Session Information
Session Title: Research Spotlight: Musculoskeletal and Sports Medicine
Session Time: None. Available on demand.
Disclosures: Donald Kasitinon, MD: No financial relationships or conflicts of interest
Objective: After sustaining a concussion, athletes progress through a stepwise return-to-play (RTP) protocol. Collegiate athletes often have unique pressures to return to sport as quickly as possible, especially while in season. There are few studies looking comprehensively at different factors which may be associated with prolonged RTP. Furthermore, many prior studies heavily emphasize concussions in elite male contact-sports, which may not be representative of the larger collegiate athlete population.
Design: Retrospective case-control study.Setting : A student-athlete clinic at a National Collegiate Athletic Association (NCAA) Division I institution.Participants : 159 NCAA Division I collegiate athletes who were diagnosed with at least one concussion between September 2017 and August 2020.
Interventions: Not applicable.
Main Outcome Measures: Initial and follow-up sport concussion assessment tool 5 (SCAT5) data including symptom score and severity, standard assessment of concussion (SAC), and balance error scoring system (BESS); vestibular examination; medical history; eye tracking; and RTP timelines.
Results: Prolonged RTP was significantly associated with specific symptoms in the SCAT5 (balance problems, difficulty concentrating, light sensitivity, drowsiness, fatigue/low energy, and difficulty remembering), total initial symptom score, total number of symptoms, number of prior concussions, history of migraines, and abnormal vestibular exam findings. Interestingly, initial symptom decrease (from initial post-injury to follow-up assessments), history of ADHD, and BESS scores did not have statistical significance in their associations with prolonged RTP.Conclusions: Certain SCAT5 symptoms and the presence of abnormalities on the vestibular exam are significantly associated with prolonged concussion recovery and thus increased RTP time in collegiate athletes. Although the nature of concussion makes specific RTP times difficult to predict, these results can help guide clinicians in estimating potential RTP times to better optimize concussion care and RTP for this unique population.
Level of Evidence: Level III
To cite this abstract in AMA style:
Kasitinon D, Hwang CE, Kussman A, Abrams G. Factors Associated with Extended Return to Play After Concussion in Collegiate Athletes [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/factors-associated-with-extended-return-to-play-after-concussion-in-collegiate-athletes/. Accessed May 21, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/factors-associated-with-extended-return-to-play-after-concussion-in-collegiate-athletes/