Citation

Chandler MC, Bloom J, Fonseca J, Ramsey K, De Maio VJ, Callahan CE, Register-Mihalik JK. J. Athl. Train. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, National Athletic Trainers' Association (USA))

DOI

10.4085/1062-6050-0552.22

PMID

37347117

Abstract

CONTEXT: Persistent post-concussion symptoms (PPCS) are associated with lower health-related quality of life (HRQoL) in children and adolescents. Despite commonly-cited criteria for PPCS involving three or more complaints, many individuals experience just one or two symptoms that may still negatively affect HRQoL.

OBJECTIVE: Determine differences in HRQoL between children and adolescents with 0, 1-2, and 3+ parent-reported persistent symptoms one-month post-concussion.

DESIGN: Prospective cohort. SETTING: Community practice clinics.

PARTICIPANTS: Individuals aged 8-18 years presented at initial visit within 3 days of a sport- or recreation-related concussion. One month later, parents/guardians reported persistent symptoms using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Individuals with complete symptom data were used for analysis (n=236/245, Mage=14.3±2.1 years; n=97 females). Participants were grouped by number of discrete RPQ symptoms reported as worse than pre-injury (0, 1-2, 3+).

OUTCOME MEASURES: Total summary and subscale scores on the PedsQL™ 23-item HRQoL inventory and 18-item multidimensional fatigue scale (MDFS).

MAIN RESULTS: Kruskal-Wallis rank sum tests highlighted significant differences in PedsQL™ HRQoL and MDFS total scores across symptom groups (PedsQL™ HRQoL: χ2(2)=85.53, P<.001; MDFS: χ2(2)=93.15, P<.001). Dunn's post-hoc analyses indicated all three groups were significantly different from each other (P-values<.001). PedsQL™ HRQoL total: 0 symptoms (median=93.5, IQR 84.2-98.8); 1-2 symptoms (median=84.8, IQR 73.9-92.4); 3+ symptoms: (median=70.7, IQR 58.7-78.0). MDFS total: 0 symptoms (median=92.4, IQR 76.4-98.6); 1-2 symptoms (median=78.5, IQR 65.6-88.9); 3+ symptoms: (median=54.2, IQR 46.2-65.3). Similar group differences were observed for each PedsQL™ HRQoL and MDFS subscale score.

CONCLUSIONS: Children and adolescents whose parents reported 1-2 PPCS had lower HRQoL and more fatigue than those with none. Across all three groups, those with 3+ persistent symptoms had the lowest HRQoL and most fatigue.

FINDINGS indicate continued need for intervention in this age group to prevent and address persistent post-concussion symptoms.

Language: en

Keywords

youth; sport-related concussion; mild traumatic brain injury; health related quality of life; persistent symptoms