The natural history of sport-related concussion in collegiate athletes: Findings from the NCAA-DoD CARE Consortium

Authors

Steven P. Broglio, Michigan Concussion Center, University of Michigan, 830 N. University Ave, Ann Arbor, MI, 48109, USA. broglio@umich.edu.
Thomas McAllister, Department of Psychiatry, Indiana University, Indianapolis, IN, USA.
Barry P. Katz, Department of Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health, Indiana University School of Medicine, Indianapolis, IN, USA.
Michelle LaPradd, Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
Wenxian Zhou, Department of Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health, Indiana University School of Medicine, Indianapolis, IN, USA.
Michael A. McCrea, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
CARE Consortium Investigators
Holly J. Benjamin, Advocate Aurora Health

Recommended Citation

Broglio SP, McAllister T, Katz BP, et al. The Natural History of Sport-Related Concussion in Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium. Sports Med. 2022;52(2):403-415. doi:10.1007/s40279-021-01541-7

Abstract

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.

Type

Article

PubMed ID

34427877