Symptom recovery trajectories in children aged 5 to 12 years are similar for both sport-related and non–sport-related concussions (excluding motor vehicle crashes and assaults), suggesting that management protocols for both types of injury can be largely the same, according to a recent study.
The cohort study, conducted from August 2013 to June 2015, examined the recovery trajectories of children aged 5 to 12 years with acute concussions, focusing on the differences between sport-related concussions (SRC) and non–sport-related concussions (non-SRC). The study, which was part of the Predicting and Preventing Postconcussive Problems in Pediatrics study, involved 1,747 children from nine pediatric emergency departments within the Pediatric Emergency Research Canada network.
Of those recruited, 477 children aged 5-7 years, and 1,157 aged 8-12 years were included in the final analysis. The study population was predominantly male (62.4% in the 5-7 age group and 65.3% in the 8-12 age group). The primary aim was to determine whether symptom recovery differed between children who sustained SRC and those with non-SRC. Participants were assessed using the Post-Concussion Symptom Inventory (PCSI) at 1, 2-, 4-, 8-, and 12-weeks post-injury. The study's analysis utilized mixed-effects models, adjusting for factors such as age, injury setting, baseline symptoms, and other clinical characteristics, to assess symptom change over time.
The results, published in JAMA Network Open, revealed that recovery trajectories were similar between the SRC and non-SRC groups. For children aged 5 to 7 years, 43.4% (n=207) sustained SRC, and for those aged 8 to 12 years, 67.2% (n=790) sustained SRC. No significant differences were found in symptom trajectories between the SRC and non-SRC groups (β = −0.09; 95% confidence interval [CI], −1.10 to 0.92 for 5-7 years and β = 0.11; 95% CI, −1.50 to 1.70 for 8-12 years). Similarly, symptom recovery did not differ significantly based on sport classification (contact/collision, limited contact, or noncontact).
Several factors were associated with slower recovery, including appearing dazed and confused, anxiety, loss of consciousness, answering questions slowly, and forgetting recent information. Further analysis suggested that children in limited-contact sports had a higher percentage of persistent symptoms over time, particularly in activities with higher velocity or increased fall risk, such as skiing, snowboarding, and dodgeball.
These findings indicate that similar management protocols can be used for sport and nonsport mechanisms of injury (excluding assault and motor vehicle crash) in the younger population. The study's results suggest that considering factors like activity characteristics, rather than solely focusing on the type of concussion mechanism, may be important in managing pediatric concussions.
Full disclosures can be found in the published study.