CoChat
Sign Up
Cited by 917Traumatic Brain Injury ResearchSports injuries and preventionLong-Term Effects of COVID-19

Predictors of clinical recovery from concussion: a systematic review

Open access
Iverson, Grant L, Gardner, Andrew J, Terry, Douglas P, Ponsford, Jennie L, Sills, Allen K, Broshek, Donna K, Solomon, Gary S·2017·British Journal of Sports Medicine
DOI 10.1136/bjsports-2017-097729PMC PMC5466929
Open this paper in CoChat — free accountOpen PDF

Abstract

Objective: A systematic review of factors that might be associated with, or influence, clinical recovery from sport-related concussion. Clinical recovery was defined functionally as a return to normal activities, including school and sports, following injury. Design: Systematic review. Data sources: PubMed, PsycINFO, MEDLINE, CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus and Web of Science. Eligibility criteria for selecting studies: Studies published by June of 2016 that addressed clinical recovery from concussion. Results: A total of 7617 articles were identified using the search strategy, and 101 articles were included. There are major methodological differences across the studies. Many different clinical outcomes were measured, such as symptoms, cognition, balance, return to school and return to sports, although symptom outcomes were the most frequently measured. The most consistent predictor of slower recovery from concussion is the severity of a person’s acute and subacute symptoms. The development of subacute problems with headaches or depression is likely a risk factor for persistent symptoms lasting greater than a month. Those with a preinjury history of mental health problems appear to be at greater risk for having persistent symptoms. Those with attention deficit hyperactivity disorder (ADHD) or learning disabilities do not appear to be at substantially greater risk. There is some evidence that the teenage years, particularly high school, might be the most vulnerable time period for having persistent symptoms—with greater risk for girls than boys. Conclusion: The literature on clinical recovery from sport-related concussion has grown dramatically, is mostly mixed, but some factors have emerged as being related to outcome.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bjsports-2017-097729

Cites

152 of 152 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Both noninjury and injury factors predict persisting symptoms after concussion (PSAC) following a concussion, with the contribution of injury factors decreasing over time.

    “Studies have demonstrated that both noninjury and injury factors predict PSAC following a concussion [2,5,6], with the contribution of injury factors to PSAC decreasing over time.”

    From Smartphone App–Delivered Mindfulness-Based Intervention for Mild Traumatic Brain Injury in Adolescents: Protocol for a Feasibility Randomized Controlled Trial (2024) · cites this paper as [5]

    The Conclusions identify preinjury mental health problems and greater acute or subacute symptom severity as predictors of persistent symptoms or slower recovery. The Discussion describes initial injury-severity indicators as less important than early symptom burden, but does not say that the contribution of injury factors to persisting symptoms decreases over time. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Following mTBI, women tend to experience more symptoms and take significantly longer to recover compared to men.

    “Following mTBI, women tend to experience more symptoms and take significantly longer to recover compared to men for reasons currently unknown [28, 51, 67, 114].”

    From DNA repair deficiency and senescence in concussed professional athletes involved in contact sports (2019) · cites this paper as [67]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. [84]Covassin T, Elbin RJ, Harris W, et al The role of age and sex in symptoms, neurocognitive performance, and postural stability in Athletes after concussion. Am J Sports Med 2012; 40: 1303– 12. 10.1177/0363546512444554 22539534 · DOI
  2. [87]Lau BC, Collins MW, Lovell MR Cutoff scores in neurocognitive testing and symptom clusters that predict protracted recovery from concussions in high school athletes. Neurosurgery 2012; 70: 371– 9. 10.1227/NEU.0b013e31823150f0 21841522 · DOI
  3. [132]Marar M, McIlvain NM, Fields SK, et al Epidemiology of concussions among United States high school Athletes in 20 sports. Am J Sports Med 2012; 40: 747– 55. 10.1177/0363546511435626 22287642 · DOI
  4. [149]Dick RW Is there a gender difference in concussion incidence and outcomes? Br J Sports Med 2009; 43(Suppl 1): i46– 50. 10.1136/bjsm.2009.058172 19433425 · DOI
  5. [150]Iverson GL, Atkins JE, Zafonte R, et al Concussion History in Adolescent Athletes with Attention-Deficit Hyperactivity Disorder. J Neurotrauma 2016; 33: 2077– 80. 10.1089/neu.2014.3424 25375785 · DOI

Cited by

Sorted by citations

Related

Authors
Iverson, G. L., Gardner, A. J., Terry, D. P., Ponsford, J. L., Sills, A. K., Broshek, D. K., & Solomon, G. S.
Affiliations
  • Harvard University (US)
  • University of Newcastle Australia (AU)
  • Monash University (AU)
  • Vanderbilt University Medical Center (US)
  • University of Virginia (US)
  • Vanderbilt University (US)
Corresponding author
Iverson, Grant L
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2017-05-31
Volume
51
Issue
12
Pages
941-948
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2017-097729
PMC
PMC5466929
OpenAlex
W2618999110
Cited by
917
References
152
Citations by year
2026: 64 · 2025: 80 · 2024: 118 · 2023: 105 · 2022: 112 · 2021: 143 · 2020: 144 · 2019: 86 · 2018: 58 · 2017: 6 · 2014: 1
FWCI
10.65
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • British Journal of Sports Medicine (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Monash University Research Portal (Monash University) (acceptedVersion, other-oa)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • Figshare (submittedVersion, cc-by-nc)
  • HighWire Press Open Archive (submittedVersion)
  • NOVA (University of Newcastle Australia) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
Keywords
sports-related concussion, clinical recovery, predictors of recovery, persistent post-concussion symptoms, concussion symptom severity, return to school, return to sport, attention deficit hyperactivity disorder, learning disabilities, adolescent concussion, sex differences
MeSH terms
Return to Sport, Athletic Injuries, Attention Deficit Disorder with Hyperactivity, Brain Concussion, Cognition, Depression, Postural Balance, Headache, Humans, Learning Disabilities, Neuropsychological Tests, Risk Factors, Sports

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review