{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:43:24Z","timestamp":1777927404446,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n                    The results of prior research concerning the effects of repeated concussions have been mixed. The aim of this study was to evaluate how concussion outcomes and presentation changed within patients who were evaluated at a concussion specialty clinic multiple times with a concussion. Subjects included 202 patients (54% male) aged 10\u201321 years (M\u2009=\u200913.17) who presented to a specialty concussion clinic for two and three concussions (77% sport-related) and were followed through formal clearance. First, growth curve models were estimated to determine recovery time and initial symptom burden across the multiple injuries. Second, covariates were added to these models to evaluate which demographic, risk factor, or injury variables predicted any change that did occur in evaluation or outcome variables. Models indicated that each subsequent concussion linearly resulted in significantly fewer days to recovery (-4.62 days,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.047) across three concussions, and significantly lower (and linear) symptom scores on the post-concussion symptom scale (PCSS) (-2.16,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.05). More severe presentation (i.e., days to recovery; higher symptom score) was significantly associated (-.62,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.005) with greater improvement in recovery time (-.62,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.005) and symptom burden (-.56,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) at subsequent injuries. No covariates were significantly associated with improvement (or lack thereof) at subsequent injuries. This study adds to evidence suggesting multiple injuries is not associated with protracted recovery at subsequent injuries, in the context of treatment and full clearance for each injury at a multi-disciplinary clinic.\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0148","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T07:20:02Z","timestamp":1707290402000},"page":"1409-1416","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating Recovery After Two and Three Repeated Concussions Using Growth Curves"],"prefix":"10.1177","volume":"41","author":[{"given":"Jonathan","family":"Preszler","sequence":"first","affiliation":[{"name":"Department of Neuropsychology, Sanford Health, Bismarck, North Dakota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Manderino","sequence":"additional","affiliation":[{"name":"Aptiva Health Concussion Program, Louisville, Kentucky, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn R.","family":"Eagle","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Trbovich","sequence":"additional","affiliation":[{"name":"UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Kissinger-Knox","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA."},{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Feder","sequence":"additional","affiliation":[{"name":"Northside Hospital Concussion Institute, Duluth, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bindal","family":"Mehmel","sequence":"additional","affiliation":[{"name":"UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Collins","sequence":"additional","affiliation":[{"name":"UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA."},{"name":"Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony P.","family":"Kontos","sequence":"additional","affiliation":[{"name":"UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA."},{"name":"Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6724a3"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-100338"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-021-01541-7"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2022.0266"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31820e382e"},{"key":"e_1_3_4_7_2","article-title":"Possible lingering effects of multiple past concussions","volume":"2012","author":"Iverson GL","year":"2012","unstructured":"Iverson GL, , Echemendia RJ, , LaMarre AK, et al. 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