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Change in health-related quality of life and functional disability over time post-concussion in youth

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Abstract

Purpose

Concussions can have detrimental on children’s cognitive, emotional, behavioral, and/or social functioning. We sought to examine changes in health-related quality of life (HRQOL) and functional disability from pre-injury to 1-week post-concussion, and to symptom resolution among youth ages 11–17 with a concussion.

Methods

In this prospective, longitudinal cohort study, 83 concussed youth, ages 11–17, self-reported post-concussion symptoms daily as well as HRQOL and functional disability at baseline (pre-injury, retrospective), 1-week post-concussion, and symptom resolution. We modeled changes in overall and sub-scale HRQOL and functional disability scores over time from pre-injury to 1-week post-concussion and from 1-week post-concussion to symptom resolution using a piecewise linear mixed model, adjusting for potential covariables. Estimated fixed effects with a corresponding adjusted coefficient (beta), along with their 95% confidence intervals are presented.

Results

Overall HRQOL worsened from pre-injury to 1-week post-injury (β = − 5.40, 95%CI − 9.22, − 1.58) but did not change from 1-week post-injury to symptom resolution. Physical HRQOL worsened from pre-injury to 1-week post-injury (β = − 9.90, 95%CI − 14.65, − 5.14) but improved from 1-week post-injury to symptom resolution (β = 1.64, 95%CI 0.50, 2.78), while psychosocial HRQOL showed no change over time. Functional disability worsened from pre-injury to 1-week post-injury (β = 8.36, 95%CI 5.93, 10.79) but with no change from 1-week post-injury to symptom resolution. Youth with symptom duration > 14 days reported worse HRQOL and functional disability than those who recovered in ≤ 14 days and greater daily post-concussion symptom scores were associated with worse HRQOL and functional disability.

Conclusion

Concussions have a negative impact on overall and physical HRQOL and functional disability in youth acutely post-injury. Ratings of HRQOL could be used to inform clinical treatment decisions to assist with the recovery process.

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Data Availability

The data that support the findings of this study are available from the corresponding author, JZY, upon reasonable request.

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Funding

This work was supported by Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) (R21HD086451 [JZY]). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, 43205, USA

    Robyn Recker, Enas Alshaikh, Archana Kaur & Jingzhen Yang

  2. Department of Psychology, University of Calgary, Calgary, AB, Canada

    Keith Owen Yeates

  3. Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB, Canada

    Keith Owen Yeates

  4. Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada

    Keith Owen Yeates

  5. College of Medicine, The Ohio State University, Columbus, OH, 43210, USA

    Jingzhen Yang

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  1. Robyn Recker
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  2. Enas Alshaikh
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Contributions

RR: Conceptualization, Methodology, Investigation, Writing—Original draft, Writing—Review & Editing. EA: Methodology, Formal analysis, Writing—Original draft, Writing—Review & Editing. AK: Conceptualization, Investigation, Writing—Review & Editing. KOY: Conceptualization, Investigation, Writing—Review & Editing. JY: Conceptualization, Methodology, Investigation, Supervision, Funding acquisition, Data curation, Writing—Original draft, Writing—Review & Editing.

Corresponding author

Correspondence to Jingzhen Yang.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board at The Abigail Wexner Research Institute at Nationwide Children’s Hospital (July 29, 2016/IRB16-00613).

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Informed consent/assent was obtained from all individual participants included in the study.

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Recker, R., Alshaikh, E., Kaur, A. et al. Change in health-related quality of life and functional disability over time post-concussion in youth. Qual Life Res 32, 3339–3347 (2023). https://doi.org/10.1007/s11136-023-03480-4

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