@article{ref1,
title="The variability of recovery from pediatric concussion using multimodal clinical definitions",
journal="Sports health",
year="2023",
author="Corwin, Daniel J. and Metzger, Kristina B. and McDonald, Catherine C. and Pfeiffer, Melissa R. and Arbogast, Kristy B. and Master, Christina L.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: While concussions are common pediatric injuries, a lack of agreement on a standard definition of recovery creates multiple challenges for clinicians and researchers alike. HYPOTHESIS: The percentage of concussed youth deemed recovered as part of a prospective cohort study will differ depending on the recovery definition. STUDY DESIGN: Descriptive epidemiologic study of a prospectively enrolled observational cohort. LEVEL OF EVIDENCE: Level 3. <br><br>METHODS: Participants aged 11 to 18 years were enrolled from the concussion program of a tertiary care academic center. Data were collected from initial and follow-up clinical visits ≤12 weeks from injury. A total of 10 recovery definitions were assessed: (1) cleared to full return to sports; (2) return to full school; (3) self-reported return to normal; (4) self-reported full return to school; (5) self-reported full return to exercise; (6) symptom return to preinjury state; (7) complete symptom resolution; (8) symptoms below standardized threshold; (9) no abnormal visio-vestibular examination (VVE) elements; and (10) ≤1 abnormal VVE assessments. <br><br>RESULTS: In total, 174 participants were enrolled. By week 4, 63.8% met at least 1 recovery definition versus 78.2% by week 8 versus 88.5% by week 12. For individual measures of recovery at week 4, percent recovered ranged from 5% by self-reported full return to exercise to 45% for ≤1 VVE abnormality (similar trends at 8 and 12 weeks). <br><br>CONCLUSION: There is wide variability in the proportion of youth considered recovered at various points following concussion depending on the definition of recovery, with higher proportions using physiologic examination-based measures and lower proportions using patient-reported measures. CLINICAL RELEVANCE: These results further emphasize the need for a multimodal assessment of recovery by clinicians as a single and standardized definition of recovery that captures the broad impact of concussion on a given patient continues to be elusive.<p /> <p>Language: en</p>",
language="en",
issn="1941-7381",
doi="10.1177/19417381231152448",
url="http://dx.doi.org/10.1177/19417381231152448"
}