Do patients who receive treatment earlier recover from concussion faster?

Recovery after concussion can vary significantly between patients, one factor that may play a role in recovery time – but has received little attention – is timeliness of seeking clinical care. Therefore, a team of researchers have investigated the effect of early clinical treatment.

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According to new research led by a team from the University of Pittsburgh Sports Medicine Concussion Program (PA, USA), early clinical treatment may significantly reduce recovery time following a concussion. The study, published in JAMA Neurology, reported that delays in seeking treatment is a driving factor for increased recovery time.

“Our study emphasizes the importance of seeking appropriate, specialized care early on. Delaying clinical care following a concussion leaves patients to deal with symptoms on their own and negates the positive effects of early and targeted interventions,” commented senior author Anthony Kontos (Sports Medicine Concussion Program).

Symptoms, including cognitive impairment and sleep disturbance, can last from several hours to days, weeks, months or longer, therefore the team at the University of Pittsburgh wanted to investigate what factors contributed to the variation in patient’s recovery times.

After Kontos and his team analyzed their sample of 162 athletes aged 12–22 years, they discovered that athletes treated within the first week of injury recovered faster when compared with athletes who did not receive care until 8 days to 3 weeks after injury.

Once in care, the length of time spent recovering was the same for both groups, suggesting that the time before initial clinical care is the primary cause for the longer recovery duration.

“Early clinical care including behavioral management interventions and targeted exertion, vestibular and oculomotor rehabilitation exercises also may minimize missed time at work, school or sports, helping the patient return to a normal routine sooner,” commented Michael Collins, Executive and Clinical Director at University of Pittsburgh Sports Medicine Concussion Program.

The team mentioned that future research should investigate the biological explanations behind why earlier engagement in care promotes faster recovery and further their current findings to discover whether they could be applied to different patient groups, such as military personnel.   

Sources: Kontos P, Jorgensen-Wagers K, Trbovich AM, et al. Association of time since injury to the first clinic visit with recovery following concussion. JAMA Neurol. doi:10.1001/jamaneurol.2019.4552 (2019) (Epub ahead of print);

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Kimberley Ndungu

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