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Meta-Analysis
. 2015 Jun;45(6):893-903.
doi: 10.1007/s40279-015-0325-8.

Concussion recovery time among high school and collegiate athletes: a systematic review and meta-analysis

Richelle M Williams  1 , Tim W Puetz, Christopher C Giza, Steven P Broglio
Affiliations
Meta-Analysis

Concussion recovery time among high school and collegiate athletes: a systematic review and meta-analysis

Richelle M Williams et al. Sports Med. 2015 Jun.

Abstract

Background: Concussion diagnosis and management is made through the clinical exam using assessment tools that include self-report symptomatology, postural control, and cognitive evaluations. The specific timing of concussion resolution varies between individuals. However, despite a lack of research in concussion recovery, it is widely accepted that the majority of young adults will recover in 7-10 days, with youth athletes taking longer.

Objectives: The purpose of this review is to directly compare the recovery duration among high school and collegiate athletes on symptom reports and cognitive assessments following concussion.

Data sources: Data were collected from a literature search comprising high school or college athletes only. This included studies (n = 6) that reported symptom or cognitive performance recovery to the exact day.

Results: High school athletes self-reported symptom recovery at 15 days compared with 6 days in collegiate athletes. Both college and high school athletes showed cognitive recovery at similar rates of 5 and 7 days.

Limitations: This review only included articles that were directly related to concussed high school or college athletes. Additionally, athletes in the high school and college setting typically receive a battery of neurocognitive tests that may not be as sensitive or as comprehensive as a full neuropsychological exam.

Conclusion: The review finds that neurocognitive recovery rates are similar among high school and college athletes, while symptom reporting shows longer recovery time points in high school than in college.

Implications of key findings: An individualized and stepwise concussion management plan is important for proper concussion recovery regardless of age.

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Conflict of interest statement

Conflict of interests Richelle Williams declares no conflict. Tim Puetz declares no conflict. Steven Broglio declares no conflict. Chris Giza has received funding from many sources with interest in sports and concussions, and also serves on multiple advisory committees for sports organizations. For the purpose of this manuscript, these did not directly influence the creation of the study, but are included in an effort to have transparency and full disclosure.

Figures

Fig. 1
Fig. 1
Study selection process
Fig. 2
Fig. 2
Funnel plot evaluating publication bias. Visual inspection indicates symmetrical distribution, and the Begg’s rank correlation analysis was not statistically significant, suggesting an absence of publication bias [τ(15) = 0.30, p = 0.150]
Fig. 3
Fig. 3
Distribution of effect sizes for concussion-related symptoms and neurological declines. Overall, there was a significant change (Δ = 1.14 [1.04–1.25]; z = 21.16, p < 0.001)
Fig. 4
Fig. 4
The interaction of age and concussion measure with the Johnson–Neyman procedure indicating the critical point for age at 17.8 years. This age represents the point at which age moderates the recovery process
Fig. 5
Fig. 5
Days for recovery based on assessment measure. High school athletes demonstrated greater and more variable recovery times than college athletes based on self-reported concussion symptoms, and more similar and less variable recovery times based on neurocognitive tests
See this image and copyright information in PMC

Comment in

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