Exploring Symptom Profiles and Severity, and Their Relation to Recovery Among Student Athletes in the Ivy League-Big Ten Epidemiology of Concussion Study

• Activity Number: 407 - Emerging Methods in Sports Injury Research: Strategies for Shifting the Paradigm
• Type: Topic Contributed
• Date/Time: Wednesday, August 5, 2020 : 1:00 PM to 2:50 PM
• Sponsor: Section on Statistics in Sports
• Author(s): Bernadette Anne D'Alonzo* and Douglas J Wiebe
• Companies: University of Pennsylvania, School of Medicine and University of Pennsylvania, School of Medicine
• Keywords: Sport-related concussion; Symptom profiles; Concussion management

Abstract

Athletes experience various symptoms after sport-related concussion (SRC) and differences in symptom presentation may influence recovery. SRC management recommends stepwise progression through return-to-learn (RTL) and return-to-play (RTP) protocols. Athletic trainers collect demographic and clinical information on athletes with SRC (N=2,898) including 22 symptoms and dates through RTL/RTP. We use factor analysis to identify symptom domains and Kaplan-Meier curves to determine outcomes by profile type and severity. We define recovery profiles by sequence athlete proceeded through RTL/RTP and with Chi-square, Kruskal-Wallis examine how they differ by symptom profile type. Among 455 football SRCs (med symptom=11), 22 symptoms loaded on 5 domains (alpha=0.88): 1)emotional, 2)foggy, 3)nausea/vestibular, 4)headache/light sensitivity, 5)pressure/neckpain. Endorsing High/Low on each symptom domain was associated with 3-5 day delay in symptom resolution (p< .001). 4 recovery profiles accounted for how 85% athletes returned to sport; the most common sequence (40.4%) academics, symptom resolution, exertion, limited play, full play. SRC management could be tailored to symptom profile type.