41 (17B) Relationship of significant life events with symptom resolution in sport-related concussions in adolescent athletes

Purpose To investigate if a targeted multidisciplinary treatment for children and adolescents with persisting post-concussion symptoms (pPCS) is more beneficial than usual care in reducing physical symptoms.Methods Children aged 8 -18 years who sustained a concussion were recruited from the Royal Children's Hospital Melbourne emergency department or community health practitioners in Melbourne between 13 August 2019 and 15 July 2024.Children were screened for pPCS and included in the study if they remained symptomatic at 3 weeks.Throughout the trial, parents and children completed the Post Concussion Symptom Inventory (PCSI).They attended for face to face secondary physical and psychological measures.Participants were then randomized into Concussion Essentials (CE) or usual care (UC).UC consisted of routine follow up.The CE multidisciplinary team included a neuropsychologist and physiotherapist who delivered an individualised symptomdirected program that included a combination of education, psychological management and physiotherapy treatment.Participants underwent weekly treatment for up to 8 weeks.At 12 weeks post injury participants were reassessed.Results 140 children were recruited into the study with randomization of 67 into CE and 73 into UC.The mean age was 13.1 (range 8-18) years of age with 56.4% male.Pretreatment PCSI physical symptom mean scores (maximum 48) were UC 12.18 (95% CI 9.94-14.42)and CE 12.44 (95% CI 10.11-14.76),(p=0.876).Post-treatment mean scores at 12 week follow up were UC 7.80 (95% CI 5.29 -10.31) and CE 2.31 (1.53-3.09),(p<0.001)see figure 1.