See Wan Tham1
1) United States
Sports and recreation-related concussion is a major public health issue. It is estimated that annually in the United States, over 500,00 Emergency Department visits are related to concussions. While the majority of children have resolution of symptoms at 2 weeks after injury, up to 30% may remain symptomatic after one month. The long term comorbidities commonly include pain and sleep deficiency. However, the risk factors underlying chronification of symptoms after concussion in the pediatric population are unclear. The goal of this study is to examine the trajectories of pain, sleep and postconcussion symptoms in the acute phase after injury and examine for risk factors of persistent post concussion symptoms in adolescents. The sample included 30 adolescents (33% males, M = 14 years, SD = 1.8) recruited from a children’s hospital Emergency Department within 7 days after a sport- or recreation-related concussion. They completed questionnaires assessing post-concussion symptoms (Health Behavior Inventory), pain (Numerical Pain Rating), anxiety and depression (PROMIS) at 1, 2 and 3 weeks post-injury. Generalized estimating equations were used to analyze the longitudinal change in outcomes. Postconcussion symptoms (β = 7.88, p = 0.002) and pain intensity( β= 0.83, p = 0.07) peaked at one week after concussion, and decreased to baseline measurements in the subsequent weeks. Anxiety and depression symptoms remain unchanged in this time period. The presence of moderate to severe pain (β = 8.43, p = 0.07) prior to concussion was found to be associated with greater persistent post-concussion symptoms (F (3,25) = 3.77, p = 0.02). Study findings revealed that postconcussion symptoms and pain resolve early after concussion in the majority of adolescents. However, higher pain intensity pre-injury was found to be associated with more persistent post-concussion symptoms. Future studies need to extend our understanding of pain and its impact on recovery post concussion.
