Clinical examination factors that predict delayed recovery in individuals with concussion.
Corina Martinez, Zachary Christopherson, Ashley Lake and 4 others
PMID 32514379WHAT IT FOUND
Concussed athletes who had cognitive symptoms or positive vestibular exam findings on initial evaluation were significantly more likely to have delayed recovery.
These predictors were strongest when the examination occurred early after injury.
Key findings
01Cognitive symptoms and positive vestibular testing at initial evaluation were independently associated with delayed clearance to activity.
02The association between these clinical findings and delayed recovery was stronger in athletes examined earlier after injury compared to those examined later.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Retrospective design limits control over data collection and potential confounders. Delayed recovery was defined statistically (above median time to clearance) rather than by a clinically accepted threshold (e.g., >14 or >28 days), which may affect generalizability. Time to clearance is influenced by non-clinical factors such as physician variability, access to care, and psychosocial components, which were not fully controlled. Symptom reporting relies on patient recall and self-report, which can vary based on time since injury and individual interpretation.
Declared interests
None reported.
The easy way to misread this
Do not assume that headache or dizziness alone are independent predictors of delayed recovery in a multivariate context; only cognitive symptoms and vestibular exam findings remained significant after controlling for other variables.