{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T18:21:15Z","timestamp":1759774875171,"version":"3.38.0"},"reference-count":34,"publisher":"Human Kinetics","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Context<\/jats:bold>:<\/jats:italic> Social determinants of health including insurance type, income, race, and ethnicity have been shown to influence the utilization of physical therapy and recovery after an orthopedic injury. The influence of social determinants of health on the utilization of physical therapy and recovery from concussion is not well understood. <jats:italic><jats:bold>Design<\/jats:bold>:<\/jats:italic> Prospective observational registry study in a specialty concussion program. <jats:italic><jats:bold>Methods<\/jats:bold>:<\/jats:italic> Patients diagnosed with a concussion using the Postconcussion Symptom Inventory and the visio-vestibular examination (VVE) who were also referred to physical therapy were included. The main outcomes of interest were the number of days from referral to initial physical therapy evaluation and the number of physical therapy visits completed. Information related to patients\u2019 age, race, ethnicity, sex, insurance type, and Child Opportunity Index was extracted from the registry. Multivariate and univariate regressions were used to assess the associations of each sociodemographic characteristic with the outcomes. <jats:italic><jats:bold>Results<\/jats:bold>:<\/jats:italic> A total of 341 patients diagnosed with concussion between January 2017 and December 2023 met inclusion criteria. The average age was 14.77, and 64% were female. Patients\u2019 age, race, ethnicity, insurance type, and Child Opportunity Index were not associated with days to evaluation or length of care in physical therapy. Higher PCSI scores in children under 12\u00a0years (coefficient: 0.17, 95% CI,\u00a00.06\u20130.29) and female sex (coefficient: 1.2, 95% CI, 0.26\u20132.1) were associated with a longer course of care in physical therapy. Patients with an abnormal VVE score had on average 2.1 more physical therapy visits than those with a normal VVE score (coefficient: 2.1, 95% CI, 0.73\u20133.5). <jats:italic><jats:bold>Conclusions<\/jats:bold>:<\/jats:italic> Higher PCSI scores in children, female sex, and higher VVE scores in general predicted a longer course of care in physical therapy. Implementation of a clinical care pathway for concussion care using the PCSI and the VVE may be one strategy to help mitigate systemic factors that might otherwise negatively influence access to physical therapy.<\/jats:p>","DOI":"10.1123\/jsr.2024-0113","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T19:32:41Z","timestamp":1729711961000},"page":"328-334","source":"Crossref","is-referenced-by-count":2,"title":["Factors Influencing Length of Care in Physical Therapy After Pediatric and Adolescent Concussion"],"prefix":"10.1123","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2484-0883","authenticated-orcid":true,"given":"Michael","family":"Karl","sequence":"first","affiliation":[{"name":"Sports Medicine and Performance Center, Children\u2019s Hospital of Philadelphia, King of Prussia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-9524","authenticated-orcid":true,"given":"Daniele","family":"Fedonni","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6717-4270","authenticated-orcid":true,"given":"Christina L.","family":"Master","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"},{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1694-4562","authenticated-orcid":true,"given":"Kristy B.","family":"Arbogast","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"},{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-1535","authenticated-orcid":true,"given":"Elliot","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Sports Medicine and Performance Center, Children\u2019s Hospital of Philadelphia, King of Prussia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3402-7650","authenticated-orcid":true,"given":"James","family":"Wilkes","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"100","reference":[{"issue":"10","key":"r1","series-title":"Jama","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1001\/jama.2016.1203","article-title":"Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED","volume":"315","author":"Zemek R","year":"2016","unstructured":"Zemek R, Barrowman N, Freedman SB, et\u00a0al. 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