Concussion History And Recovery Time: Consideration Of Clinical Setting And Model Of Care

Sport related concussion (SRC) poses a unique challenge to clinicians to do the heterogenous nature of the injury. Interdisciplinary care and the use of the clinical profiles model may reduce the risk of prolonged recovery, despite the presence of risk factors, like concussion history. PURPOSE: To examine the associations among concussion history, clinical profiles, and recovery time in pediatric patients with SRC treated at an interdisciplinary concussion clinic. METHODS: This retrospective cross-sectional study included 302 patients (age 15.5±1.54 years). There were 97 patients with concussion history and 205 with no concussion history. Clinical profiles were determined by a clinical neuropsychologist or sports medicine physician at first clinical visit from a comprehensive assessment including the clinical interview, symptom reporting, computerized neurocognitive testing, vestibular and ocular motor screening, and the concussion clinical profiles screening tool. Prolonged recovery was defined as ≥28 days from date of injury to date of clearance. Chi-square analysis and Fisher’s exact test assessed the associations among (1) concussion history and clinical profiles, (2) clinical profiles and prolonged recovery, and (3) clinical profiles and prolonged recovery in a subset of patients with concussion history. Non-inferiority analysis assessed if patients with concussion history had significantly non-inferior recovery times compared to patients with no concussion history. RESULTS: There was no significant association between (1) concussion history and clinical profiles (p = .91), (2) clinical profiles and prolonged recovery (p = .32), and (3) clinical profiles and prolonged recovery in a subset of patients with concussion history (p = .24). Recovery time of patients with concussion history (22.91±16.04 days) was significantly non-inferior to the recovery time of patients with no concussion history (23.44±18.48 days; p = .01). CONCLUSIONS: There was no significant relationship among concussion history, clinical profiles, and recovery time. Recovery time for patients with concussion history was not worse than patients with no concussion history. When examining risk factors and recovery time, researchers should consider the setting and model of care used to treat patients with SRC.