Confidence to Return to Play After Concussion.

Area of Science:

• Sports Medicine
• Neurology
• Psychology

Background:

• Concussion sequelae can negatively impact an athlete's psychological readiness to return to play (RTP).
• Athlete confidence in RTP is infrequently monitored post-concussion, despite its psychological implications.

Purpose of the Study:

• To investigate the acute and longitudinal effects of concussion on athlete confidence to RTP.
• To examine the relationship between self-reported symptoms and confidence to RTP.
• To explore how concussion symptoms, sex, and sport type influence confidence to RTP.

Main Methods:

• Forty-six college athletes completed the Injury Psychological Readiness to Return to Sport (I-PRRS) scale at three time points: acutely post-injury, pre-RTP protocol, and post-RTP clearance.
• Data were analyzed to assess changes in confidence over time and correlations with symptom severity, sex, and sport type.

Main Results:

• Athletes reported low initial confidence (I-PRRS mean [SD] = 32.59 [18.45]) post-concussion, which improved by the RTP clearance stage (post-RTP mean [SD] = 57.45 [5.96]).
• Higher acute symptom severity was significantly associated with lower confidence (P < .001).
• A subset of athletes returned to competition with persistent confidence concerns (I-PRRS < 50).

Conclusions:

• While confidence generally improves during concussion recovery, acute symptom severity is a key predictor of diminished confidence.
• Some athletes return to play with unresolved psychological concerns regarding their readiness.
• The findings support the routine assessment and monitoring of athlete confidence throughout the concussion rehabilitation process.