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BMJ Open. 2016 Jan 12;6(1):e009427. doi: 10.1136/bmjopen-2015-009427.

Protocol for a prospective, longitudinal, cohort study of postconcussive symptoms in children: the Take C.A.Re (Concussion Assessment and Recovery Research) study.

Author information

1
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Women's and Children's Health, University of Padova, Padova, Italy.
2
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia School of Psychological Sciences, University of Melbourne, Victoria, Australia.
3
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia School of Psychological Sciences, University of Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Psychology Service, The Royal Children's Hospital, Melbourne, Victoria, Australia.
4
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
5
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Emergency Department, Royal Children's Hospital Melbourne, Victoria, Australia.
6
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Department of Rehabilitation Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.

Abstract

INTRODUCTION:

A substantial minority of children who sustain a concussion suffer prolonged postconcussive symptoms. These symptoms can persist for more than 1 month postinjury and include physical, cognitive, behavioural and emotional changes. Those affected can develop significant disability, diminishing their quality of life. The precise prevalence of postconcussive symptoms following child concussion is unclear, with heterogeneous and at times conflicting results published regarding factors that predict children at risk for developing long-lasting postconcussive symptoms. The aim of the Take C.A.Re (Concussion Assessment and Recovery Research) study is to provide an in-depth multidimensional description of the postconcussive recovery trajectories from a physical, neurocognitive and psychosocial perspective in the 3 months following concussion, with a focus on the early postconcussive period, and identification of factors associated with prolonged recovery.

METHODS AND ANALYSIS:

Take C.A.Re is a prospective, longitudinal study at a tertiary children's hospital, recruiting and assessing patients aged 5-<18 years who present to the emergency department with a concussion and following them at 1-4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: postconcussive symptoms, balance and coordination, neurocognition, behaviour, quality of life, fatigue, post-traumatic stress symptoms, parental distress and family burden. 'Delayed recovery' is operationalised as the presence of ≥ 3 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline. Main analyses comprise analysis of variance (recovery trajectories, delayed vs normal recovery groups) and regression analyses of predictors of recovery (preinjury, acute and family factors).

ETHICS AND DISSEMINATION:

Ethical approval has been obtained through the Royal Children's Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.

TRIAL REGISTRATION NUMBER:

ACTRN12615000316505.

KEYWORDS:

MENTAL HEALTH; REHABILITATION MEDICINE; TRAUMA MANAGEMENT

PMID:
26758260
PMCID:
PMC4716210
DOI:
10.1136/bmjopen-2015-009427
[Indexed for MEDLINE]
Free PMC Article

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