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Recovery from sports-related concussion in youth hockey players: A case series study.

British Journal of Sports Medicine. 2009 May;

43(Suppl 1):i95.

Keightley, M. L., N. P. Reed, J. McAuliffe, T. Taha, B. Faught, M. McPherson and W. Montelpare.

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Abstract:

Objective: To describe the resolution of post-concussion symptoms (PCS) and neurocognitive function in bantam-aged (14 years) minor and female ice hockey players following a sport-related concussion. Design: A prospective case series study of clinical recovery following paediatric sport-related concussion. Setting: 30 participants (one bantam boys team and one bantam girls team) were recruited from the Greater Toronto Hockey League and Ontario Women’s Hockey Association in Toronto, Ontario, Canada. Subjects: Three subjects (14 years old) were diagnosed with concussion resulting from a direct blow to the head (including face or jaw) and defined by post-concussion symptoms that scored higher than 21 on the PCS scale, as well as alteration in mental state (eg, feeling dazed, disoriented or confused). Outcome Measures: Immediate post-concussion assessment and cognitive testing (ImPACT), Conners’ continuous performance test 2 (CPT-2) and the attention network test (ANT). Results: Results from ImPACT showed a significant increase in PCS compared with baseline for all three subjects. Two out of three subjects showed significantly poorer performance on the visual composite score, with performance returning to baseline functioning within 7 days post-concussion. In contrast, the third subject showed significantly poorer verbal memory, visual motor speed and reaction time composite scores, which returned to baseline within 7 days post-concussion. The CPT-2 results were variable, but indicated changes (using a reliable change index) in omissions, commissions, perseverations and reaction time that varied over the course of recovery for all three subjects. Follow-up testing with the ANT revealed a greater number of errors on the executive function of attention, which in some cases did not resolve even by 255 days post-concussion. Conclusion: The results suggest more research is needed regarding the potential impact of neural development on recovery from concussion and has important implications for the management of concussion in youth sustaining multiple injuries.

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