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Updated: Apr 23, 2026

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

Published on: September 25, 2014

The Postconcussion Symptom Scale: utility of a three-factor structure.

Aisha S Joyce¹, Cynthia R Labella, Rebecca L Carl

¹1Division of Orthopaedic Surgery and Sports Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; 2Department of Pediatrics, Northwestern University's Feinberg School of Medicine, Chicago, IL; 3Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; 4Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; and 5Department of Psychiatry and Behavioral Sciences, Northwestern University's Feinberg School of Medicine, Chicago, IL.

Medicine and Science in Sports and Exercise

|October 1, 2014

Summary

The Postconcussion Symptom Scale shows a three-factor structure in pediatric concussion patients, with females and those with anxiety experiencing more symptoms. Delayed treatment may worsen emotional health.

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Published on: April 27, 2021

Area of Science:

Sports Medicine
Neurology
Pediatric Health

Background:

Concussion is a common injury in pediatric athletes.
Accurate assessment of postconcussion symptoms is crucial for recovery.
The factor structure of the Postconcussion Symptom Scale (PCS) requires validation in pediatric populations.

Purpose of the Study:

To determine the factor structure of the 19-item Postconcussion Symptom Scale (PCS).
To examine associations between PCS factor scores and demographic/clinical variables.
To investigate the impact of sex, concussion history, and time since injury on symptom presentation.

Main Methods:

Retrospective review of pediatric concussion patients (2008-2012).
Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) of the 19-item PCS.
ANOVA and regression analyses to assess associations with sex, anxiety, and time since injury.

Main Results:

EFA identified an 18-item, three-factor structure: neurocognitive, somatic, and emotional symptoms.
CFA confirmed the unidimensionality of these three factors.
Females and patients with anxiety disorders reported higher symptom scores across all factors. Patients evaluated >14 days post-injury showed worse emotional symptoms.

Conclusions:

The Postconcussion Symptom Scale exhibits a consistent three-factor structure in pediatric concussion.
Anxiety disorders and female sex are associated with increased symptom burden.
Delayed medical evaluation may be linked to prolonged emotional symptoms following concussion.