Examining the Recovery Course of Adolescent Concussion Patients With Protracted Recovery Referred to a Specialty Concussion Clinic.

OBJECTIVE

This study investigated the role of specialty concussion care on the clinical course of recovery in adolescent patients who initiated care beyond 3 weeks from their injury.

DESIGN

Retrospective analysis of protracted recovery groups was based on the number of days in which a patient presented for care postinjury: early (22-35 days), middle (36-49 days), and late (50+ days).

SETTING

Sports medicine and orthopedics clinic.

PATIENTS

101 patients aged 12 to 18 years.

INDEPENDENT VARIABLES

Age, race/ethnicity, sex, concussion or migraine history, neurodevelopmental or psychiatric diagnosis, King-Devick, Trails Making, Vestibular Ocular Motor Screening (VOMS), and Postconcussion Symptom Scale (PCSS).

MAIN OUTCOME MEASURES

Days since injury to evaluation, recovery days from evaluation, and total recovery days.

RESULTS

There were no significant differences between groups for PCSS, average K-D scores, and Trails B-A. Vestibular Ocular Motor Screening change score was significantly different between groups such that the late group had less change in VOMS score compared with the early group (F = 3.81, P = 0.03). There were significant differences between groups in terms of days since injury to evaluation (F = 399.74, P < 0.001) and total recovery days (F = 19.06, <0.001). The middle (25.83 ± 34.95) and late group (30.42 ± 33.54) took approximately 1 week and 12 days longer to recover compared with the early group, respectively. Recovery days from evaluation were not significantly different between the 3 groups (F = 1.30; P = 0.28).

CONCLUSIONS

Protracted recovery patients evaluated in a specialty concussion clinic received medical clearance to complete the return-to-play process with an athletic trainer within 1 month from the initial visit. The findings are consistent with previous research suggesting that earlier concussion care can expedite recovery.