Physical Maturity and Concussion Symptom Duration among Adolescent Ice Hockey Players - 24/03/16
, Cynthia Stein, MD 2, Janet Kent, MD 3, Danielle Ruggieri, BA 1, Emilie Dolan, BS 1, Michael O'Brien, MD 2, 4, William P. Meehan, MD 2, 4Abstract |
Objective |
To investigate the association between physical maturity and risk of prolonged concussion symptoms in adolescent ice hockey players.
Study design |
Prospective cohort study of 145 patients ages 13-18 years with concussion referred to 3 hospital-affiliated sports medicine clinics between September 1, 2012 and March 31, 2015. Concussion evaluations included Post Concussive Symptom Score, neurologic examination, and postinjury computerized neurocognitive testing. Pubertal development at initial visit was assessed by the Pubertal Developmental Scale. Duration of concussion symptoms (days) was the main outcome. Statistical comparisons were conducted using Student t test, Wilcoxon rank sum, and logistic regression.
Results |
Mean symptom duration was 44.5 ± 48.7 days. Nearly one-half (48.3%) of all players enrolled had prolonged concussion symptoms (≥28 days); most (86.9%) had symptom resolution by 90 days. Among males, less physically mature adolescents took longer to recover than more physically mature players (54.5 days vs 33.4 days; P = .004). “Early” Pubertal Category Score was the strongest predictor of prolonged symptoms (OR = 4.29, 95% CI 1.24-14.85; P = .021) among males. Among females, heavier weight increased the odds of experiencing prolonged symptoms (OR 1.07, 95% CI 1.00-1.14; P = .039).
Conclusions |
Among adolescent ice hockey players, early-pubertal stage is independently associated with longer recovery from concussion in males, and heavier weight is associated with longer concussion recovery in females. Until further studies determine valid physical maturity indicators, peripubertal collision sport athletes should compete in leagues grouped by relative age and be discouraged from “playing up” on varsity teams.
Le texte complet de cet article est disponible en PDF.Keyword : JV, PCSS, PDS
Plan
| Funded in part by Rhode Island Foundation (20113642) and the National Federation of State High School Associations Foundation (701-5917). The content of this report is solely the responsibility of the authors and does not necessarily reflect the official views of the funders. W.M. receives royalties from ABC-Clio publishing for the sale of his book, Kids, Sports, and Concussion: A guide for coaches and parents, and royalties from Wolters Kluwer for working as an author for UpToDate; he is under contract with ABC-Clio publishing for a future book, Concussions, and with Springer International publishing for a future book, Head and Neck Injuries in Young Athletes; and his research is funded, in part, by the National Football League Players Association and philanthropic support from the National Hockey League Alumni Association through the Corey C. Griffin Pro-Am Tournament. The other authors declare no conflicts of interest. |
Vol 171
P. 234 - avril 2016 Retour au numéro
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