Children sustaining concussions outside of sports see specialists later and have less access to appropriate care, despite being more common than sport-related concussions
This article was initially published in the 7/18/24 edition of our Concussion Update newsletter; please consider subscribing.
In a recent observational study published in The Journal of Pediatrics, researchers found that recreation-related concussions (RRC)––such as those from recess, gym class, and play––and non-sport or recreation-related concussions (non-SRRC)––from events like motor vehicle crashes, falls, and assault––are more common among patients 5 through 12 years old than sports-related concussions (SRC) from organized sports. Additionally, as stated in an article published by Physician’s Weekly, the study found that “patients with RRC and non-SRRC were first evaluated by specialists 4 and 6 days later than those with SRC.”
The study authors, Patricia Roby et al., identified the need to study RRC and non-SRRC separately from SRC due to differences such as less “supervision available at time of injury” and less direct access to established and informed concussion healthcare. According to the Physician’s Weekly article, the disparities in time between injury and first specialist visit for RRC and non-SRRC may also lead to “greater symptom burden and prolonged recovery.” Although most concussion research has focused on sports, SRC “represented less than one-third of concussions in [the] study sample.”
When compared to children with RRC and SRC, children with non-SRRC present to specialty care reporting a higher reported symptom burden, “more frequent visio-vestibular abnormalities, and more changes to sleep and daily habits.” The study authors note that this greater severity of symptoms is “associated with greater effects on academic performance” and suggests expanding the role of school nurses. These findings indicate not only a need for further research in concussions as it pertains to “children outside of [organized] sports,” but also that education of physicians who see RRC and non-SRRC patients would make quality care more accessible to all children “regardless of the mechanism of injury,” as supported by a press release published by the Children’s Hospital of Philadelphia.
Conducted retroactively, researchers at Children’s Hospital of Philadelphia (CHOP) utilized “electronic health records for patients seen for a concussion within the specialty care concussion program at…(CHOP)” for 1,141 patients between the ages of 5 and 12 who attended their first care visit within 28 days of the injury. The researchers then assigned patients to groups according to injury description: RRC, non-SRRC, and SRC. Patients were also categorized by date of injury as pre-, early-, and late-COVID, as the study was conducted between January 1, 2018, and September 12, 2022.
The large proportion of RRC and non-SRRC cases suggests the need for an increase of research specific to these situations to further assist patients. The study authors emphasized the importance of educating primary-care providers and emergency departments on current concussion protocols and, according to the Physician’s Weekly abstract, developing “tailored management and intervention strategies” that recognize the distinct needs of young RRC and non-SRRC patients.
