Medical Student Vanderbilt University School of Medicine
Introduction: Sport-related concussion (SRC) is an evolving public health concern, especially among youth athletes. While return-to-learn (RTL) is an emerging area of interest in the SRC literature, consensus guidelines and primary research regarding such topic is sparse. We sought to: 1) describe patterns of RTL among athletes by school-level (middle-school/high-school/college), and 2) evaluate the predictive value of school-level on RTL duration.
Methods: A retrospective, single-institution, cohort study of adolescent athletes 12-23 years old who sustained a SRC from 11/2017-04/2022 was conducted. Athletes were categorized based on school-level (middle-school/high-school/college). The primary outcome was RTL duration, which was dichotomized into normal (≤7 days) vs. late (>7 days). Descriptive statistics, ANOVA, t-tests, and univariate/multivariable logistic regressions were performed. Covariates included sex, race/ethnicity, personal history of learning disabilities/ADHD/psychiatric/migraines, family history of psychiatric/migraines, post-concussion symptoms scale scores, and number of prior concussions.
Results: School-levels among 1,119 athletes were: 126 (11.3%) middle-school, 918 (82.0%) high-school, and 75 (6.7%) college. Mean RTL times for athletes at each school-level were 11.0±36.3 (middle-school), 11.7±38.4 (high-school), and 23.5±57.6 (college). ANOVA and t-tests did not show significant differences in mean RTL duration (in days) between three groups. Both univariate/multivariable logistic regressions showed that compared to high school athletes, middle school and collegiate athletes did not differ significantly in RTL duration (dichotomized). Similarly, there was no statistically significant difference in RTL duration (dichotomized) between middle-school and collegiate athletes.
Conclusion : RTL duration does not seem to differ by school-level, between middle-school, high-school, and collegiate athletes. Future studies should investigate possible differences in other outcome measures after SRC, such as return-to-play and time-to-symptom resolution between these groups.
