After concussion, athletes may need a break from class

A week after suffering a concussion, student athletes reported difficulty concentrating in the classroom and performing well on tests and quizzes, says Erin Wasserman. "Most students who play sports are not going to become professional athletes but they will need to continue with school and prepare for a career." (Credit: Rennett Stowe/Flickr)

Student-athletes who get a concussion often return to the classroom within a week—but then struggle with their academic work.

Researchers say the findings suggest the need for accommodations and return-to-learn guidelines following a concussion.

For a new study in the American Journal of Public Health, researchers compared academic problems among 70 students following a diagnosed concussion versus academic problems among 108 students who suffered other sports-related injuries to arms or legs, such as an ankle sprain. Most of the athletes were injured during a high school sport or a club or intramural sport at college.

All the students in the study visited emergency departments for treatment within 24 hours of being injured.  Investigators used telephone surveys to assess each patient’s schoolwork—the ability to concentrate and take tests or quizzes, for example—one week after injury and again one month after the injury occurred.

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On a 174-point scale, academic problems among the concussed students were nearly 16 points higher at one week than the students who suffered other types of sports injuries. At one month post-injury, there were no differences except among athletes with a history of two or more prior concussions and women. (Previous research has shown that a woman’s menstrual cycle plays an important role in brain recovery and that women generally recover more slowly from brain injuries.)

There are no science-based protocols to guide school districts, colleges, and concussed athletes about going back to class, says Erin Wasserman, who conducted the research as a doctoral candidate in epidemiology in the public health sciences department at the University of Rochester and is now working as a postdoctoral research trainee at the University of North Carolina at Chapel Hill.

“Most students who play sports are not going to become professional athletes but they will need to continue with school and prepare for a career,” Wasserman says. “So, just as they need guidance for when they can play again, they need guidance and protection for when it’s appropriate to return to class and what to expect.”

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Accommodating students with a brain injury is no different from accommodating students with a broken leg, says coauthor Jeffrey Bazarian, professor of emergency medicine, neurology, neurosurgery, and public health sciences.

“You wouldn’t ask students to run a mile or do the 100-yard dash the day they get their cast off,” Bazarian says. “Going to school is taxing on the brain and we have to show flexibility when it comes to our students.”

He suggests that future guidelines would find a middle ground between staying home and going back to school initially for a full day. As symptoms such as headache, dizziness, blurry vision, and difficulties with concentration and memory disappear, students can gradually increase their school time, says Bazarian.

The study also notes that 24 percent of students who were diagnosed with a concussion did not return to school within one week. These athletes participated in the survey a month after their injury. Having so many students unable to return to class quickly reinforces a need for return-to-learn guidelines and academic accommodations.

Source: University of Rochester