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Sport-Specific Recovery Trajectories for NCAA Collegiate Athletes Following Concussion

  • S.I. : Concussions II
  • Published:
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Abstract

The recovery trajectories of collegiate athletes with sport-related concussion (SRC) are well characterized in contact/collision sports but are less well understood in limited contact sports with lower risk, reducing the ability of clinicians to effectively manage the return-to-play (RTP) process. The current study investigated the time to asymptomatic and RTP across a broad range of male and female collegiate sports and sought to group sports by recovery intervals. Data from the Concussion Assessment, Research and Education (CARE) Consortium included 1049 collegiate athletes who sustained a SRC while participating in game or practice/training of their primary sport. Injury setting and subsequent clinical presentation data were obtained. Survival analysis using the Cox Proportional Hazard model estimated the median recovery times for each sport. Optimal univariate K-means clustering grouped sports into recovery categories. Across all sports, median time to asymptomatic following SRC ranged from 5.9 (female basketball) to 8.6 days (male wrestling). Median RTP protocol duration ranged from 4.9 days (female volleyball) to 6.3 days (male wrestling). Median total RTP days ranged from 11.2 days (female lacrosse) to 16.9 days (male wrestling). Sport clusters based on recovery differences in time to asymptomatic (3) and RTP protocol duration (2) were identified. The findings from this study of a large sample of more than 1000 NCAA collegiate athletes with SRC show there exists ranges in recovery trajectories. Clinicians can thus manage athletes with similar guidelines, with individualized treatment and recovery plans.

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Data Availability

The NCAA-DoD CARE Consortium dataset is available in the FITBIR database (https://ftbir.nih.gov/). The R code is accessible by contacting the corresponding author.

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Acknowledgements

Alphabetically by last name, CARE Consortium investigators include: Scott Anderson, ATC (University of Oklahoma, USA), Holly Benjamin, MD (University of Chicago, USA), Thomas Buckley, EdD (University of Delaware, USA), Kenneth Cameron, PhD (Keller Army Hospital, USA), Sara Chrisman, MD (University of Washington), James Clugston, MD (University of Florida, USA), Stefan Duma, PhD (Virginia Tech, USA), James Eckner, MD (University of Michigan, USA), Luis Feigenbaum, PT (University of Miami, USA), Christopher Giza, MD (University of California Los Angeles, USA), Joshua Goldman, MD (University of California Los Angeles), April Hoy, MS (Azusa Pacific University, USA), Jonathan Jackson, MD (United States Air Force Academy, USA), Thomas Kaminski, PhD (University of Delaware, USA), Louise Kelly, PhD (California Lutheran University, USA), Anthony Kontos, PhD (University of Pittsburgh, USA), Dianne Langford, PhD (Temple University, USA), Laura Lintner, DO (Wake Forest University), Christina Master, MD (University of Pennsylvania, USA), Jane McDevitt, PhD (Temple University, USA), Gerald McGinty, PT (United States Air Force Academy, USA), Jason Mihalik, PhD (University of North Carolina at Chapel Hill, USA), Chris Miles, MD (Wake Forest University, USA), Justus Ortega, PhD (California Polytechnic University Humboldt, USA), Margot Putukian, MD (Major League Soccer, USA), Nicholas Port, PhD (Indiana University, USA), Steve Rowson, PhD (Virginia Tech, USA), Adam Susmarski, DO (United States Naval Academy, USA), and Steven Svoboda, MD (MedSTAR Orthopaedic Institute, USA). We would also like to thank Jody Harland, Susan Perkins, Barry Katz, Janetta Matesan, and Larry Riggen (Indiana University), Ashley Rettmann, Nicole L'Heureux (University of Michigan), Melissa Koschnitzke (Medical College of Wisconsin), Michael Jarrett, Vibeke Brinck, and Bianca Byrne (Quesgen), Thomas Dompier, Christy Collins, Melissa Niceley Baker, and Sara Dalton (Datalys Center for Sports Injury Research and Prevention), and the research and medical staff at each participating site.

Funding

This publication was made possible in part by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs, through the Combat Casualty Care Research Program, endorsed by the Department of Defense, through the Joint Program Committee 6/Combat Casualty Care Research Program – Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH1820047. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.

Author information

Authors and Affiliations

  1. Department of Neurology, Traumatic Brain Injury & Concussion Center, University of Utah School of Medicine, Salt Lake City, UT, USA

    Spencer W. Liebel

  2. George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA

    Spencer W. Liebel

  3. Synaptek LLC, Lexington, KY, USA

    Kathryn L. Van Pelt

  4. Department of Physical Medicine & Rehabilitation, Uniformed Services University, Bethesda, MD, USA

    Paul F. Pasquina

  5. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA

    Thomas W. McAllister

  6. Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA

    Michael A. McCrea

  7. Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA

    Steven P. Broglio

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  1. Spencer W. Liebel
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  2. Kathryn L. Van Pelt
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  3. Paul F. Pasquina
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  4. Thomas W. McAllister
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  5. Michael A. McCrea
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  6. Steven P. Broglio
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Consortia

CARE Consortium Investigators

  • Scott Anderson
  • , Holly Benjamin
  • , Thomas Buckley
  • , Kenneth Cameron
  • , Sara Chrisman
  • , James Clugston
  • , Stefan Duma
  • , James Eckner
  • , Luis Feigenbaum
  • , Christopher Giza
  • , Joshua Goldman
  • , April Hoy
  • , Jonathan Jackson
  • , Thomas Kaminski
  • , Louise Kelly
  • , Anthony Kontos
  • , Dianne Langford
  • , Laura Lintner
  • , Christina Master
  • , Jane McDevitt
  • , Gerald McGinty
  • , Jason Mihalik
  • , Chris Miles
  • , Justus Ortega
  • , Margot Putukian
  • , Nicholas Port
  • , Steve Rowson
  • , Adam Susmarski
  •  & Steven Svoboda

Contributions

SWL, KLVP, and SPB contributed to the design of the study, data analysis, and writing of the manuscript. PFP, MAM, TWM, and SPB aided in obtaining the dataset, securing funding, and revising the manuscript.

Corresponding author

Correspondence to Spencer W. Liebel.

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Conflict of interest

SWL and KLVP have no conflicts of interest directly relevant to the content of this study. PFP, MAM, TWM, and SPB received research support from the NCAA and the U.S. Department of Defense.

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Associate Editor Joel Stitzel oversaw the review of this article.

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Liebel, S.W., Van Pelt, K.L., Pasquina, P.F. et al. Sport-Specific Recovery Trajectories for NCAA Collegiate Athletes Following Concussion. Ann Biomed Eng (2023). https://doi.org/10.1007/s10439-023-03406-8

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