Quality of Life in Pediatric Mild Traumatic Brain Injury and its Relationship to Postconcussive Symptoms

Moran, Lisa; Taylor, H. Gerry; Rusin, Jerome; Bangert, Barbara; Dietrich, Ann; Nuss, Kathryn E.; Wright, Martha; Minich, Nori; Yeates, Keith Owen

doi:10.1093/jpepsy/jsr087

Cited by 83 publications

(81 citation statements)

References 45 publications

(51 reference statements)

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“…Moran and colleagues have shown that lower quality of life in children with mild TBI correlates with more post-concussive symptoms at initial assessment. 3 There are a number of implications of our study for future research. The reasons for the variability in outcomes are unknown, and efforts to better detail the location and nature of the injury, as well as to assess the genetic contributions to recovery are needed; such information can provide more accuracy in prognostic discussions for families and patients.…”

Section: Discussionmentioning

confidence: 94%

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Persistence of Disability 24 to 36 Months after Pediatric Traumatic Brain Injury: A Cohort Study

Rivara

Vavilala

Durbin

et al. 2012

Journal of Neurotrauma

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This study examined the outcome of 0-to 17-year-old children 36 months after traumatic brain injury (TBI), and ascertained if there was any improvement in function between 24 and 36 months. Controls were children treated in the emergency department for an arm injury. Functional outcome 36 months after injury was measured by the Pediatric Quality of Life Inventory (PedsQL), the self-care and communication subscales of the Adaptive Behavior Assessment Scale-2nd edition (ABAS-II), and the Child and Adolescent Scale of Participation (CASP). At 36 months after TBI, those with moderate or severe TBI continued to have PedsQL scores that were 16.1 and 17.9 points, respectively, lower than at baseline, compared to the change seen among arm injury controls. Compared to the baseline assessment, children with moderate or severe TBI had significantly poorer functioning on the ABAS-II and poorer participation in activities (CASP). There was no significant improvement in any group on any outcomes between 24 and 36 months. Post-injury interventions that decrease the impact of these deficits on function and quality of life, as well as preventive interventions that reduce the likelihood of TBI, should be developed and tested.

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Section: Discussionmentioning

confidence: 94%

“…[1][2][3] Prior studies have demonstrated improvement in functioning during the first year after injury, 4 although many injured children, including some with mild TBI, have persistent disability. 5 Information about the persistence of disability beyond 1 year is important for parents, health care providers, and community resources such as schools.…”

mentioning

confidence: 99%

Persistence of Disability 24 to 36 Months after Pediatric Traumatic Brain Injury: A Cohort Study

Rivara

Vavilala

Durbin

et al. 2012

Journal of Neurotrauma

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“…2,3 This high proportion of unreported SRCs results in a lack of care and increased risk for future injury and long-term neurologic deficits, reducing the individual's quality of life and eventually burdening our health care systems. 4,5 Due to the increased general awareness of and concern about SRC, many programmatic and educational efforts (specifically those geared toward coaches, parents, and athletes) have been developed to aid in better prevention, identification, and management. Numerous documents [6][7][8][9][10] have been published concerning SRC knowledge and various educational techniques aimed at improving SRC knowledge across many levels of sport.…”

mentioning

confidence: 99%

A Multifactorial Approach to Sport-Related Concussion Prevention and Education: Application of the Socioecological Framework

Baugh

Kroshus

et al. 2017

Journal of Athletic Training

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Objective: To offer an overview of sport-related concussion (SRC) prevention and education strategies in the context of the socioecological framework (SEF). Athletic trainers (ATs) will understand the many factors that interact to influence SRC prevention and the implications of these interactions for effective SRC education.Background: Concussion is a complex injury that is challenging to identify and manage, particularly when athletes fail to disclose symptoms to their health care providers. Education is 1 strategy for increasing disclosure. However, limited information addresses how ATs can integrate the many factors that may influence the effectiveness of SRC education into their specific settings. Public health models provide an example through the SEF, which highlights the interplay among various levels of society and sport that can facilitate SRC prevention strategies, including education.Description: For ATs to develop appropriate SRC prevention strategies, a framework for application is needed. A growing body of information concerning SRC prevention indicates that knowledge alone is insufficient to change concussion-related behaviors. The SEF allows this information to be considered at levels such as policy and societal, community, interpersonal (relationships), and intrapersonal (athlete). The use of such a framework will facilitate more comprehensive SRC prevention efforts that can be applied in all athletic training practice settings.Clinical Applications: Athletic trainers can use this information as they plan SRC prevention strategies in their specific settings. This approach will aid in addressing the layers of complexity that exist when developing a concussion-management policy and plan.

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“…Unfortunately, the nature and persistence of postconcussion symptoms may place adolescent patients at risk for substantial declines in HRQOL. 7 Investigators have demonstrated that adolescent brain injuries, including concussions, negatively influence HRQOL by affecting sleep patterns; fatigue levels; anxiety and depression symptoms; executive functions; behavioral and social concerns; and attention, cognition, and memory.…”

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confidence: 99%

Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion

Iadevaia

Roiger

Zwart

2015

Journal of Athletic Training

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Context: Moderate to severe traumatic brain injuries can negatively influence health-related quality of life (HRQOL) in adolescent patients. The effect of sport-related concussion on adolescent HRQOL remains unclear.Objective: To investigate the perceptions of adolescent student-athletes and their parents regarding the adolescents' HRQOL 1 year after sport-related concussion.Design: Qualitative study. Setting: Secondary school.Patients or Other Participants: Seven adolescent studentathletes (age range, 12-16 years) who sustained a sport-related concussion at least 1 year (15.3 6 2.8 months) before the study participated along with their primary care-giving parents (n ¼ 7).Data Collection and Analysis: Fourteen semistructured face-to-face interviews (7 adolescents, 7 parents) were completed. Interviews were transcribed and inductively analyzed by a team of 3 athletic trainers with 32 combined years of professional experience. Themes were negotiated through a consensual review process. Participant checks were completed to ensure trustworthiness of the results.Results: Four major themes emerged from the interviews: (1) significant effect of symptoms, (2) feelings of frustration, (3) influence on school attendance and activities, and (4) nature of interpersonal and team relationships. Participants indicated that the physical symptoms of the concussion substantially affected their emotional and academic function. The influence of the concussion on social interactions seemed to depend on the nature of interpersonal relationships.Conclusions: Sport-related concussion can negatively influence physical and emotional function, academics, and interpersonal interactions as perceived by adolescent studentathletes and their parents. Education of parents and their children, school professionals, coaches, and teammates remains critical to effectively recognize and manage sport-related concussion. Secondary school districts also play a critical role in the concussion-management process by establishing and implementing accommodation policies that alleviate student concerns about falling behind while ensuring a healthy return to normal school routines. Furthermore, adolescent support systems must be considered throughout the recovery process.

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Quality of Life in Pediatric Mild Traumatic Brain Injury and its Relationship to Postconcussive Symptoms

Abstract: Effective management of PCS may be associated with improvements in HRQOL following pediatric mild TBI.

Cited by 83 publications

References 45 publications

Persistence of Disability 24 to 36 Months after Pediatric Traumatic Brain Injury: A Cohort Study

Persistence of Disability 24 to 36 Months after Pediatric Traumatic Brain Injury: A Cohort Study

A Multifactorial Approach to Sport-Related Concussion Prevention and Education: Application of the Socioecological Framework

Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion

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