Mild Sports-Related Brain Injury Requires Longer than Recommended Recovery Time

Researchers have questioned the current concussions in sports group (CISG) guidelines that say that all sports-related concussions resolve within 10 days. The new findings, published in Clinical Journal of Sports Medicine, says that not even half the patients with sports-related mild brain injury (mTBI) recover during this period.

On the contrary, they found that most sportsmen with mTBI recover after at least 14 days and age plays an important role in determining the speed of recovery.

Dr. Stephen Kara, MBChB, FRNZCGP, Dip Sports Med, MPhil (Hons), and his colleagues conducted this study to figure out the recovery time and factors that could play a major role in the recovery after sports-related mTBI.

Sports and recreational activities contribute to about 21% of all traumatic brain injuries among American children and adolescents.

Traumatic brain injury refers to a blow to the head that could disturb the normal functioning of the brain. It can occur when the head hits an object or an object pierces the skull. TBI symptoms can be mild, moderate or severe depending on the damage to the brain. Mild injury results in a change in the mental state whereas severe injury may result in a period of unconsciousness or even death.

Source: US Department of Defense

The research was a prospective cohort study conducted in New Zealand Sports Concussion Clinic. 822 patients were included in the study over a 2-year period within 14 days of sports-related injury (SRI). The standard protocol was used to assess participants consisting of relative rest followed by cognitive and physic loading. A reassessment was performed 14 days after injury consisting of a sub-symptom threshold exercise program ±cervicovestibular rehabilitation (if required) for participants who remained symptomatic. The assessment was done every 14 days until clinical recovery.

594 participants were selected for examination and categorized into three age groups: less than 12 years, adolescents of 13 to 18 years, and adults greater than the age of 19.

The results revealed that 45% of participants showed recovery within 14 days. 77% by four weeks after injury and 96% by eight weeks after injury. The recovery time didn’t vary much between age groups. In females, prolonged recovery was common.

Dr. Stephen Kara says:

This study challenges current perceptions that most people with a sports-related mTBI recover within 10 to 14 days. This rate of recovery is slower than described in the previous CISG, and other position statements. We believe that our data may reflect the natural recovery timeline for those with a sports-related mTBI. Early access to care after mTBI leads to faster recovery. It enables physicians and therapists to empower patients to be actively involved in their recovery from both a physical and cognitive perspective, supported by a clinical recovery protocol.

A concussion is a brain injury and is defined as a complex pathophysiological process induced by biomechanical forces. It can be caused by a blow to head, neck or elsewhere. It results in the rapid onset of short-lived dysfunction of the brain that resolves spontaneously.

Source: CDC

According to the US Consumer Product Safety Commission (CPSC) data, there were an estimated 446,788 sports-related head injuries treated at US hospital emergency rooms in 2009.

Following sports contributed to head injury in 2009.

Cycling: 85,389, Football: 46,948, Baseball and Softball: 38,394, Basketball: 34,692, Water Sports (Diving, Scuba Diving, Surfing, Swimming, Water Polo, Water Skiing, Water Tubing): 28,716, Powered Recreational Vehicles (ATVs, Dune Buggies, Go-Carts, Mini bikes, Off-road): 26,606, Soccer: 24,184, Skateboards/Scooters: 23,114, Fitness/Exercise/Health Club: 18,012, Winter Sports (Skiing, Sledding, Snowboarding, Snowmobiling): 16,948, Horseback Riding: 14,466, Cheerleading: 10,223, Golf: 10,035, Hockey: 8,145, Trampolines: 5,919, Rugby 5,794, Ice Skating: 4,608.

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