188 Recovery after a sports-related concussion: a longitudinal study of adolescent rugby union players in Northern Ireland

TL;DR

This study tracks recovery from concussions in adolescent rugby players, finding prolonged symptoms and differences between males and females.

Contribution

It provides longitudinal data on recovery times and symptom persistence in adolescent rugby players after concussion.

Findings

PCSS and PFAB-TBI took the longest to return to baseline scores after concussion.

Male and female players experienced prolonged post-concussive symptoms based on self-reported measures.

Statistically significant differences were found in recovery time across clinical measures.

Abstract

Adolescent athletes who sustain a sports-related concussion may experience a prolonged recovery period. Evidence suggests female athletes and those with a history of previous concussion may have an extended recovery period, spanning multiple weeks to months. The purpose of this study was to track recovery from a concussion across patient-reported measures and determine the time taken to return to pre-injury levels in adolescent rugby union players.

A longitudinal study was utilised across a single rugby union playing season (2022-23). Ethical approval was granted from Ulster University Research Ethics Committee

Male and female rugby union players were recruited from nine school and club rugby teams across Northern Ireland. To be eligible, participants had to be 16-18years of age, injury free and currently playing at First XV level. Participants completed demographic and established questionnaires including Post-Concussion Symptom Scale (PCSS), Concussion Clinical Profiling (CP), Paediatric Fear Avoidance Behaviour after Traumatic Brain Injury (PFAB-TBI), General Anxiety Disorder (GAD) and Patient Health Questionnaire (PHQ). Those who sustained a concussion were re-assessed at 3, 7, 14, 23, 90 and 180days post-event. Recovery was defined as questionnaire score at pre-injury level. The primary outcome measure was Post-Concussion Symptom Scale.

Of the 149 participants (113M (76%); 36F (24%)), 11 (7%) sustained a concussion during the season (9M: 2F), of which four had a previous history of concussion (2M: 2F). PCSS and PFAB-TBI took the longest time to return to baseline scores. Statistically significant differences in survival distribution (Chi-square 9.27 (df = 4) p < 0.05) across self-reported outcomes; pairwise comparisons show the largest differences in survival distribution were seen between PCSS and GAD (p = 0.02) and PCSS and PHQ (p < 0.04).

Adolescent male and female rugby union players experienced prolonged post-concussive symptoms based on self-reported measures. Further research on male and female adolescent athletes is needed to track recovery across various clinical measures.

This study was funded by the Department for the Economy (DfE) as part of a sponsorship of postgraduate students