Sport-Related Concussions: Symptom Recurrence After Return to Exercise

Area of Science:

• Sports Medicine
• Neurology
• Pediatrics

Background:

• Current concussion guidelines recommend gradual exercise progression.
• The rate of symptom recurrence during exercise in athletes, after being symptom-free at rest, is not well-established.
• Understanding symptom recurrence is crucial for refining return-to-play protocols.

Purpose of the Study:

• To determine the proportion of athletes experiencing concussion symptom recurrence with exercise.
• To identify risk factors associated with symptom recurrence after a concussion.

Main Methods:

• A case-control study involving 217 athletes from a sports concussion clinic.
• Data collected via standardized questionnaires on symptoms, injury history, and recovery time.
• Key outcome: recurrence of concussion symptoms with exercise after being symptom-free at rest.

Main Results:

• 12% (25 of 217) of athletes reported symptom recurrence with exercise.
• Loss of consciousness during injury and longer time to clinical presentation were linked to decreased recurrence risk.
• Previously undiagnosed concussions and longer duration of resting symptoms increased the risk of recurrence.

Conclusions:

• Symptom recurrence during exercise is relatively uncommon in athletes who are symptom-free at rest post-concussion.
• Athletes with prior undiagnosed concussions or prolonged resting symptoms face a higher risk of recurrence.
• Early identification of at-risk athletes can guide treatment and exercise progression strategies.