Recovery Time Among High School Athletes with Concussion

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Table of Contents

Abstract
Introduction
Discussion
Conclusion
References

Abstract

The problem of concussion among athletes is not new due to its high prevalence. Still, concussion among high school athletes is of particular interest due to certain reasons. First of all, there is a reporting problem because many students fail to inform a coach or another adult about trauma due to the fear of exclusion from the sport. Secondly, recovery time in case of late reporting takes more time and leads to complications. Thirdly, athletes with multiple concussions are likely to demonstrate worse outcomes than those with a single concussion. The purpose of this research is to analyze recovery periods of high school athletes and compare recovery times of individuals with a single concussion to those with multiple concussions.

The study will use a survey for obtaining factual information about participants. Data for analysis will be extracted from medical records of participants. Statistical analysis will allow analyzing variables and compare outcomes for two research groups. Research is expected to reveal disparities between recovery time of athletes with a single concussion contrasted to multiple concussions. The study findings will contribute to further research in the field of high school athletes’ trauma and recovery.

Introduction

A concussion is a highly prevalent form of traumatic brain injury and a frequent cause of referring to an emergency department (ED). For example, in 2013, there were nearly 2.8 million TBI-related ED visits, hospitalizations, and deaths registered in the United States (Taylor, Bell, Breiding, & Xu, 2017). For the period of six years from 2007 to 2013, rate the s of TBI-related ED visits grew up by 47% (Taylor et al., 2017).

During 2012, 329,290 children aged 19 or younger need treatment for sports and recreation-related injuries, which comprised a diagnosis of concussion or TBI (Coronado et al., 2015). The situation is threatening because from 2001 to 2012, the rate of ED visits of young patients aged 19 other younger for sports and recreation-related injuries with a diagnosis of concussion or TBI increased more than twice (Coronado et al., 2015).

One of the possible reasons for this tendency is that athletes are monitored more closely than they have been in the past (Register-Mihalik et al., 2013). One of the peculiarities of concussions is the recovery time, which is different for each student-athlete and depends on a variety of factors such as post-concussion return to play or multiple concussions (Marar, McIlvain, & Fields, 2013). Thus, student-athletes who receive multiple concussions are expected to have longer recovery time than those students who have only suffered one concussion and the side effects such as post-traumatic headaches are likely to affect those patients more frequently.

Discussion

A concussion is defined as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces” (Lezak, Howieson, Bigler, & Tranel, 2012, p. 1089). It is one of traumatic brain injury (TBI) types, which is usually caused by a direct blow to the head, face, or neck. Also, concussion leads to short-lived impairment of neurologic function or may result in neuropathologic changes (Lezak et al., 2012).

There are many studies investigating concussion among student-athletes and diverse aspects of this problem. One of the popular issues is that of recovery after concussion. Findings in this area contribute to the theoretical background of the proposed research. For example, Beauchamp et al. (2013) investigate predictors of neuropsychological outcomes after a concussion in childhood and conclude that each student who suffers from a concussion is affected differently and their recovery time also has peculiarities. Each athlete’s recovery time depends on following the doctor’s directions (Nelson et al., 2016).

Despite the supposition that recovery can last longer depending on an athlete’s age, there are no clinically significant age differences in recovery after sport-related concussion (Nelson et al., 2016). Concussion has some adverse effects that influence different spheres of life. For example, there is evidence that concussion and severe post-concussion symptoms result in an increase in school-related problems as well as worse academic effects (Ransom et al., 2015). Also, Kerr, Thomas, Simon, McCrea, and Guskiewicz (2018) claim that multiple concussions lead to adverse health outcomes among former collegiate football players. Thus, the prevalence of disorders such as depression or alcohol dependence was higher among the respondents with three or more concussion cases.

After the concussion occurs, the medical professional who is monitoring the athlete that sustained the injury uses multiple different assessment tools, one of the tools are called the Sports Concussion Assessment Tool (SCAT-3), Glasgow Coma Scale, Maddocks Score, Post-Concussion Symptom Scale, the Standardized Assessment of Concussion (Begasse de Dhaem, Barr, Balcer, Galetta, & Minen, 2017).

These assessment tools help to determine the baseline for the patient’s level of trauma. These assessment tools evaluate the level of pain in which the patient is in and how the recovery is progressing (Begasse de Dhaem et al., 2017). Utilization of more than one assessment tool gives the medical professional a better idea on the pain level the patient is experiencing. After the recovery period, if the patient is not responding as expected, the assessment tools guide the medical provider with a path that helps in the aid of recovery (Begasse de Dhaem et al., 2017).

A concussion is a mild form of TBI (Hall & Ketchman, 2017). Therefore, they share a common side effect such as headaches. The headache factor for most of these patients with a concussion was not part of their daily lives until they sustained a TBI. About 89% of patients who sustained a TBI suffer from post-traumatic headaches (Begasse de Dhaem, et al., 2017). Lucas, Hoffman, Bell, and Dikmen (2013) in their research reveal that 90% of individuals experience headaches after TBI while only 18% had a problem with headaches before the injury.

Post-concussion symptoms and their measurement are one of the concerns related to concussion among children. The evaluation of these patients uses, in addition to SCAT-3, such testing tools as the Post-Concussion Symptom Inventory (PCSI) and Standardized Assessment of Concussion (SAC) (Beauchamp et al., 2018). The results obtained through these tools will also allow evaluating the recovery process for each patient. Moreover, such tools provide data about a variety in the recovery process of different patients and their return to the normal daily routine as well as changes in a person’s attitudes and personality (Beauchamp et al., 2018).

A preliminary study by Register-Mihalik et al. (2013) surveyed high school athletes who were not medically diagnosed with a concussion since they did not report their injury to an adult. The research is focused on revealing the fears related to injury reporting and involves the analysis of change in attitudes and influence on playing capabilities. High school students in six different sports were asked specific questions in a survey relating to the recognition of concussion-like symptoms. Some students may not realize that they received a concussion until the second or third time they are injured (Register-Mihalik et al., 2013).

The more injuries they obtain to the head/, the slower their reaction time will be to recover immediately following the injury. The students may not be aware of the injury due to the lack of knowledge about its symptoms (Register-Mihalik et al., 2013). Therefore, there is a need in providing young athletes with information to help them learn how to better recognize a concussion or other injury and how they should report it to a coach or a medical professional (Register-Mihalik et al., 2013).

As it was mentioned, one of the problems with young athletes with traumas such as concussion is the lack of reporting regularly (Asken et al., 2016). The athletes do not want to report themselves as injured, especially with a head trauma because of the factors of missing out on their activity. Still, such behavior leads to prolonged recovery due to the high vulnerability of an individual after concussion in case of not delivering medical aid. Moreover, not reporting multiple concussions can cause more serious side effects and result in a complicated and less effective recovery.

The recovery period is crucial for an athlete because the success of recovery predetermines further career opportunities in sports and has an impact on the health of an individual on the whole. It was already mentioned that the process of recovery can be monitored with the help of specialized tools applied during regular visits to a healthcare facility (Begasse de Dhaem et al., 2017). In addition to this strategy, the student-athlete is expected to follow the caregivers’ plan of recovery since it is a significant factor for the recovery time.

The patient must follow the period of limited screen time, including cell phones, video games and the time they spend watching television, altering their school schedule if they have a hard time focusing or getting tired extremely easy and it is also important they get their sleep (Begasse de Dhaem et al., 2017).

It is hard to measure and compare different athletes because every trauma has a specific character. Still, it is possible for the athletes and their recovery time by the number of concussions they have had or are currently experiencing. Thus, the research problem is the discovery of differences in recovery time among high school athletes depending on several concussions. This problem is of great significance for student sport because a recovery plan for athletes with a concussion should consider peculiarities of trauma depending on its single or multiple characters.

The purpose of this study is to analyze recovery periods of high school athletes and compare recovery times of high school athletes with a single concussion to those with multiple concussions. The hypothesis is as follows: Do high school athletes with a single concussion need less time to recover than those experiencing multiple concussions. The hypothesis will be tested using a quantitative study design with the application of statistical tools.

The independent variable for this study is the number of concussions diagnosed in life. The dependent variable is recovery time, and it is the key outcome addressed in this research. The utilizationothesis is likely to be true because previous studies prove that athletes with multiple concussions have more adverse effects, which can lead to a longer recovery time to manage all the symptoms. The hypothesis as well as the selected design allows discovering the existing differences in recovery time, which is related to the research problem since it focuses on recovery time disparities depending on several concussions.

On the whole, the number of concussions the athlete has had can also affect their remaining time in the sport. A patient can only sustain so much head trauma before the injury or side effects become permanent. The side effects such as traumatic headaches can become a lifetime obstacle for that patient and in the long-term effect their long-term education goals and even their long terms goals in their career. Head traumas can be very frustrating for an athlete.

They must understand what has happened to the brain when they sustained the injury. This would also allow them to cooperate more with the plan of recovery and help them understand why simple things such as screen time should be limited. Despite significant attention to the issue of concussion among student-athletes, there is no recent research that compares the recovery time depending on the number of concussions experienced by an athlete.

Nevertheless, the results of such research can contribute to the stimulation of trauma reporting in case there is evidence that multiple concussions and those without proper treatment in particular result in longer recovery that a single concussion. Thus, the primary focus of this research is to reveal disparities between the recovery time of athletes with a single concussion contrasted to multiple concussions.

Conclusion

Summarizing, it should be mentioned that the problem of trauma in sport is diverse and actively researched. The aspect of concussion among high school athletes is of great significance in the context of student sport because concussion as a form of traumatic brain injury can have adverse effects that have an impact on the career of athletes, their academic performance, and health condition in general.

Therefore, the issue of recovery after concussion demands careful investigation because well-planned recovery has the potential of minimizing adverse effects and providing an athlete with an opportunity to continue both education and sports activities. This research is expected to discover the differences in recovery time experienced by high school athletes with a single concussion and multiple concussions. The study findings will contribute to research in the field of sport-related trauma as a whole and the problem of post-concussion recovery in particular.

References

Asken, B., McCrea, M., Clugston, J., Snyder, A., Houck, Z., & Bauer, R. (2016). “Playing through it”: Delayed reporting and removal from athletic activity after concussion predicts prolonged recovery. Journal of Athletic Training, 51(4), 329-335. Web.

Beauchamp, M. H., Aglipay, M., Yeates, K. O., Désiré, N., Keightley, M., Anderson, P., &… Zemek, R. (2018). Predictors of neuropsychological outcome after pediatric concussion. Neuropsychology, 32(4), 495-508. Web.

Begasse de Dhaem, O., Barr, W. B., Balcer, L. J., Galetta, S. L., & Minen, M. T. (2017). Post-traumatic headache: The use of the sport concussion assessment tool (SCAT-3) as a predictor of post-concussion recovery. The Journal of Headache and Pain, 18(1), 60-68. Web.

Coronado, V. G., Haileyesus, T., Cheng, T. A., Bell, J. M., Haarbauer-Krupa, J., Lionbarger, M. R., … Gilchrist, J.(2015). Trends in sports- and recreation-related traumatic brain injuries treated in US emergency departments: The National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) 2001-2012. Journal of Head Trauma Rehabilitation, 30(3), 185–197. Web.

Hall, E. E., & Ketcham, C. J. (2017). Concussions in athletics: Assessment, management and emerging issues. New York, NY: Nova Science Publishers, Inc.

Kerr, Z., Thomas, L., Simon, J., McCrea, M., & Guskiewicz, K. (2018). Association between history of multiple concussions and health outcomes among former college football players: 15-year follow-up from the NCAA concussion study (1999-2001). The American Journal of Sports Medicine, 46(7), 1733-1741. Web.

Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). New York, NY: Oxford University Press.

Lucas, S., Hoffman, J., Bell, K., & Dikmen, S. (2013). A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia, 34(2), 93-102. Web.

Marar, M., McIlvain, N. M., & Fields, S. K. (2013). Epidemiology of concussions among United States high school athletes in 20 sports. The American Journal of Sports Medicine, 40(4), 747-755. Web.

Nelson, L., Guskiewicz, K., Barr, W., Hammeke, T., Randolph, C., Ahn, K., … McCrea, M. A. (2016). Age differences in recovery after sport-related concussion: A comparison of high school and collegiate athletes. Journal of Athletic Training, 51(2), 142-152. Web.

Ransom, D., Vaughan, C., Pratson, L., Sady, M., McGill, C., & Gioia, G. (2015). Academic effects of concussion in children and adolescents. Pediatrics, 135(6), 1043-1050. Web.

Register-Mihalik, J. K., Guskiewicz, K. M., McLeod, T. C. V., Linnan, L. A., Mueller, F. O., & Marshall, S. W. (2013). Knowledge, attitude, and concussion-reporting behaviors among high school athletes: A preliminary study. Journal of Athletic Training, 48(5), 645–653. Web.

Taylor, C.A., Bell, J. M., Breiding, M. J., & Xu, L. (2017). Traumatic brain injury–related emergency department visits, hospitalizations, and deaths — United States, 2007 and 2013. MMWR Surveillance Summary, 66(SS-9), 1–16. Web.

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