{"id":11623,"date":"2025-06-09T06:00:22","date_gmt":"2025-06-09T05:00:22","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11623"},"modified":"2025-06-08T19:51:01","modified_gmt":"2025-06-08T18:51:01","slug":"identifying-symptom-profiles-and-how-they-relate-to-recovery-timelines-among-collegiate-athletes-with-sport-related-concussion","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2025\/06\/09\/identifying-symptom-profiles-and-how-they-relate-to-recovery-timelines-among-collegiate-athletes-with-sport-related-concussion\/","title":{"rendered":"Identifying symptom profiles and how they relate to recovery timelines among collegiate athletes with sport-related concussion"},"content":{"rendered":"

Keywords: <\/b>symptoms, recovery, concussion<\/span><\/p>\n

In this blog post, we will explain how collegiate student-athletes with concussion fit into four distinct \u2018symptom profile\u2019 groups. Our study, recently published in BJSM (1),<\/span>\u00a0included sport-related concussions (SRC) across five academic years 2015-2016\/2019\u20132020 (n=1160) from the Ivy League\u2013Big Ten Epidemiology of Concussion Study (Ivy-B1G Study) (2).<\/span><\/p>\n

Why is this study important?<\/b><\/p>\n

Clinical management of concussion, guided by symptom domain presentation is an important and evolving strategy in concussion care (3).<\/span>\u00a0Understanding the nature of symptom experiences (as affective vs vestibular, for example) more precisely guides rehabilitation efforts to combat persisting post-concussion symptoms. We recognize that symptoms represent important clinical characteristics related to concussion recovery timelines. However, prior investigations into how individual concussion symptoms may cluster together only identify and describe these symptom domains. In our previous work in the Ivy-B1G Study,<\/span>4<\/span> we identified six symptom domains best describe how individual symptoms measured via the Sport Concussion Assessment Tool (SCAT) 22-symptom evaluation group together: <\/span><\/p>\n

1) headache<\/span><\/p>\n

2) vestibulo-ocular<\/span><\/p>\n

3) sensory<\/span><\/p>\n

4) cognitive<\/span><\/p>\n

5) sleep<\/span><\/p>\n

6) affective\u00a0<\/span><\/p>\n

Our study here extends this work by investigating how these student-athletes with SRC fit into distinct clinical symptom profiles, representing how they experience multiple, concurrent symptom domains. We then examined whether certain symptom profiles are associated with speed of recovery. The role of sex in these relationships was also examined. Our findings provide guidance for targeted, symptom domain-specific treatments to manage concussion. Additionally, the symptom profiles we identified can be studied further, together with physical examinations to better understand how reported symptoms correspond to other clinically objective characteristics.<\/span><\/p>\n

<\/b>How did the study go about this?<\/b><\/p>\n

We leveraged data from the Ivy-B1G Study and included SRCs across five academic years 2015-2016\/2019\u20132020 (n=1160). From our previous work identifying six symptom domains,<\/span>4<\/span> here, we performed an analysis that grouped collegiate student-athletes (mean age=19.8 years). together based on shared symptom domains, which we call \u2018symptom profiles.\u2019 Symptom profiles characterize how these athletes endorse concurrent symptom domains. We were interested in the outcomes time (in days) from SRC injury to symptom resolution, return to academics, and full play. We used statistical models to determine relationships between symptom profile and time to these outcomes, adjusting for available demographic and clinical characteristics previously shown to be related to concussion symptoms and\/or recovery outcomes. We also investigated whether such relationships between symptom profile and outcomes were different by sex, given existing, conflicting evidence that concussion symptoms differ by sex.<\/span><\/p>\n

<\/b>What did the study find?<\/b><\/p>\n

In our previous work in the Ivy-B1G Study, we found that a six-domain structure best represented our symptom data: 1) headache domain (headache, pressure, neck pain); 2) vestibulo-ocular domain (nausea, dizziness, blurred vision, balance); 3) sensory domain (sensitivity to light, sensitivity to noise); 4) cognitive domain (feeling slowed down, feeling in a fog, don\u2019t feel right, difficulty concentrating, difficulty remembering, confusion); 5) sleep domain (fatigue, drowsiness, difficulty falling asleep); and 6) affective domain (more emotional, irritability, sadness, nervous or anxious).<\/span>4<\/span>\u00a0<\/span><\/p>\n

Building upon this work \u2013 here, we found four symptom profiles emerged to characterize the ways in which the six symptom domains co-occur:<\/span><\/p>\n

    \n
  1. \u2018Low\u2019 on all symptom domains<\/span><\/li>\n
  2. \u2018High\u2019 on headache and sensory domains<\/span><\/li>\n
  3. \u2018High\u2019 on vestibulo-ocular, cognitive, and sleep domains<\/span><\/li>\n
  4. \u2018High\u2019 on all symptom domains<\/span><\/li>\n<\/ol>\n

    We also found that, compared with symptom profile 1 (low on all symptom domains), those with symptom profile 2 (headache and sensory), 3 (vestibulo-ocular, cognitive, and sleep) and 4 (high on all symptom domains) on average took a longer time to complete recovery than profile 1. Time to recovery outcomes across symptom profiles did not vary significantly by sex.<\/span><\/p>\n

    What are the key take-home points?<\/b><\/p>\n