Ensuring a high school athlete has returned to an asymptomatic state after a concussion can be challenging, according to the authors of a study that found a significant proportion of uninjured adolescent athletes report at least one symptom of concussion.
A cross-sectional observational study of 31,958 high school athletes, none of whom had experienced a concussion in the prior 6 months, showed 19% of boys and 28% of girls reported a symptom burden resembling an ICD-10 diagnosis of mild postconcussional syndrome, according to a paper published online Oct. 12 in JAMA Pediatrics.
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Concussion symptoms were particularly prevalent among students with preexisting conditions such as psychiatric problems, learning disorders, migraine, attention deficit/hyperactivity disorder, or substance abuse. Students who had experienced a concussion previously were the least likely to show concussion symptoms (JAMA Pediatrics. 2015 Oct. 12 [doi: 10.1001/jamapediatrics.2015.2374]).
Boys most commonly reported symptoms such as fatigue, sleep troubles, and difficult concentration, while girls were more likely to report fatigue, sleep troubles, headaches, sadness, feeling emotional, and difficulty concentrating.
“When managing a student athlete with a concussion, it has been widely noted that the athlete should be ‘asymptomatic’ at rest and with exercise before returning to sports, and sometimes athletes are kept out of school for prolonged periods while they wait for symptoms to resolve, which could have negative consequences for their academic, social, and emotional functioning and contribute to symptom reporting,” wrote Grant L. Iverson, Ph.D., from Harvard Medical School, Boston, and his coauthors.
“These results reinforce that ‘asymptomatic’ status after concussion can be difficult to define,” they added.
The study was supported by the Goldfarb Center for Public Policy and Civic Engagement/Colby College, the Bill and Joan Alfond Foundation, the Harvard Integrated Program to Protect and Improve the Health of National Football League Players Association Members, and the Mooney-Reed Charitable Foundation. The lead author declared speakers fees from private industry, but there were no other conflicts of interest declared.