{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:02:30Z","timestamp":1792188150888,"version":"4.4.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Persistent postconcussive symptoms (PCS) are poorly understood in children. Research has been limited by an assumption that children with concussion are a homogenous group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To identify (i) distinctive postconcussive recovery trajectories in children and (ii) injury-related and psychosocial factors associated with these trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This study is part of a larger prospective, longitudinal study. Parents of 169 children (5-18 yr) reported their child's PCS over 3 mo following concussion. PCS above baseline levels formed the primary outcome. Injury-related, demographic, and preinjury information, and child and parent mental health were assessed for association with trajectory groups. Data were analyzed using group-based trajectory modeling, multinomial logistic regression, and chi-squared tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We identified 5 postconcussive recovery trajectories from acute to 3 mo postinjury. (1) Low Acute Recovered (26.6%): consistently low PCS; (2) Slow to Recover (13.6%): elevated symptoms gradually reducing; (3) High Acute Recovered (29.6%): initially elevated symptoms reducing quickly to baseline; (4) Moderate Persistent (18.3%): consistent, moderate levels of PCS; (5) Severe Persistent (11.8%): persisting high PCS. Higher levels of child internalizing behaviors and greater parental distress were associated with membership to the Severe Persistent group, relative to the Low Acute Recovered group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>This study indicates variability in postconcussive recovery according to 5 differential trajectories, with groups distinguished by the number of reported symptoms, levels of child internalizing behavior problems, and parental psychological distress. Identification of differential recovery trajectories may allow for targeted early intervention for children at risk of poorer outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyaa310","type":"journal-article","created":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T07:09:18Z","timestamp":1593673758000},"page":"36-45","source":"Crossref","is-referenced-by-count":21,"title":["Trajectories and Risk Factors for Pediatric Postconcussive Symptom Recovery"],"prefix":"10.1227","volume":"88","author":[{"given":"Katie","family":"Truss","sequence":"first","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"},{"name":"School of Psychological Sciences, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J C","family":"Hearps","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz E","family":"Babl","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"},{"name":"School of Psychological Sciences, University of Melbourne, Melbourne, Australia"},{"name":"Department of Pediatrics, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Takagi","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"},{"name":"School of Psychological Sciences, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin A","family":"Davis","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathriona","family":"Clarke","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Anderson","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa C","family":"Rausa","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bressan","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"},{"name":"Department of Women's and Children's Health, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Dunne","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"},{"name":"Department of Pediatrics, University of Melbourne, Melbourne, Australia"},{"name":"Department of Rehabilitation Medicine, Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Anderson","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Melbourne, Australia"},{"name":"School of Psychological Sciences, University of Melbourne, Melbourne, Australia"},{"name":"Psychology Service, Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1]]},"reference":[{"issue":"11","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport\u2014the 5th international conference on concussion in sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br J Sports Med"},{"issue":"12","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1136\/bjsports-2016-097415","article-title":"What is the difference in concussion management in children as compared with adults? 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