Neurology Central

Study reports prolonged recovery from concussion in children and youths

Concussion experts from York University (Canada) recently reported that children and youths may take longer than previously thought to fully recover from a concussive injury.

The study, recently published in Concussion, showed that it may take almost 2 years post-event for children and adolescents to perform comparably to controls with no history of concussion at tasks that require cognitive–motor integration. Despite this, young athletes are usually expected to rejoin their sports teams a few weeks following the incident if they do not have any active symptoms.

“Performing motor tasks, guided by what we see, is crucial in skill-based activities such as sports,” commented corresponding author Lauren Sergio. “But the current return-to-sport assessment doesn’t test to see if the injured person has regained this ability. Because of this, often children and youth who have had a concussion end up returning to normal activities before they are fully recovered. We believe this makes them more vulnerable to another concussion.”

The study investigated the prolonged difficulty in cognitive–motor integration in 50 children and adolescents (8–16 years of age) with a history of concussion, and compared this with 49 subjects that had never had a concussive injury. Members of both groups were asked to perform two different tasks on a dual-touch screen laptop.

In the first task, target location and motor action were aligned. The second task tested cognitive–motor integration; in this test the required movement was not aligned with the guiding visual target and so simultaneous thinking was required in order to be successful.

“We noticed significant difficulty in completing the tasks among those with concussion history,” stated lead author Marc Dalecki. “In fact, it took many of the children 2 years after the concussion to have a similar performance on the task as children who did not have a history of concussion.”

Current return-to-play assessments that do not test cognitive–motor integration may not provide accurate information on the functional abilities of young athletes post-concussion. This study highlights the importance for future discussion around return-to-play guidelines in order to reduce the risk of repeat injuries in this age group.

Sources: York University (Canada) press release; Dalecki M, Albines D, Macpherson A, Sergio LE. Prolonged cognitive-motor impairments in children and adolescents with a history of concussion. Concussion doi:10.2217/cnc-2016-0001 (2016).