Duration of continued athletic participation after sport-related concussion impacts recovery outcomes

By Minhong Kim. This article was initially published in our Concussion Update newsletter; please consider subscribing.

A study by Dr. Shawn R Eagle et al., published in Sports Medicine, evaluated the duration of continued participation after a suspected sport-related concussion (SRC) and its impact on recovery outcomes in collegiate athletes. The researchers found that continued participation (within a range of 0-90 minutes) after SRC was associated with worse outcomes.

Eagle et al. analyzed 378 collegiate athletes from 17 sports who sustained SRCs. The authors collected data, such as presence and severity of symptoms, duration of continued participation after SRC, demographic/health history, and length of recovery time for statistical analysis. Athletes completed the Graded Symptom Checklist to “evaluate the severity of total symptoms and migraine/fatigue, cognitive/ocular, and affective symptom clusters.” In addition, the duration of continued participation after SRC was estimated with the help of team-affiliated physicians, athletic trainers, and the athletes themselves.

The researchers found that a longer duration of continued participation after SRC was associated with greater symptom severity, longer symptom duration, and more time missed from sport. Within 0-90 minutes after injury, the average length of continued participation after SRC was 28 minutes. “Longer estimated continued participation [within the range of 0-90 min] was associated with greater symptom severity, affective and migraine/fatigue symptoms, longer symptom duration, and longer time missed.”

Furthermore, SRC outcomes in those who continued to play were more “severe for female athletes, athletes with migraine history, and athletes with prior concussions.” The study authors conclude that “The findings can help clinicians and administrators to educate athletes on the importance of immediate removal following a suspected SRC.”

While the findings suggest that the duration of continued participation after SRC impacts recovery outcomes in collegiate athletes, further research may need to validate these results because the period of continued participation after SRC was estimated, not measured. Some athletes may have been mischaracterized as “immediately removed,” despite continued participation.