schmidt, Christopher C Giza, Aliyah R Snyder, Zachary M Houck, Anthony P Kontos, Thomas W McAllister, …

The American journal of sports medicine, Vol.46(6), pp.1465-1474

2018-05

DOI: https://doi.org/10.1177/0363546518757984

PMCID: PMC6988451

PMID: 29558195

Abstract

Humans

Athletic Injuries - therapy

Male

Brain Concussion - therapy

Recovery of Function

Universities

Young Adult

Rest

Students

Time Factors

Sports Medicine

Return to Sport

Adolescent

Female

Cohort Studies

Timely removal from activity after concussion symptoms remains problematic despite heightened awareness. Previous studies indicated potential adverse effects of continuing to participate in physical activity immediately after sustaining a concussion. Hypothesis/Purpose: The purpose was to determine the effect of timing of removal from play after concussion on clinical outcomes. It was hypothesized that immediate removal from activity after sport-related concussion (SRC) would be associated with less time missed from sport, a shorter symptomatic period, and better outcomes on acute clinical measures. Cohort study; Level of evidence, 3. Data were reported from the National Collegiate Athletic Association and Department of Defense Grand Alliance: Concussion Awareness, Research, and Education (CARE) Consortium. Participants with 506 diagnosed SRCs from 18 sports and 25 institutions and military service academies were analyzed and classified as either immediate removal from activity (I-RFA) or delayed removal from activity (D-RFA). Outcomes of interest included time missed from sport attributed to their SRC, symptom duration, and clinical assessment scores. There were 322 participants (63.6%) characterized as D-RFA. I-RFA status was associated with significantly less time missed from sport ( R change = .022-.024, P < .001 to P = .001) and shorter symptom duration ( R change = .044-.046, P < .001 [all imputations]) while controlling for other SRC recovery modifiers. These athletes missed approximately 3 fewer days from sport participation. I-RFA athletes had significantly less severe acute SRC symptoms and were at lower risk of recovery taking ≥14 days (relative risk = .614, P < .001, small-medium effect size) and ≥21 days (relative risk = .534, P = .010, small effect size). I-RFA is a protective factor associated with less severe acute symptoms and shorter recovery after SRC. Conveying this message to athletes, coaches, and others involved in the care of athletes may promote timely injury reporting.

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Citation topics: 1 Clinical & Life Sciences; 1.134 Trauma & Emergency Surgery; 1.134.286 Traumatic Brain Injury
Web Of Science research areas: Orthopedics; Sport Sciences
ESI research areas: Clinical Medicine

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Title: Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes
Creators: Breton M Asken - Investigation performed at the University of Florida, Gainesville, Florida, USA
Russell M Bauer - Investigation performed at the University of Florida, Gainesville, Florida, USA
Kevin M Guskiewicz - Investigation performed at the University of Florida, Gainesville, Florida, USA
Michael A McCrea - Investigation performed at the University of Florida, Gainesville, Florida, USA
Julianne D Schmidt - Investigation performed at the University of Florida, Gainesville, Florida, USA
Christopher C Giza - Investigation performed at the University of Florida, Gainesville, Florida, USA
Aliyah R Snyder - Investigation performed at the University of Florida, Gainesville, Florida, USA
Zachary M Houck - Investigation performed at the University of Florida, Gainesville, Florida, USA
Anthony P Kontos - Investigation performed at the University of Florida, Gainesville, Florida, USA
Thomas W McAllister - Investigation performed at the University of Florida, Gainesville, Florida, USA
Steven P Broglio - Investigation performed at the University of Florida, Gainesville, Florida, USA
James R Clugston - Investigation performed at the University of Florida, Gainesville, Florida, USA
Scott Anderson - Investigation performed at the University of Florida, Gainesville, Florida, USA
Jeff Bazarian - Investigation performed at the University of Florida, Gainesville, Florida, USA
Alison Brooks - Investigation performed at the University of Florida, Gainesville, Florida, USA
Thomas Buckley - Investigation performed at the University of Florida, Gainesville, Florida, USA
Sara Chrisman - Investigation performed at the University of Florida, Gainesville, Florida, USA
Michael Collins - Investigation performed at the University of Florida, Gainesville, Florida, USA
John DiFiori - Investigation performed at the University of Florida, Gainesville, Florida, USA
Stefan Duma - Investigation performed at the University of Florida, Gainesville, Florida, USA
Brian Dykhuizen - Investigation performed at the University of Florida, Gainesville, Florida, USA
James T Eckner - Investigation performed at the University of Florida, Gainesville, Florida, USA
Luis Feigenbaum - Investigation performed at the University of Florida, Gainesville, Florida, USA
April Hoy - Investigation performed at the University of Florida, Gainesville, Florida, USA
Louise Kelly - Investigation performed at the University of Florida, Gainesville, Florida, USA
T Dianne Langford - Investigation performed at the University of Florida, Gainesville, Florida, USA
Laura Lintner - Investigation performed at the University of Florida, Gainesville, Florida, USA
Gerald McGinty - Investigation performed at the University of Florida, Gainesville, Florida, USA
Jason Mihalik - Investigation performed at the University of Florida, Gainesville, Florida, USA
Christopher Miles - Investigation performed at the University of Florida, Gainesville, Florida, USA
Justus Ortega - Investigation performed at the University of Florida, Gainesville, Florida, USA
Nicholas Port - Investigation performed at the University of Florida, Gainesville, Florida, USA
Margot Putukian - Investigation performed at the University of Florida, Gainesville, Florida, USA
Steve Rowson - Investigation performed at the University of Florida, Gainesville, Florida, USA
Steven Svoboda - Investigation performed at the University of Florida, Gainesville, Florida, USA
Publication Details: The American journal of sports medicine, Vol.46(6), pp.1465-1474
Publisher: United States
Grant note: I21 RX001730 / RRD VA UL1 RR029890 / NCRR NIH HHS
Academic Unit: Miller School of Medicine; UMMG Dept of Physical Therapy
Language: English
Resource Type: Journal article
PMID: 29558195
PMCID: PMC6988451
Record Identifier: 991031577686902976