College students take more time to recover from concussion, study shows

A new study, presented this week at the Association of Academic Physiatrists Annual Meeting in Las Vegas, Nevada, shows college students take significantly more time to recover from a concussion than the general national average of seven to 14 days.

According to the Centers for Disease Control, a concussion is a "type of traumatic brain injury — or TBI — caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain." The CDC also estimates 1.6-3.8 million concussions occur in the United States each year.

On average, a person takes seven to 14 days to recover from a concussion, and researchers recently questioned if recovery takes longer in college students who might find it difficult to give themselves time to recover.

"Recovering from a concussion requires active rest and refraining from excessive physical and cognitive stimuli, such as contact sports, reading, writing and even the need for limitation of watching television and online activities, says Prakash Jayabalan, MD, PhD who is lead investigator on the study and is an attending physician at the Rehabilitation Institute of Chicago (RIC) and assistant professor at Northwestern University Feinberg School of Medicine. "These are all things that the average college student encounters on a daily basis and will find challenging to limit. Therefore, our research team wanted to determine if recovery time for patients in a college setting is different from those people outside of that setting."

To assess this, Dr. Jayabalan and the research team at Northwestern University Student Health Center in Evanston, Ill., reviewed the medical charts of 128 students who were seen for concussion during the 2014-2015 academic year. On average, the students were 20 years old and predominately female (53.1 percent). Forty-four students were varsity athletes, 33 played club sports, 34 played recreational sports, and 17 did not engage in regular physical activity or did not report their activity level when seen.

Dr. Jayabalan's team found that varsity athletes experienced a shorter duration of concussion symptoms (11.5 days, on average) when compared to club (nearly 19 days) and recreational athletes (nearly 23 days). This, according to Dr. Jayabalan, could be due to the higher amount of medical support student athletes receive.

Female students took longer to recover in comparison to men (nearly 21 days vs. nearly 15 days). People with seizure disorders or prior concussions were more likely to have symptoms that last longer than 28 days. Finally, graduate students took two weeks longer to recover when compared to undergraduates (31 days vs. 16), although the number of graduate students who sustained a concussion was relatively small in this study.

"This is the first cross-sectional study reporting the outcome of concussions at a collegiate institution," says Dr. Jayabalan, who also notes the need for improved resources for university students who suffer a concussion. "The findings in our study highlight the difficulty in treating collegiate students with concussions, due to both the academic rigors of institutions and the differing needs of student populations. The study also provides insight into at-risk subsets of the student population. Factors such as level of sport, year in school, athlete vs. non-athlete, pre-morbid conditions and gender may affect outcome, and this needs to be an important consideration for the physician managing concussed college students."
As a next step, the research team plans to implement resources for students with concussion and assess the effect of them on the concussion recovery.