Research Reports - Predictors of clinical recovery from concussion

Br J Sports Med. 2017 Jun;51(12):941-948. doi: 10.1136/bjsports-2017-097729.

Iverson GL(1)(2), Gardner AJ(3), Terry DP(1)(2), Ponsford JL(4), Sills AK(5),
Broshek DK(6), Solomon GS(7).

OBJECTIVE: A systematic review of factors that might be associated with, or
influence, clinical recovery from sport-related concussion. Clinical recovery was
defined functionally as a return to normal activities, including school and
sports, following injury.
DESIGN: Systematic review.
DATA SOURCES: PubMed, PsycINFO, MEDLINE, CINAHL, Cochrane Library, EMBASE,
SPORTDiscus, Scopus and Web of Science.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies published by June of 2016
that addressed clinical recovery from concussion.
RESULTS: A total of 7617 articles were identified using the search strategy, and
101 articles were included. There are major methodological differences across the
studies. Many different clinical outcomes were measured, such as symptoms,
cognition, balance, return to school and return to sports, although symptom
outcomes were the most frequently measured. The most consistent predictor of
slower recovery from concussion is the severity of a person's acute and subacute
symptoms. The development of subacute problems with headaches or depression is
likely a risk factor for persistent symptoms lasting greater than a month. Those
with a preinjury history of mental health problems appear to be at greater risk
for having persistent symptoms. Those with attention deficit hyperactivity
disorder (ADHD) or learning disabilities do not appear to be at substantially
greater risk. There is some evidence that the teenage years, particularly high
school, might be the most vulnerable time period for having persistent
symptoms-with greater risk for girls than boys.
CONCLUSION: The literature on clinical recovery from sport-related concussion has
grown dramatically, is mostly mixed, but some factors have emerged as being
related to outcome. 

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