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Fact or Fiction-Accelerometry Versus Self-Report in Adherence to Pediatric Concussion Protocols: Prospective
Carol DeMatteo1,2, Sarah Randall1,2, Josephine Jakubowski1
1Department of Rehabilitation Sciences, McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada, 1 9055259140.
JMIR Pediatrics and Parenting
|October 9, 2024
Summary
Youth concussion recovery protocols showed low objective adherence but higher self-reported adherence. Less restrictive activity guidelines may improve adherence and support quicker recovery without increasing reinjury risk.
Area of Science:
- Pediatric neurology
- Sports medicine
- Public health
Background:
- Concussion (mild traumatic brain injury) is a significant public health issue, particularly affecting children and adolescents.
- Concussion prevalence is high in youth, necessitating effective management strategies.
Purpose of the Study:
- To evaluate adherence to Return to Activity (RTA) protocols in youth with concussion.
- To determine the impact of RTA protocol adherence on recovery time and reinjury rates.
Main Methods:
- 139 children and adolescents (5-18 years) with concussion were monitored for symptoms and recovery stages.
- Objective adherence was measured using accelerometry, alongside self-reported adherence.
- Physical, cognitive, and behavioral assessments were conducted at multiple time points.
Main Results:
- Objective adherence to RTA protocols was low across all stages (11-34%) when measured by accelerometry.
- Subjective self-reported adherence correlated with faster symptom resolution (13 vs. 20 days).
- No significant agreement was found between objective and subjective adherence measures or clinical outcomes; reinjury rate was 2%.
Conclusions:
- Adherence to concussion recovery protocols in youth is challenging, especially with strict physical activity restrictions.
- Self-reported adherence may indicate better outcomes, despite discrepancies with objective measures.
- Findings support less restrictive protocols and earlier activity resumption for improved youth concussion management.
