Journal CME, August 2023: Sport participation among children with complicated mild traumatic brain injury-Journal CME, August 2023: Sport participation among children with complicated mild traumatic brain injury

Journal CME, August 2023: Sport participation among children with complicated mild traumatic brain injury

Pdf Summary

This study by Colby Hansen MD and colleagues examines the sports participation outcomes in children aged 5-18 who experienced complicated mild traumatic brain injury (C-mTBI), mild traumatic brain injury with skull fracture (mTBI-SF), or mild traumatic brain injury (mTBI) between 2010 to 2013. Conducted through a cross-sectional survey at a Level I pediatric trauma center, it includes analysis of pre- and post-injury sports participation and factors associated with repeated injuries. Key findings are as follows:<br /><br />1. **Sports Participation Post-Injury**:<br />   - Of 247 children surveyed, 95.1% returned to sports post-injury.<br />   - There was no significant difference in the rate of return to any sports or high-risk sports based on mTBI type.<br />   - Younger children were more likely to return to sports compared to older children.<br />   - Children typically resumed participation in sports with similar risk profiles to those pre-injury.<br /><br />2. **Repeated mTBI**:<br />   - 17% of the children sustained another mTBI after their initial injury.<br />   - Children with C-mTBI had a significantly lower probability of repeated mTBI compared to those with mTBI (odds ratio 0.30).<br />   - Longer recovery periods (3 months or more) were associated with higher likelihoods of repeated mTBI.<br />   - Delaying return to contact sports (3 months or more) reduced the risk of repeated mTBI.<br /><br />3. **Physician Clearance**:<br />   - 73.8% were cleared by physicians to return to all sports, 16.7% for low-risk sports only, and 9.5% were not cleared but still participated.<br />   - A significant number of children engaged in high-risk sports despite recommendations to avoid them.<br /><br />The authors suggest that children with C-mTBI or mTBI-SF generally resume sports participation at similar rates and risk levels as children with mTBI. However, they found that more cautious return-to-sports strategies might lower the risk of repeated concussions. The study calls for prospective research to inform evidence-based guidelines for children recovering from various types of mTBI to balance sport participation with injury risks.

Keywords

sports participation

children

mild traumatic brain injury

C-mTBI

mTBI-SF

repeated injuries

physician clearance

return to sports

risk profiles

recovery periods