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Early access to care speeds recovery from sports concussion

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Most athletes need more than two weeks to recover from a sports-related concussion, a new study shows.

Researchers at a sports concussion clinic in New Zealand analysed recovery time in 594 patients with sports-related mild traumatic brain injury (mTBI) — the scientific term for concussion — over a two-year period.

Patients were managed in a standardised assessment and management protocol in line with current international guidelines. This included an initial period of “relative rest” for 48 hours, with gradually increasing cognitive and physical activity. Patients were re-evaluated at 14 days post injury and then every two weeks until clinical recovery — as defined by symptom scores, resolution of any abnormalities on initial examination, and demonstration of exercise tolerance.

According to the internationally recognised Concussion in Sport Group (CISG) guidelines, 80-90% of sports-related concussions resolve within seven to ten days.

However, in the study, at 14 days mTBI symptoms had resolved in only 45% of patients — meaning that 55% did not yet have clinical recovery.

The clinical recovery rate rose to 77% at four weeks after injury and 96% at eight weeks.

Findings published in Clinical Journal of Sport Medicine show that children and adults took a similar length of time to recover, but recovery times were longer for female athletes and for patients with certain “concussion modifiers” (history of migraine or mental health issues) previously linked to prolonged recovery.

Patients who waited longer before their first visit to the concussion clinic were also more likely to have a prolonged recovery time: “For a seven-day increase in time to the initial appointment, we could expect an approximate 15% increase in the number of days until clinical recovery,” the authors wrote.

“This study challenges current perceptions that most people with a sports-related mTBI recover within 10 to 14 days,” said Stephen Kara, MBChB, of Axis Sports Medicine in Auckland.

The findings also question the belief that children recover more slowly after sports-related concussion, and highlight the importance of early access to care, noted journal publisher Wolters Kluwer Health.

https://www.eurekalert.org/pub_releases/2020-03/wkh-twa030920.php

https://journals.lww.com/cjsportsmed/Fulltext/2020/03000/Less_Than_Half_of_Patients_Recover_Within_2_Weeks.2.aspx?PRID=CJSM_PR_030920