A new multi-center study suggests that the median time to return to sport after a concussion is within 21 days in the majority of cases based on a review of previously published research.
Researchers Pinpoint Time to Return to Sports After Concussion
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The study, “Median Time to Return to Sports After Concussion Is Within 21 Days in 80% Of Published Studies,” was published online on November 25, 2022 in the journal Arthroscopy.
The researchers performed a systematic review of the literature in August 2022 using PubMed, Scopus, Medline, Embase and Cochrane Library databases. They also collected data on prognostic variables affecting concussion, time to return to school, time to symptom resolution of concussive symptoms, and time each patient spent in the return to play protocol.
For their analysis, they included 65 studies and 21,966 patients. The return to play time intervals ranged from 1-1,820 days, with 80.7% of the median return to play timeframes for each study within 21 days.
The data showed that pre-concussion risk factors for a longer return to play were female gender, younger age, presence of psychiatric disorders, and a history of previous concussion. Post-concussion risk factors include severe symptom scores at initial clinic visit, loss of consciousness, non-elite athletes, and a delayed removal from competition.
The researchers determined that concussions were more likely to occur in contact sports, especially football and soccer. The media time to symptom resolution ranged from 2 to 11 days. The median time in return to play protocol was 1 to 6 days.
“Median time to return to sports after concussion is within 21 days in 80% of published studies,” the researchers wrote.
Study authors included Trevor J. Wait, M.D., Amelia Drumm, B.A., Jensen G. Kolaczko, M.D., Ognjen Stevanovic, M.D., PharmD, and Martin Boublik, M.D., all from the University of Colorado. Andrew G. Eck, M.D., of the University of Texas, and Tyler Loose, B.S., M.S., of University of Washington also contributed to the study.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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