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Updated: Nov 11, 2025
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
The Influence of Timing of Reporting and Clinic Presentation on Concussion Recovery Outcomes: A Systematic Review and
Mitchell Barnhart1, R Curtis Bay2, Tamara C Valovich McLeod3,4,5
1Athletic Training Programs, A.T. Still University, 5850 E Still Circle, Mesa, AZ, 85206, USA.
Background:
Identifying risk factors for prolonged recovery following concussion can assist clinicians with appropriate management strategies. It is thought that athletes who continue to participate following a hit to the head or body may take longer to recover following a concussion diagnosis.
Objective:
To systematically review the body of literature regarding the effect of delayed reporting and delayed presentation to medical providers on concussion recovery times.
Design:
Systematic review with meta-analysis.
Data Sources:
PubMed, Ovid Medline, SPORTDiscus, Cochrane Central Register of Controlled Trials and hand searches of reference lists. All the searches were performed in April 2020.
Eligibility Criteria For Selected Studies:
Studies included an investigation of immediate versus delayed reporting or early versus late presentation following a concussion, were published in the past ten years, and were level 4 evidence or higher.
Results:
12 studies were included. Patients who continued play or delayed reporting their concussion had significantly longer recovery times (standardized mean difference = 0.36 days (95%CI 0.066, 0.662) than those who immediately reported or were removed from play (p = 0.017). Expressed in raw scores, those who immediately reported recovered in 5.4 days (95% CI - 10.14, - 0.75) fewer than delayed reporters. Comparable results were found for post-concussion symptom scores (p = 0.034) with immediate reporters demonstrating lower symptom severity scores. Our qualitative synthesis found patients who presented earlier to a concussion specialist tended to recover faster than those who presented later.
Conclusions:
Patients who delayed reporting or continued play had longer recovery times compared to their immediately-reporting peers. Providers should ask concussion patients approximately how long they waited to report their injury, and also focus educational efforts on encouraging immediate reporting of concussion.
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