Quality of Life in Youth Soccer Players After Mild Traumatic Brain Injury

Abstract

Context Pediatric mild traumatic brain injuries (mTBI) represent an evolving field of interest in youth athletics. While most players recover within 4 weeks, some have symptoms that last longer. Little is known about youth health-related quality of life (HRQoL) following mTBI. Objective To characterize youth HRQoL following soccer-related mTBI and to identify predictors of individual differences in HRQoL recovery. Design Prospective cohort study Setting Youth Soccer Participants Soccer players, ages 8–17 years, who sustained mTBI (n=23), orthopedic injuries (OI, n=24), or remained uninjured (n=23) during a single season. Main Outcome Measures HRQoL was assessed via the Pediatric Quality of Life Version 4.0 and post-concussive symptomatology via the Health and Behavior Index. Serial assessments occurred at 24–48 hours, 7 days, 30 days and 90 days post-injury via telephone interview. Results Seven days post-injury, the mTBI and OI groups had poorer Total HRQoL (F[2,67] =11.35, p<0.001) than uninjured controls. At 7 days, the mTBI group had the poorest Psychosocial HRQoL, while OI had the poorest Physical HRQoL. Differences between the mTBI group and uninjured controls resolved by 30 days. Within the mTBI group, players with significant post-concussive symptoms at 7 days had poorer Total (F[1,21]=23.071, p<=0.001; F[1,21]=5.798, p=0.028), Psychosocial (F[1,21]=16.488, p=<0.001; F[1,21]=5.050, p=0.039), and Physical HRQoL (F[1,21]=21.671, p=<0.001; F[1,21]=5.119, p=0.038) at 7 and 30 days than players with minimal symptoms, and these differences resolved by 90 days. Conclusion As a groups, youth soccer players who sustained mTBI had transient impairments in HRQoL that resolved by 30 days. A subset of players with significant post-concussive symptoms at 7 days post-injury have poorer HRQoL for at least 30 days post-injury than those whose post-concussive symptoms had resolved within a week of injury. This suggests ongoing recovery in this subset at 30 days and potential utility of HRQoL as a measure of recovery.