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Monitoring Adolescent Sport-Related Concussion Recovery Using Consumer-Grade Wearables: A Pilot Study.

Danielle M Ransom1, Brant H Tudor, Sarah A Irani

  • 1Author Affiliations: Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida (Dr Ransom); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Ransom); Center for Pediatric Data Science & Analytic Methodology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida (Drs Tudor, Rehman, Ahumada); Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (Drs Tudor, Rehman, Ahumada); Division of Sports Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida (Drs Irani, Mularoni); Brain Injury Clinical Research Center, Kennedy Krieger Institute, Baltimore, Marlyland (Drs Suskauer, Svingos); Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland (Drs Suskauer, Svingos); and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland (Drs Suskauer, Mularoni).

The Journal of Head Trauma Rehabilitation
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Consumer-grade wearable devices (CGWDs) detected physiological differences in adolescent athletes recovering from sport-related concussion (SRC) compared to musculoskeletal (MSK) injuries. Wearable data may aid in objective concussion monitoring and individualized recovery assessment.

Keywords:
adolescentbrain concussionfeasibility studiesheart rate/physiologymonitoringmotor activity/physiologyphysiologicrecovery of functionsleep wake disorders/physiopathologysports injurieswearable electronic devices

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Area of Science:

  • Sports Medicine
  • Neurology
  • Biomedical Engineering

Background:

  • Diagnosing sport-related concussion (SRC) in adolescents can be challenging, often relying on subjective symptom reporting.
  • Consumer-grade wearable devices (CGWDs) offer continuous physiological monitoring capabilities.
  • Understanding if CGWDs can differentiate between SRC and musculoskeletal (MSK) injuries is crucial for objective assessment.

Purpose of the Study:

  • To evaluate CGWDs' ability to detect physiological differences between adolescent athletes with SRC versus MSK injuries.
  • To examine associations between wearable-derived physiological markers and symptom burden in the acute post-injury phase.

Main Methods:

  • A prospective observational cohort study included 34 high school student-athletes (14-18 years) within 10 days of SRC or MSK injury.
  • Participants used a Fitbit Sense for passive monitoring of sleep, activity, and heart rate for up to 6 weeks.
  • Primary outcomes compared CGWD metrics (sleep, activity, heart rate) between groups across three time intervals; secondary outcomes correlated data with symptom burden (PCSI-2).

Main Results:

  • Adolescent athletes with SRC exhibited significantly more light sleep, increased nocturnal wake time, and lower daily step counts compared to MSK peers in the first 4 weeks post-injury.
  • No significant differences were found in REM sleep, deep sleep, or heart rate between the SRC and MSK groups.
  • In the SRC group, greater nocturnal wake time and lower resting heart rate correlated with higher cognitive symptom ratings; emotional symptoms correlated with step counts.

Conclusions:

  • CGWDs show potential in identifying recovery-specific physiological disruptions in adolescent athletes following SRC, particularly concerning sleep and physical activity patterns.
  • These findings suggest that wearable technology could support more individualized and objective approaches to concussion monitoring in clinical settings.
  • Further research can explore integrating wearable data for enhanced concussion management and recovery tracking.