Examining the Recovery Course of Adolescent Concussion Patients With Protracted Recovery Referred to a Specialty Concussion Clinic

Objective: This study investigated the role of specialty concussion care on the clinical course of recovery in adolescent patients who initiated care beyond 3 weeks from their injury.

Design: Retrospective analysis of protracted recovery groups was based on the number of days in which a patient presented for care postinjury: early (22-35 days), middle (36-49 days), and late (50+ days).

Setting: Sports medicine and orthopedics clinic.

Patients: 101 patients aged 12 to 18 years.

Independent variables: Age, race/ethnicity, sex, concussion or migraine history, neurodevelopmental or psychiatric diagnosis, King-Devick, Trails Making, Vestibular Ocular Motor Screening (VOMS), and Postconcussion Symptom Scale (PCSS).

Main outcome measures: Days since injury to evaluation, recovery days from evaluation, and total recovery days.

Results: There were no significant differences between groups for PCSS, average K-D scores, and Trails B-A. Vestibular Ocular Motor Screening change score was significantly different between groups such that the late group had less change in VOMS score compared with the early group (F = 3.81, P = 0.03). There were significant differences between groups in terms of days since injury to evaluation (F = 399.74, P < 0.001) and total recovery days (F = 19.06, <0.001). The middle (25.83 ± 34.95) and late group (30.42 ± 33.54) took approximately 1 week and 12 days longer to recover compared with the early group, respectively. Recovery days from evaluation were not significantly different between the 3 groups (F = 1.30; P = 0.28).

Conclusions: Protracted recovery patients evaluated in a specialty concussion clinic received medical clearance to complete the return-to-play process with an athletic trainer within 1 month from the initial visit. The findings are consistent with previous research suggesting that earlier concussion care can expedite recovery.