Preliminary Evidence of a Dose-Response for Continuing to Play on Recovery Time After Concussion.
Daniel B Charek, R J Elbin, Alicia Sufrinko and 4 others
PMID 31033740WHAT IT FOUND
Young athletes who kept playing after concussion had longer recovery.
Playing for more than 15 minutes was linked to the longest recovery and the greatest chance of taking 21 days or more.
Key findings
01Continued play after concussion was associated with longer recovery time.
02Athletes who played for more than 15 minutes after concussion took longer to recover than those removed immediately and those who played for 15 minutes or less.
03Compared with immediate removal, continuing to play for 15 minutes or less was associated with 5.43 times greater odds of recovery lasting 21 days or more, and continuing to play for more than 15 minutes with 11.76 times greater odds.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was small and came from athletes seen at a concussion specialty clinic within 7 days of injury, so it may not represent all athletes. Information about on-field signs, symptoms, and how long athletes kept playing was gathered retrospectively, so it may not be entirely accurate. The study did not measure additional head impacts, aerobic activity, or dynamic exertion during continued play, so it cannot determine why recovery was longer. The study is observational, so it shows association rather than proof that continued play caused slower recovery.
Declared interests
The paper lists NIH extramural research support. The conflict-of-interest statement says all other authors have no potential conflicts of interest; it does not provide a complete author-by-author disclosure.
The easy way to misread this
Do not conclude that continuing to play caused longer recovery. The study is observational and did not measure additional head impacts or exertion during play, so it cannot separate the effects of trauma and activity.