Comparison of recovery time from uncomplicated sports-related mild traumatic brain injury (mTBI) in intercollegiate athletes: A baseline study

Abstract

Sports-related mild traumatic brain injuries (mTBIs) have become an increasingly popular topic. Cognitive and physical rest are the mainstays of management, but effective evidence-based therapies do not exist. Very few studies report mean recovery times from mTBI and even less for intercollegiate athletes. The primary aim is to retrospectively compare the recovery time in athletes from a large Division I University that suffered a sports-related mTBI during 2010 - 2012 to published data for quality assessment and improvement. Since the institution's concussion management follows current guidelines, no significant difference was expected. Secondary aims included comparing recovery times between gender, sport, and league. As reported in current literature, no significant gender differences were expected. 53 athletes with sports-related mTBI (27 male and 26 female) showed a mean recovery time of 10.11 days (95 % confidence interval [CI] = 8.58 - 11.65 days), statistically different than the time reported in 1 study of 7 days, but not in another of 7 - 10 days. Mean recovery time in males and females was 9.74 days (95 % CI = 7.38 - 12.1 days) and 10.5 days (95 % CI = 8.4 - 12.6 days), respectively. Mean recovery time in National Collegiate Athletic Association (NCAA) and non-NCAA (club) athletes was 9.91 days (95 % CI = 8.27 - 11.55) and 11.25 days (95 % CI = 5.87 - 16.63), respectively. A nonparametric Wilcoxon rank-sum test showed no significant variation between genders and between NCAA and non-NCAA athletes. Subgroup statistics of 13 sports were inconclusive due to inadequate power. However, the subgroup of male football athletes showed a mean recovery time of 6.5 days (95 % CI = 4.86 - 8.14 days), which was not significantly different than published rates. Multiple confounding variables were not well controlled for including: sport, gender, concussion severity, multiple concussions, etc. However, this study did highlight areas for quality improvement in the institution's concussion management plan. Further investigation with increased power and confounding variable control is indicated for a more definitive mean time to recovery. This study is the first to detail the mean time to recovery from sports-related mTBI in an intercollegiate athletic program. Similar studies should be done at other institutions for quality assessment and improvement of 4 concussion management. Such data will be useful in establishing a baseline for measure of efficacy in future investigations of therapeutic interventions.