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 Researchers examined data on 162 athletes ages 12 to 22who were
diagnosed with concussions. Recovery time averaged 57 days, and
ranged from 9 to 299 days.
Compared with athletes who started treatment within a week, those
who didn't receive care that quickly were over four times more
likely to have a recovery that took more than 30 days, the study
found.
"There was an assumption that only patients with more severe
symptoms and impairment following concussion would benefit from
early care, which typically involved prescribed rest and restricted
activities," said lead author Anthony Kontos, research director of
the Sports Medicine Concussion Program at the University of
Pittsburgh Medical Center.
"However, our research shows that regardless of symptoms and
impairments, patients who seek specialty care earlier have better
outcomes and recover sooner than those who seek care later."
A concussion is a traumatic brain injury caused by a jolt to the
head or body that disrupts the function of the brain. This injury
can result in physical, cognitive, emotional or sleep-related
symptoms that may or may not involve a loss of consciousness. The
symptoms can last from several minutes to days, weeks, months or
longer.
More than half of athletes who sustain concussions don't receive
care beyond an initial evaluation or diagnosis around the time of
injury, researchers note in JAMA Neurology.
In the current study, recovery times from when athletes started
follow-up concussion care were similar, suggesting that differences
in recovery trajectories were due to the number of days they waited
to begin treatment.
At their first follow-up checkups, athletes who received care within
a week and those who took longer to start treatment had similar
symptom severity as well as similar levels of impairment in areas
like cognitive ability, vision, sleep and balance.
Later initiation of treatment as well as more severe vision and
motion-related symptoms at diagnosis were both associated with much
longer recovery times.
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One limitation of the study is that researchers lacked data on how
closely athletes followed any prescribed treatments or
rehabilitation programs, how soon athletes returned to practice or
competition, and how quickly they resumed regular academic work. All
these factors could influence concussion recovery time.
Athletes may be advised on when to resume exercise or school work
based on the severity of their injuries and their progress in
treatment, said Jingzhen Yang of the Center for Injury at Nationwide
Children's Hospital in Columbus, Ohio.
"Specifically, athletes may be advised on things they should avoid,
such as strict rest or excessive physical activity, as these could
result in increased symptoms or delayed recovery," Yang, who wasn't
involved in the study, said by email. "Athletes may also be
encouraged to engage in the symptom-limited, light physical activity
as these could help mitigate symptoms and hasten concussion
recovery."
Earlier treatment may help athletes receive therapy targeted to
their specific combination of symptoms, which might include some mix
of anxiety, mood swings, sleep difficulties, balance problems,
dizziness, vision impairment, attention deficits and cognitive
problems.
Although the study didn't explain why some athletes waited longer
than others for care, it's possible many either were unaware of the
need for rapid follow-up treatment or were unable to find or afford
specialists, Yang said.
"It is imperative that student-athletes and parents understand that
delayed presentation for clinical care after concussion may result
in prolonged symptom duration, whereas early presentation for
clinical care after concussion may lead to a shorter symptom
duration and recovery time," Yang said.
SOURCE: https://bit.ly/30a5Nb9 JAMA Neurology, online January 6,
2020.
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