The Journal of head trauma rehabilitation · 2026
Factors Associated With Return-to-Learn Duration After Concussion in US Service Academy Cadets and Midshipmen.
СтатьяНазвание и аннотация: Перевод в очереди
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Ross Jeremy D, Aderman Michael J, Roach Megan H, Malvasi Steven R, Susmarski Adam, Brodeur Rachel M, McGinty Gerald, Robb Joel, Jackson Jon, Broglio Steven P, McCrea Michael A, McAllister Thomas W, Pasquina Paul F, Cameron Kenneth L
Аннотация
OBJECTIVE: Patterns of clinical recovery and factors that may influence return to activity after concussion have been well studied; however, data regarding return-to-learn (RTL) duration after concussion and factors that influence this period have not been adequately explored.
HYPOTHESIS: We have hypothesized that sport level, sex, concussion history, and initial symptom burden will be associated with RTL duration after concussion.
SETTING: The study was conducted at US military service academies.
STUDY DESIGN: This was a prospective cohort study.
PARTICIPANTS: A total of 1509 service academy cadets (41% female, 20.2 ± 1.48 y, 174.9 ± 10.3 cm, 73.8 ± 14.0 kg) who sustained a concussion during the study period from December 2014 to March 2020 were included.
MAIN MEASURES: The primary outcome of interest was time elapsed between an incident injury and self-reported return to normal academic performance. All participants provided baseline demographics, including sex (male, female), sport level (varsity, non-varsity), and concussion history (yes, no). Participants completed standardized concussion assessments at regular time points. Initial symptom burden was collected within 48 hours after injury, and self-reported RTL duration was collected during the unrestricted return-to-activity (URTA) evaluation.
RESULTS: On average, RTL duration was faster in men (8.1 ± 11.2 days) than in women (13.6 ± 20.3 days). Univariate models demonstrated that participants with an initial symptom burden ≤6 returned sooner than those endorsing 7-15 symptoms (HR = 0.73, 95% CI = 0.64-0.83, P ≤ .001) and ≥16 symptoms (HR = 0.56, 95% CI = 0.48-0.65, P ≤ .001). Sex (HR = 0.70, 95% CI = 0.62-0.77, P ≤ .001), and sport level (HR = 0.66, 95% CI = 0.59-0.73, P ≤ .001) also contributed to RTL duration in the univariate model. In the multivariable model, participants with an initial symptom burden ≤6 returned 25%-41% sooner than those endorsing 7-15 symptoms (HR = 0.75, 95% CI = 0.65-0.86, P ≤ .001) and ≥16 symptoms (HR = 0.59, 95% CI = 0.51-0.69, P ≤ .001). Sex (HR = 0.71, 95% CI = 0.64-0.80, P ≤ .001) and sport level (HR = 0.75, 95% CI = 0.67-0.85, P < .001) also contributed to RTL duration in the multivariable model.
CONCLUSIONS: RTL duration for men, varsity athletes, and individuals with fewer initial symptoms after injury was significantly faster than for women, nonvarsity athletes, and individuals with a greater initial symptom burden.
HYPOTHESIS: We have hypothesized that sport level, sex, concussion history, and initial symptom burden will be associated with RTL duration after concussion.
SETTING: The study was conducted at US military service academies.
STUDY DESIGN: This was a prospective cohort study.
PARTICIPANTS: A total of 1509 service academy cadets (41% female, 20.2 ± 1.48 y, 174.9 ± 10.3 cm, 73.8 ± 14.0 kg) who sustained a concussion during the study period from December 2014 to March 2020 were included.
MAIN MEASURES: The primary outcome of interest was time elapsed between an incident injury and self-reported return to normal academic performance. All participants provided baseline demographics, including sex (male, female), sport level (varsity, non-varsity), and concussion history (yes, no). Participants completed standardized concussion assessments at regular time points. Initial symptom burden was collected within 48 hours after injury, and self-reported RTL duration was collected during the unrestricted return-to-activity (URTA) evaluation.
RESULTS: On average, RTL duration was faster in men (8.1 ± 11.2 days) than in women (13.6 ± 20.3 days). Univariate models demonstrated that participants with an initial symptom burden ≤6 returned sooner than those endorsing 7-15 symptoms (HR = 0.73, 95% CI = 0.64-0.83, P ≤ .001) and ≥16 symptoms (HR = 0.56, 95% CI = 0.48-0.65, P ≤ .001). Sex (HR = 0.70, 95% CI = 0.62-0.77, P ≤ .001), and sport level (HR = 0.66, 95% CI = 0.59-0.73, P ≤ .001) also contributed to RTL duration in the univariate model. In the multivariable model, participants with an initial symptom burden ≤6 returned 25%-41% sooner than those endorsing 7-15 symptoms (HR = 0.75, 95% CI = 0.65-0.86, P ≤ .001) and ≥16 symptoms (HR = 0.59, 95% CI = 0.51-0.69, P ≤ .001). Sex (HR = 0.71, 95% CI = 0.64-0.80, P ≤ .001) and sport level (HR = 0.75, 95% CI = 0.67-0.85, P < .001) also contributed to RTL duration in the multivariable model.
CONCLUSIONS: RTL duration for men, varsity athletes, and individuals with fewer initial symptoms after injury was significantly faster than for women, nonvarsity athletes, and individuals with a greater initial symptom burden.