Evaluating Adherence to Return to School and Activity Protocols in Children After Concussion

Area of Science:

• Pediatric neurology and sports medicine, focusing on concussion management.

Background:

• International recognition of the need for pediatric-specific concussion management protocols for Return to School (RTS) and Return to Activity (RTA).
• Evaluating the effectiveness of these protocols hinges on understanding adherence rates in children and youth.

Purpose of the Study:

• To determine the prevalence of adherence to RTS and RTA concussion management protocols in children and youth.
• To identify predictors of adherence to these pediatric concussion protocols.

Main Methods:

• Prospective cohort study of 139 children/youth (aged 5-18) diagnosed with concussion.
• Adherence measured via multiple sources: knowledge of protocols, personnel evaluations, self-reported stages, and Post-Concussion Symptom Scale (PCSS) scores.
• Statistical analysis included Spearman correlations and logistic regression to assess relationships and predictors.

Main Results:

• Fifty-three percent adherence to RTS protocols and 56% adherence to RTA protocols were observed.
• Significant negative association found between total PCSS scores and the stage of RTS/RTA protocol progression.
• Children's knowledge of protocols and PCSS scores were significant predictors of adherence.

Conclusions:

• Adherence to pediatric concussion management protocols (RTS/RTA) is moderate, with knowledge and symptom severity being key factors.
• Improving children's understanding of protocols and managing concussion symptoms are crucial for enhancing adherence during recovery.