Injury Setting and Social Support as Moderators of the Effects of Pediatric Concussion on Post-Concussive Symptoms

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Concussions are a pressing public health concern. Concussions often result in physical, cognitive, and emotional problems, known as post-concussive symptoms (PCS). Although most children recover from concussions without complication, a subset are hindered by persistent PCS that reduce their quality of life. Previous research tends to differentiate between sport-and-recreation-related and non-sport-related concussions because there may be differences between these settings that affect concussion outcomes. Social support, the perceived or actual support a person receives from their community and social networks, is known to protect against detrimental consequences of health problems. However, little research has examined the effect of social support on PCS after concussion. Social support may foster recovery, particularly for children with sport-related concussions, who are often isolated from their teams during recovery, resulting in feelings of loneliness and isolation. This study aimed to identify the effects of social support on PCS in children after sport-related versus non-sport-related concussion. Participants were children/adolescents aged 8-16 years with either concussion or orthopedic injury who were recruited during Emergency Department visits at five sites across Canada. Injury information was collected in the Emergency Department, social support was measured at 10 days, and PCS were measured at 10 days, 3 months, and 6 months post-injury. Linear multi-level modelling analysis was used to examine injury group (concussion versus orthopedic injury), injury setting (sport-related versus non-sport-related), and social support as predictors of PCS over time. The analyses found that social support predicted lower ratings of cognitive PCS, but regardless of the type of injury. However, injury setting did have a specific moderating effect on recovery from concussion, such that concussions in non-sport-related settings were associated with higher cognitive PCS relative to orthopedic injuries and concussions occurring in sport-related settings. We did not find any significant effects of social support or injury setting on somatic PCS, which suggests that trajectories of somatic and cognitive PCS after concussion may be associated with different risk factors.
concussion, post-concussive symptoms, social support, injury setting, pediatric
Chadwick, L. (2020). Injury Setting and Social Support as Moderators of the Effects of Pediatric Concussion on Post-Concussive Symptoms (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from