{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T21:07:21Z","timestamp":1774732041600,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T00:00:00Z","timestamp":1662768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The purpose of this retrospective chart review was to compare sports-related concussion (SRC) recovery time in protracted recovery (\u226528 days) patients who were prescribed physical therapy (PPT) with those who were only provided a home exercise program (HEP). We hypothesized PPT would be associated with shorter recovery times relative to HEP. Associations were evaluated with multivariable zero-truncated negative binomial regressions. Among the 48 (30.2%) PPT and 111 (69.8%) HEP patients, the majority were female (57.9%), the mean age was 15.3 \u00b1 1.4 (PPT) and 14.2 \u00b1 2.8 (HEP), and time to clinic was a median 6.0 (IQR = 3.0\u201327.0; PPT) and 7.0 (IQR = 3.0\u201323.0; HEP) days. After adjusting for demographic (age, sex) and clinical measures (concussion history, convergence, VOMS, PCSS score, and days to clinic), PPT unexpectedly was associated with 1.21 (95% CI: 1.05, 1.41) additional recovery days compared with HEP. One reason for this could be related to patients adhering to the number of a priori prescribed PT sessions which may or may not have aligned with the patient\u2019s symptom resolution. Future research should explore this hypothesis while aiming to evaluate the effect of PPT versus HEP using a randomized design. If confirmed, these findings are encouraging for patients who could not otherwise access or afford specialty rehabilitation.<\/jats:p>","DOI":"10.3390\/children9091371","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T20:52:25Z","timestamp":1663015945000},"page":"1371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of Prescribed Physical Therapy to a Home Exercise Program for Pediatric Sports-Related Concussion Patients"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2340-895X","authenticated-orcid":false,"given":"August M.","family":"Price","sequence":"first","affiliation":[{"name":"Children\u2019s Health Andrews Institute, Plano, TX 75024, USA"},{"name":"Department of Psychiatry, University of Texas Southwestern, Dallas, TX 75390, USA"},{"name":"Bellapianta Orthopaedics & Sports Medicine, Montclair, NJ 07042, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Arvin","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Andrews Institute, Plano, TX 75024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Seagraves","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Andrews Institute, Plano, TX 75024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott O.","family":"Burkhart","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Andrews Institute, Plano, TX 75024, USA"},{"name":"Children\u2019s Health Center for Youth Sport, Activity, and Health, Southern Methodist University, Dallas, TX 75205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5067-544X","authenticated-orcid":false,"given":"Gregory","family":"Knell","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Andrews Institute, Plano, TX 75024, USA"},{"name":"Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"},{"name":"Center for Pediatric Population Health, Children\u2019s Health, The University of Texas Health Science Center at Houston, Dallas, TX 75390, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1136\/ip.2010.031211","article-title":"Concussion research: A public health priority","volume":"17","author":"Wiebe","year":"2011","journal-title":"Inj. Prev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1227\/NEU.0000000000001447","article-title":"Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15\u201316, 2015","volume":"79","author":"Collins","year":"2016","journal-title":"Neurosurgery"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport\u2014the 5thinternational conference on concussion in sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1136\/bjsports-2012-091941","article-title":"American Medical Society for Sports Medicine position statement: Concussion in sport","volume":"47","author":"Harmon","year":"2012","journal-title":"Br. J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jns.2015.12.010","article-title":"Ocular motor assessment in concussion: Current status and future directions","volume":"361","author":"Ventura","year":"2016","journal-title":"J. Neurol. Sci."},{"key":"ref_6","first-page":"155","article-title":"Occurrence of oculomotor dysfunctions in acquired brain injury: A retrospective analysis","volume":"78","author":"Ciuffreda","year":"2007","journal-title":"Optom.-J. Am. Optom. Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.jsams.2019.08.004","article-title":"Persistent vestibular-ocular impairment following concussion in adolescents","volume":"22","author":"Sinnott","year":"2019","journal-title":"J. Sci. Med. Sport"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1227\/NEU.0b013e31823150f0","article-title":"Cutoff Scores in Neurocognitive Testing and Symptom Clusters That Predict Protracted Recovery From Concussions in High School Athletes","volume":"70","author":"Lau","year":"2012","journal-title":"Neurosurgery"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3233\/NRE-2007-22307","article-title":"The relation between post concussion symptoms and neurocognitive performance in concussed athletes","volume":"22","author":"Fazio","year":"2007","journal-title":"NeuroRehabilitation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"850","DOI":"10.3171\/jns.2005.102.5.0850","article-title":"Posttraumatic migraine characteristics in athletes following sports-related concussion","volume":"102","author":"Mihalik","year":"2005","journal-title":"J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/21622965.2020.1788563","article-title":"Association of sleep symptoms with mood and vestibular subtypes following sport-related concussion","volume":"11","author":"Brustman","year":"2020","journal-title":"Appl. Neuropsychol. Child"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/JSM.0000000000000128","article-title":"Brain or Strain? Symptoms Alone Do Not Distinguish Physiologic Concussion From Cervical\/Vestibular Injury","volume":"25","author":"Leddy","year":"2015","journal-title":"Clin. J. Sport Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3109\/02699052.2014.965207","article-title":"Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: An evidence-based classification system with directions for treatment","volume":"29","author":"Ellis","year":"2014","journal-title":"Brain Inj."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"228","DOI":"10.3109\/02699052.2014.974674","article-title":"A review of post-concussion syndrome and psychological factors associated with concussion","volume":"29","author":"Broshek","year":"2014","journal-title":"Brain Inj."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1001\/jamapediatrics.2018.4397","article-title":"Early Subthreshold Aerobic Exercise for Sport-Related Concussion","volume":"173","author":"Leddy","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/HTR.0000000000000238","article-title":"Aerobic Exercise for Adolescents With Prolonged Symptoms After Mild Traumatic Brain Injury: An Exploratory Randomized Clinical Trial","volume":"32","author":"Kurowski","year":"2017","journal-title":"J. Head Trauma Rehabilitation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1080\/87565641.2015.1067706","article-title":"Programmed Physical Exertion in Recovery From Sports-Related Concussion: A Randomized Pilot Study","volume":"40","author":"Maerlender","year":"2015","journal-title":"Dev. Neuropsychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e000404","DOI":"10.1136\/bmjsem-2018-000404","article-title":"Feasibility of a postacute structured aerobic exercise intervention following sport concussion in symptomatic adolescents: A randomised controlled study","volume":"4","author":"Micay","year":"2018","journal-title":"BMJ Open Sport Exerc. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/NPT.0b013e3181dde568","article-title":"Vestibular Rehabilitation for Dizziness and Balance Disorders After Concussion","volume":"34","author":"Alsalaheen","year":"2010","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1136\/bjsports-2013-093267","article-title":"Cervicovestibular rehabilitation in sport-related concussion: A randomised controlled trial","volume":"48","author":"Schneider","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/NPT.0000000000000228","article-title":"Vestibular Rehabilitation Is Associated With Visuovestibular Improvement in Pediatric Concussion","volume":"42","author":"Storey","year":"2018","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2479","DOI":"10.1177\/0363546514543775","article-title":"A Brief Vestibular\/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussions","volume":"42","author":"Mucha","year":"2014","journal-title":"Am. J. Sports Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/PEP.0000000000000729","article-title":"Changes in Vestibular\/Ocular-Motor Screen Scores in Adolescents Treated With Vestibular Therapy After Concussion","volume":"32","author":"Alsalaheen","year":"2020","journal-title":"Pediatr. Phys. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"CPG1","DOI":"10.2519\/jospt.2020.0301","article-title":"Physical Therapy Evaluation and Treatment After Concussion\/Mild Traumatic Brain Injury","volume":"50","author":"Shimamura","year":"2020","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.pmrj.2015.07.006","article-title":"Interdisciplinary Rehabilitation Referrals in a Concussion Clinic Cohort: An Exploratory Analysis","volume":"8","author":"Vargo","year":"2015","journal-title":"PM&R"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1177\/1941738116641394","article-title":"A Practical Concussion Physical Examination Toolbox","volume":"8","author":"Matuszak","year":"2016","journal-title":"Sports Health Multidiscip. Approach"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"299","DOI":"10.2519\/jospt.2019.8150","article-title":"Immediate and Short-term Effects of Thoracic Spine Manipulation in Patients With Cervical Radiculopathy: A Randomized Controlled Trial","volume":"49","author":"Young","year":"2019","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"G\u00f3mez, F., Escrib\u00e1, P., Pascual-Vaca, J.O., M\u00e9ndez-S\u00e1nchez, R., and Puente-Gonz\u00e1lez, A.S. (2020). Immediate and Short-Term Effects of Upper Cervical High-Velocity, Low-Amplitude Manipulation on Standing Postural Control and Cervical Mobility in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082580"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e000970","DOI":"10.1136\/bmjsem-2020-000970","article-title":"Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion","volume":"7","author":"Knell","year":"2021","journal-title":"BMJ Open Sport Exerc. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/JSM.0000000000000975","article-title":"Exploring Vestibular\/Ocular and Cognitive Dysfunction as Prognostic Factors for Protracted Recovery in Sports-Related Concussion Patients Aged 8 to 12 Years","volume":"32","author":"Price","year":"2021","journal-title":"Clin. J. Sport Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101626","DOI":"10.1016\/j.rehab.2021.101626","article-title":"Machine learning to predict sports-related concussion recovery using clinical data","volume":"65","author":"Chu","year":"2022","journal-title":"Ann. Phys. Rehabilitation Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.csm.2014.12.005","article-title":"Current and Emerging Rehabilitation for Concussion: A review of the evidence","volume":"34","author":"Broglio","year":"2015","journal-title":"Clin. Sports Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.spen.2019.03.011","article-title":"The Role of Physical Therapy in Concussion Rehabilitation","volume":"30","author":"Brown","year":"2019","journal-title":"Semin. Pediatr. Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1177\/0009922815588820","article-title":"Factors Associated With Problems for Adolescents Returning to the Classroom After Sport-Related Concussion","volume":"54","author":"Baker","year":"2015","journal-title":"Clin. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jpeds.2016.03.014","article-title":"Specific Factors Influence Postconcussion Symptom Duration among Youth Referred to a Sports Concussion Clinic","volume":"174","author":"Heyer","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e426","DOI":"10.1111\/apa.13486","article-title":"III. Initial somatic symptoms are associated with prolonged symptom duration following concussion in adolescents","volume":"105","author":"Howell","year":"2016","journal-title":"Acta Paediatr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.jpeds.2014.08.034","article-title":"Characteristics of Prolonged Concussion Recovery in a Pediatric Subspecialty Referral Population","volume":"165","author":"Corwin","year":"2014","journal-title":"J. Pediatr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/0363546516668624","article-title":"A Positive Vestibular\/Ocular Motor Screening (VOMS) Is Associated With Increased Recovery Time After Sports-Related Concussion in Youth and Adolescent Athletes","volume":"45","author":"Anzalone","year":"2016","journal-title":"Am. J. Sports Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1177\/0363546516685061","article-title":"Using Acute Performance on a Comprehensive Neurocognitive, Vestibular, and Ocular Motor Assessment Battery to Predict Recovery Duration After Sport-Related Concussions","volume":"45","author":"Sufrinko","year":"2017","journal-title":"Am. J. Sports Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"036","DOI":"10.1055\/s-0038-1676652","article-title":"Physical Therapy Management of Adults with Mild Traumatic Brain Injury","volume":"40","author":"Diaz","year":"2019","journal-title":"Semin. Speech Lang."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.ptsp.2022.04.010","article-title":"Early aerobic exercise among adolescents at moderate\/high risk for persistent post-concussion symptoms: A pilot randomized clinical trial","volume":"55","author":"Howell","year":"2022","journal-title":"Phys. Ther. Sport"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1249\/MSS.0000000000002787","article-title":"Acute Physical and Mental Activity Influence on Concussion Recovery","volume":"54","author":"Buckley","year":"2021","journal-title":"Med. Sci. Sports Exerc."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/9\/1371\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:28:53Z","timestamp":1760142533000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/9\/1371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,10]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["children9091371"],"URL":"https:\/\/doi.org\/10.3390\/children9091371","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,10]]}}}