Children between 5 and 12 are more likely
to experience worse symptoms and delays in specialist care if
injured during recreation or other non-sport activities
PHILADELPHIA, June 27,
2024 /PRNewswire/ -- Researchers from Children's
Hospital of Philadelphia (CHOP)
found that young children between the ages of 5 and 12 were more
likely to experience a concussion from recreation and other
non-sport activities, yet those injuries were not seen by
specialists until days later compared with sports-related
concussions in the same age group.
This study suggests concussion research is needed for children
outside of sports and that providing more resources and education
to those providers diagnosing most concussions in this age group,
particularly emergency departments and primary care, could reduce
inequities in concussion care regardless of the mechanism of injury
by which these patients experience concussions. The findings were
recently published by the Journal of Pediatrics.
Adolescents experience high rates of sports- and
recreation-related injuries, but the rate of injuries among
children ages 5 through 12 is still high, at about 72.7 injuries
per 1000 children. More than half of children in this age range
participate in sports, as daily physical activity is recommended
for optimal health and development, but with these activities comes
a risk of pediatric concussion.
Most of the research into pediatric concussions has focused on
adolescents and sports, which highlights a need to study
concussions in younger children across all mechanisms of injury.
Prior studies from nearly a decade ago reported the importance of
non-sports and recreation-related concussions in elementary age
children. Injuries sustained in these settings are marked by key
differences in supervision at the time of injury that can influence
how quickly a concussion is recognized, affecting access to and
timing of care, which can lead to longer recovery times.
"In prior research, recreation-related injuries are not often
differentiated from sports-related injuries, yet this study shows
that these injuries can be just as serious and occur more
frequently in this age group, suggesting that education and
awareness about concussion needs to be emphasized to those who
interact with children in these less structured settings," said
senior study author Kristy Arbogast,
PhD, director of the Center for Injury Research and Prevention and
co-director of the Minds Matter Concussion Program at CHOP.
"Patients injured outside of sports and recreation experienced a
higher burden of symptoms and more changes to daily life, and
delays in appropriate care could exacerbate these negative
effects."
Using contemporary data from a pediatric concussion registry,
researchers examined this age range and characterized concussions
by their mechanisms of injury, distinguishing between injuries that
occurred in organized sports and those that occurred outside of
sports. They separated recreation, such as gym class, free play, or
non-competitive sporting activities like biking, from other
non-sports mechanisms, like motor vehicle crashes or falls, owing
to the role of unstructured play in this age group. A total of
1,141 patients between the ages of 5 and 12 with concussions were
evaluated within four weeks of injury and were included in this
analysis. The researchers assessed whether the injury occurred
during sports, recreation, or some other mechanism of injury
("non-sports-or-recreation-related"). Variations in demographics,
point of healthcare entry, and clinical signs were evaluated across
mechanisms.
The study found that recreation-related injuries were the most
common in this age group at 37.3% of injuries, followed by
non-sports-or-recreation-related concussions at 31.9%. These
injuries were more likely to be seen first in the emergency
department compared to sports-related concussions. Importantly,
patients with recreation- or non-sports or recreation-related
concussions were first evaluated by concussion specialists an
average of 2 to 3 days later than sports-related concussions.
Patients with concussions outside of sports and recreation also
reported worse symptoms, including more visio-vestibular issues and
more changes to sleep and other daily habits compared with the
other patient groups.
"We see these findings as an opportunity to equip the clinical
teams who may see these patients first with the latest tools for
concussion diagnosis and management," said study co-author
Daniel Corwin, MD, Director of
Research Operations in the Division of Emergency Medicine and
Emergency Department Lead of the Minds Matter Concussion Program.
"These findings could also serve as a basis for school-based
resources, including engagement of school nurses, to help address
disparities in care across these injuries, particularly in this
less well understood elementary age population of patients who
sustain their injuries outside of sports."
This study was supported by the National Institute of Neurologic
Disorders and Stroke of the National Institutes of Health under
award numbers R01NS097549 and the Pennsylvania Department of
Health.
Roby et al, "Characteristics of Pediatric Concussion across
Different Mechanisms of Injury in 5–12-Year-Olds." J
Pediatr. Online June 18, 2024.
DOI: 10.1016/j.jpeds.2024.114157.
About Children's Hospital of Philadelphia:
A non-profit, charitable
organization, Children's Hospital of Philadelphia was founded in 1855 as the
nation's first pediatric hospital. Through its long-standing
commitment to providing exceptional patient care, training new
generations of pediatric healthcare professionals, and pioneering
major research initiatives, the hospital has fostered many
discoveries that have benefited children worldwide. Its pediatric
research program is among the largest in the country. The
institution has a well-established history of providing advanced
pediatric care close to home through its CHOP Care Network, which
includes more than 50 primary care practices, specialty care and
surgical centers, urgent care centers, and community hospital
alliances throughout Pennsylvania
and New Jersey, as well as the
Middleman Family Pavilion and its dedicated pediatric
emergency department in King of
Prussia. In addition, its unique family-centered care and
public service programs have brought Children's Hospital of
Philadelphia recognition as a
leading advocate for children and adolescents. For more
information, visit https://www.chop.edu.
Contact: Ben Leach
Children's Hospital of Philadelphia
(609) 634-7906
Leachb@email.chop.edu
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SOURCE Children's Hospital of Philadelphia