{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T19:53:33Z","timestamp":1787860413076,"version":"build-2784847793"},"reference-count":44,"publisher":"National Athletic Trainers' Association","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Persistent postconcussion symptoms (PPCSs) are associated with lower health-related quality of life (HRQoL) in children and adolescents. Despite commonly cited criteria for PPCSs involving 3 or more complaints, many individuals experience just 1 or 2 symptoms that may still negatively affect HRQoL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine differences in HRQoL between children and adolescents with 0, 1 to 2, or 3+ parent-reported persistent symptoms at 1 month postconcussion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Community practice clinics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>Individuals aged 8 to 18 years presented for the initial visit within 3 days of a sport- or recreation-related concussion. One month later, parents or guardians reported persistent symptoms using the Rivermead Post Concussion Symptoms Questionnaire (RPQ). Individuals with complete symptom data were analyzed (n = 236\/245, n = 97 females, age = 14.3 \u00b1 2.1 years). Participants were grouped by the number of discrete RPQ symptoms reported as worse than preinjury (0, 1\u20132, or 3+).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>Total summary and subscale scores on the Pediatric Quality of Life Inventory (PedsQL) 23-item HRQoL inventory and 18-item Multidimensional Fatigue Scale (MDFS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Kruskal-Wallis rank sum tests highlighted differences in PedsQL HRQoL and MDFS total scores across symptom groups (PedsQL HRQoL: \u03c722 = 85.53, P &amp;lt; .001; MDFS: \u03c722 = 93.15, P &amp;lt; .001). Dunn post hoc analyses indicated all 3 groups were statistically significantly different from each other (P &amp;lt; .001). The median (interquartile range) values for the Peds QL Inventory HRQoL totals were 93.5 (84.2\u201398.8) for those with 0 symptoms; 84.8 (73.9\u201392.4) for those with 1 to 2 symptoms; and 70.7 (58.7\u201378.0) for those with 3+ symptoms. The median (interquartile range) values for the MDFS totals were 92.4 (76.4\u201398.6) for those with 0 symptoms; 78.5 (65.6\u201388.9) for those with 1 to 2 symptoms; and 54.2 (46.2\u201365.3) for those with 3+ symptoms. Similar group differences were observed for each PedsQL HRQoL and MDFS subscale score.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Children and adolescents whose parents reported 1 to 2 PPCSs had lower HRQoL and more fatigue than those with 0 symptoms. Across all 3 groups, those with 3+ persistent symptoms had the lowest HRQoL and most fatigue. These findings indicate the continued need for intervention in this age group to prevent and address PPCSs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-0552.22","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T17:04:03Z","timestamp":1687539843000},"page":"767-774","source":"Crossref","is-referenced-by-count":5,"title":["Quality of Life Differences in Children and Adolescents With 0, 1 to 2, or 3+ Persistent Postconcussion Symptoms"],"prefix":"10.4085","volume":"58","author":[{"given":"Madison C.","family":"Chandler","sequence":"first","affiliation":[{"name":"*Matthew Gfeller Center, Department of Exercise & Sport Science"},{"name":"\u2020STAR Heel Performance Laboratory"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Bloom","sequence":"additional","affiliation":[{"name":"\u2021Carolina Family Practice & Sports Medicine, Cary, 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Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johna K.","family":"Register-Mihalik","sequence":"additional","affiliation":[{"name":"*Matthew Gfeller Center, Department of Exercise & Sport Science"},{"name":"\u2020STAR Heel Performance Laboratory"},{"name":"\u2016Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine"},{"name":"\u00b6Injury Prevention Research Center, The University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"issue":"(1)","key":"2023111614485321700_i1062-6050-58-9-767-b01","doi-asserted-by":"crossref","first-page":"e20154635","DOI":"10.1542\/peds.2015-4635","article-title":"Sports- and recreation-related concussions in US 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