Study: Most concussions in younger children not related to sports
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Key takeaways:
- Recreation-related concussions occurred in 37.3% of patients aged 5 to 12 years old.
- Sports-related concussions were more likely to be evaluated earlier.
Concussions sustained by 5- to 12-year-old patients are more likely to be the result of recreational play than sports, according to a study published in The Journal of Pediatrics.
“We knew that these elementary-age kids were sustaining injury, but the scenarios that they were getting injured were different than what we typically associate with concussions on team sports,” Kristy B. Arbogast, PhD, director of the Center for Injury Research and Prevention and co-director of the Minds Matter Concussion Program at the Children’s Hospital of Philadelphia (CHOP), told Healio.
Arbogast and colleagues classified concussions in CHOP’s clinical registry based on whether the injury was related to sports, recreation or neither.
“Organized sports have a structure, a clear plan as to how and when you seek care if you’re injured, [compared with] recreation, which is often unstructured, may be unsupervised and is just more free play in these younger kids,” Arbogast said. “We wanted to look at those two ways that we knew that these children were sustaining injury based on the kids that come through our emergency departments and clinics.”
In contrast to what is seen among older adolescents, out of 1,141 patients aged 5 to 12 years who reported for care 28 or fewer days after injury, the most common injury was a recreation-related concussion (37.3%), followed by a non-sport or recreation-related concussion (31.9%) and then sport-related concussion (30.9%), according to Arbogast and colleagues.
“It is through that unstructured free play — whether that’s gym class or playing on the playground or playing with friends in the neighborhood — that is the most common way that this age group sustains injury,” Arbogast said.
It was more common for children with a non-sport or recreation-related concussion (39.6%) or recreation-related concussion (35.7%) to be first seen in the ED compared with children who sustained a sport-related concussion (27.9%), the researchers reported.
However, sports-related concussions were more likely to be evaluated by specialists earlier than the other two types of concussions — 4 to 6 days earlier than recreation-related concussions and non-sport or recreation-related concussions, respectively, they found.
Non-sport or recreation-related concussions were associated with more symptoms and changes to sleep and daily habits (P < .001) compared with the other two types of concussions.
The most “concerning finding,” Arbogast said, is that children who sustain injuries through recreational activities are presenting to specialists 2 or 3 days later than if the injuries were sustained through sports.
“We know that any amount of delay in getting specialist care has the potential to negatively impact on recovery,” Arbogast said. “We want kids to get seen early so that targeted rehab can be started and we can get them on that path to recovery. Finding that these kids who were sustaining the injuries outside of sports were delaying seeing specialists was particularly important to us.”
Arbogast said school nurses were particularly “underrepresented” in the findings, as they are “such a critical lynchpin” in recognizing concussions when they occur in unstructured play.
“We have to recognize that those emergency department providers, the pediatricians and even the school nurses are responsible for a tremendous scope of knowledge and tasks, and their job is wide,” Arbogast said. “We’ve got to give them easy-to-use, easy-to-access tools to be able to recognize the injury when it happens and provide information to that child and their family about return to activity and return to school.”
According to Arbogast, most efforts to study pediatric concussions have focused on adolescents playing team sports. Arbogast said researchers should think about other settings where injuries can occur.
“The best medicine for any injury is to prevent it from occurring in the first place, so I think there is an opportunity for preventative efforts,” Arbogast said.
Reference:
Children’s Hospital of Philadelphia researchers find elementary age children experience more concussions during activities unrelated to sports. https://www.chop.edu/news/children-s-hospital-philadelphia-researchers-find-elementary-age-children-experience-more. Published June 27, 2024. Accessed July 5, 2024.
Roby PR, et al. J Pediatr. 2024;doi:10.1016/j.jpeds.2024.114157.
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