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Updated: Nov 17, 2025
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Protocol for a randomised clinical trial of multimodal postconcussion symptom treatment and recovery: the Concussion
Vicki Anderson1,2,3, Vanessa C Rausa4, Nicholas Anderson4
1Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia vicki.anderson@rch.org.au.
Insights
A new multimodal intervention effectively treats persistent postconcussive symptoms (pPCS) in children, accelerating recovery and improving outcomes. This approach tailors treatment to individual symptoms, offering a promising solution for pediatric concussion recovery.
Area of Science:
- Pediatric neurology
- Clinical psychology
- Rehabilitation medicine
Background:
- Persistent postconcussive symptoms (pPCS) affect approximately 30% of children beyond one month after concussion.
- Current treatments for pPCS often use unimodal approaches, despite evidence suggesting pPCS result from interacting symptom clusters.
Purpose of the Study:
- To evaluate the effectiveness of a multimodal, symptom-tailored intervention designed to accelerate recovery and increase symptom resolution in children with pPCS at 3 months post-injury.
Main Methods:
- An open-label, assessor-blinded, randomized clinical trial involving children aged 8-18 years with concussion.
- Participants were randomized into either the Concussion Essentials (CE) intervention group (multimodal, interdisciplinary treatment) or a usual care (UC) group.
- The primary outcome was the proportion of participants with resolved pPCS at 3 months post-injury.
Main Results:
- The study is pre-results, so no findings are available yet.
- The trial aims to determine if the CE intervention leads to a higher proportion of resolved pPCS compared to UC.
- Secondary outcomes include return to normal activity, quality of life, and healthcare utilization.
Conclusions:
- The study will provide crucial data on the efficacy of a novel multimodal intervention for pediatric pPCS.
- Findings are expected to inform clinical practice and improve recovery trajectories for children experiencing persistent concussion symptoms.
Introduction:
While most children recover from a concussion shortly after injury, approximately 30% experience persistent postconcussive symptoms (pPCS) beyond 1-month postinjury. Existing research into the treatment of pPCS have evaluated unimodal approaches, despite evidence suggesting that pPCS likely represent an interaction across various symptom clusters. The primary aim of this study is to evaluate the effectiveness of a multimodal, symptom-tailored intervention to accelerate symptom recovery and increase the proportion of children with resolved symptoms at 3 months postconcussion.
Methods And Analysis:
In this open-label, assessor-blinded, randomised clinical trial, children with concussion aged 8-18 years will be recruited from The Royal Children's Hospital (The RCH) emergency department, or referred by a clinician, within 17 days of initial injury. Based on parent ratings of their child's PCS at ~10 days postinjury, symptomatic children (≥2 symptoms at least 1-point above those endorsed preinjury) will undergo a baseline assessment at 3 weeks postinjury and randomised into either Concussion Essentials (CE, n=108), a multimodal, interdisciplinary delivered, symptom-tailored treatment involving physiotherapy, psychology and education, or usual care (UC, n=108) study arms. CE participants will receive 1 hour of intervention each week, for up to 8 weeks or until pPCS resolve. A postprogramme assessment will be conducted at 3 months postinjury for all participants. Effectiveness of the CE intervention will be determined by the proportion of participants for whom pPCS have resolved at the postprogramme assessment (primary outcome) relative to the UC group. Secondary outcome analyses will examine whether children receiving CE are more likely to demonstrate resolution of pPCS, earlier return to normal activity, higher quality of life and a lower rate of utilisation of health services, compared with the UC group.
Ethics And Dissemination:
Ethics were approved by The RCH Human Research Ethics Committee (HREC: 37100). Parent, and for mature minors, participant consent, will be obtained prior to commencement of the trial. Study results will be disseminated at international conferences and international peer-reviewed journals.
Trial Registration Number:
ACTRN12617000418370; pre-results.
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