{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:30:19Z","timestamp":1773984619723,"version":"3.50.1"},"reference-count":86,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Return-to-learn (RTL) recommendations and management protocols for athletes after sport-related concussion (SRC) remain heterogeneous. With respect to academics after SRC, the current systematic review evaluated 3 outcome measures in each included study: 1) RTL definition, 2) RTL duration, and 3) factors associated with longer RTL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Studies published before December 2022 that addressed RTL after an SRC were identified via a compressive literature search of the Cochrane Central Register of Controlled Trials, CINAHL, SPORTDiscus, Educational Resources Information Center, Ovid MEDLINE, and PubMed databases. Studies solely examining nonsport-related concussion\/traumatic brain injury studies were excluded. Study quality was assessed using the Oxford Centre for Evidence-Based Medicine Criteria and the Modified Newcastle-Ottawa Scale for risk of bias. For each study included, the design, participants, interventions, outcomes, results, and conclusions were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 1838 studies identified, 21 met the inclusion criteria. These studies represented 8475 athletes (aged 5\u201327 years) who sustained an SRC. A total of 17\/21 (81%) provided an RTL definition. Of the studies that defined RTL as any RTL, the median (range) was 5 (2.5\u201335.3) days, while the median (range) of those that defined RTL as full RTL without accommodations was 17.5 (3\u201349) days. Female gender (7\/9 studies) and initial symptom severity (3\/3 studies) were consistently associated with delayed RTL. Single studies identified anxiety, attention-deficit\/hyperactivity disorder (ADHD), and integrated performance management as potential factors for delayed RTL. Age (0\/5 studies), concussion history (2\/6), depression history (0\/1), migraine history (0\/2), learning disability (0\/1), school type (public vs private) (0\/2), and early air travel after SRC (0\/1) did not appear to have consistent effects on RTL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Across 21 primary studies, RTL definitions varied greatly, and similarly, a wide range of days to RTL was seen at 3\u201335 days. Female gender and initial symptom severity were most consistently associated with prolonged RTL. Certain factors such as a history of ADHD\/anxiety showed potential effects but require further investigation. Management guidelines should consider these findings while recognizing the need for more comprehensive research to confirm and quantify the impact of various factors on RTL duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.1.peds24482","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T22:54:14Z","timestamp":1746831254000},"page":"173-185","source":"Crossref","is-referenced-by-count":2,"title":["Return-to-learn following sport-related concussion: a systematic review"],"prefix":"10.3171","volume":"36","author":[{"given":"Anthony E.","family":"Bishay","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville;"},{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ousman","family":"Jallow","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"},{"name":"Meharry Medical College, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Jo","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville;"},{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Williams","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunyoung","family":"Hong","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"},{"name":"Vanderbilt University, Nashville, Tennessee; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackson","family":"Allen","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville;"},{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"},{"name":"Department of Neurological Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas P.","family":"Terry","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"10","key":"b1","series-title":"J Athl Train","first-page":"990","article-title":"Return to learn after sport-related concussion: a survey of secondary school and collegiate athletic trainers","volume":"53","author":"Williamson CL","year":"2018","unstructured":"Williamson CL, Norte GE, Broshek DK, Hart JM, Resch JE. 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