Initial Symptom Trajectories and Recovery Patterns in Collegiate Athletes with Persisting Symptoms After Concussion

Background: Concussion remains one of the most common sport-related injuries among collegiate athletes, with recovery trajectories varying considerably between individuals. While most athletes recover within days to weeks, a clinically significant subset experience persisting symptoms extending beyond ۲۸ days post-injury, posing substantial challenges for return-to-play decisions and long-term health outcomes. Despite increased recognition of this condition, the precise symptom characteristics and temporal resolution patterns that distinguish athletes with persisting symptoms from those who recover typically have not been fully characterized. Understanding these differential trajectories is essential for early identification of at-risk individuals and implementation of targeted interventions. Methods: This retrospective cohort study analyzed data from the NCAA-DoD Concussion Assessment, Research, and Education Consortium. Persisting symptoms after concussion (PSaC) was defined as symptoms lasting longer than ۲۸ days, while NoPSaC included individuals who became asymptomatic within ۲۸ days. A total of ۳۲۳ PSaC cases and ۳۹۷۳ NoPSaC cases were analyzed. Symptoms were assessed using the Sport Concussion Assessment Tool—۳rd edition symptom checklist during the initial ۱۴ days post-concussion. Separate generalized linear mixed models were conducted for each individual symptom and symptom cluster using ordinal distribution, examining group main effect, time main effect, and group×time interaction. Results: Significant interactions were observed for all individual symptoms and symptom clusters (p < ۰.۰۰۱). Post-hoc analysis revealed that the PSaC group experienced significantly more severe symptoms across all ۱۴ days post-concussion relative to the NoPSaC group. Headache and pressure in head were the most frequently reported symptoms during the first week. The PSaC group demonstrated slower, less consistent, and less pronounced symptom improvement throughout recovery, while the NoPSaC group exhibited consistent and progressive symptom resolution. Conclusion: Significant differences in symptom recovery patterns exist between athletes with and without persisting symptoms after concussion. Early identification of individuals exhibiting elevated symptom severity and delayed improvement trajectories may enable timely intervention. Future research should investigate predictive factors and targeted rehabilitation strategies for this vulnerable population.

کلیدواژه ها:

Concussion ، Persisting symptoms ، Collegiate athletes ، Recovery trajectories ، Symptom resolution ، Sport-related injury