Background

Sport-related concussion is recognized as a significant injury with variable recovery rates.

Objective

This study defined the acute natural history of sport concussion in male and female collegiate athletes participating in a broad array of sports.

Methods

We conducted a prospective, longitudinal investigation among collegiate student athletes (n = 34,709) from 30 academic institutions. Primary outcomes included the time (days) from injury until initiation of a return to participation (RTP) protocol and time from injury until medical clearance for unrestricted RTP.

Results

Concussed athletes (n = 1751, 19.2 years, 63.2% male) participating in 22 different sports began the RTP protocol in a median 6.4 (IQR 3.7–11.8) days. Time to initiate the RTP protocol was lengthened by less frequent post-injury assessments, greater initial post-injury symptom severity, limited contact sports participation, practice/training injuries, and three or more prior concussions. The median total RTP duration was 12.8 (IQR 8.7–20.1) days. Total RTP duration was shorter with ADHD medication usage, males, and greater assessment frequency; while greater initial post-injury symptom severity, practice-/training-related injuries, and three or more prior concussions had longer recoveries.

Conclusion

Although median recovery times are consistent with previous guidelines, it was not until 1 month post-injury that a preponderance of collegiate athletes were cleared to begin the RTP protocol (92%) or cleared for unrestricted sport participation (85%). Intrinsic and extrinsic factors had a small effect, altering recovery trajectories by up to 2 days, suggesting a largely unified approach to post-injury monitoring and management across all athletes. These data represent a shift from previous classification parameters of normal clinical recovery.

中文翻译：

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大学运动员运动相关脑震荡的自然史：NCAA-DoD CARE 联盟的调查结果

背景

与运动相关的脑震荡被认为是一种具有不同恢复率的重大伤害。

客观的

这项研究定义了参加各种运动的男女大学生运动员的运动脑震荡的急性自然史。

方法

我们对来自 30 个学术机构的大学生运动员 ( n  = 34,709) 进行了前瞻性纵向调查。主要结果包括从受伤到开始恢复参与 (RTP) 协议的时间（天）和从受伤到无限制 RTP 医疗许可的时间。

结果

参加 22 项不同运动的脑震荡运动员（n  = 1751，19.2 岁，63.2% 男性）开始 RTP 协议的中位数为 6.4（IQR 3.7-11.8）天。启动 RTP 协议的时间因伤后评估频率降低、初始伤后症状严重程度更高、接触性运动参与受限、练习/训练损伤以及三个或更多先前脑震荡而延长。中位总 RTP 持续时间为 12.8 (IQR 8.7–20.1) 天。使用 ADHD 药物、男性和更高的评估频率，总 RTP 持续时间更短；而更大的初始伤后症状严重程度、与练习/训练相关的伤害以及三个或更多先前的脑震荡的恢复时间更长。

结论

尽管中位恢复时间与之前的指导方针一致，但直到受伤后 1 个月，大部分大学生运动员才获准开始 RTP 协议 (92%) 或获准参加不受限制的运动 (85%)。内在和外在因素的影响很小，最多可将恢复轨迹改变 2 天，这表明对所有运动员的伤后监测和管理采用了基本统一的方法。这些数据代表了从以前的正常临床恢复分类参数的转变。