Concussion Recovery in Children and Adolescents: A Retrospective Study

Megan Lynn Ferderber; Christina Rizk; Shellie Zsoldos; Stacey Meardon; Chia-Cheng Lin

doi:10.1177/23259671221143486

Concussion Recovery in Children and Adolescents: A Retrospective Study

Orthop J Sports Med. 2022 Dec 21;10(12):23259671221143486. doi: 10.1177/23259671221143486. eCollection 2022 Dec.

Authors

Megan Lynn Ferderber¹, Christina Rizk¹, Shellie Zsoldos², Stacey Meardon², Chia-Cheng Lin²

Affiliations

¹ Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
² Department of Physical Therapy, College of Allied Health Sciences, East Carolina University, Greenville, North Carolina, USA.

Abstract

Background: Concussion is a common injury among children and adolescents, with a growing body of literature supporting a variety of diagnostic and treatment modalities. Recovery is variable and depends on multiple factors that can be evaluated through a clinic visit: a thorough history, physical examination, and use of the Post-concussion Symptom Scale (PCSS).

Purpose/hypothesis: The purpose of this study was to evaluate factors associated with overall recovery from concussion in children and adolescents in the clinical setting. It was hypothesized that the presence of 1 of a number of pre- or postinjury characteristics will be associated with poor concussion recovery.

Study design: Case-control study; Level of evidence, 3.

Methods: We conducted a retrospective chart review of adolescents and children aged 6 to 17 years with a diagnosis of concussion who were evaluated at a single sports medicine center between January 2015 and December 2019. Cases were categorized into recovered (PCSS <7) and poorly recovered (PCSS ≥7) cohorts based on the last PCSS scores during clinical follow-ups for concussion management.

Results: Of the 162 charts reviewed, 110 cases met inclusion criteria. Significant statistical differences were found between the recovered and poorly recovered cohorts regarding mean days from injury to last clinic visit, previous migraine diagnosis, and emergency room (ER) visit before the first clinic visit (P < .01 for all). Binary logistic regression analysis revealed that the most predictive factors associated with poorer recovery were having an ER visit before the first clinic evaluation (P = .01) and previous migraine diagnosis (P = .04).

Conclusion: While many factors may contribute to overall recovery from concussion in pediatric populations, our study suggested that a history of migraine and an ER visit before clinic evaluation may be associated with poor recovery of concussive symptoms.

Keywords: clinical assessment/grading scales; head injuries/concussion; pediatric sports medicine.