{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:23:06Z","timestamp":1785770586673,"version":"3.56.0"},"reference-count":32,"publisher":"National Athletic Trainers' Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p>Assessments of the duration of concussion recovery have primarily been limited to sport-related concussions and male contact sports. Furthermore, whereas durations of symptoms and return-to-activity (RTA) protocols encompass total recovery, the trajectory of each duration has not been examined separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify individual (eg, demographics, medical history), initial concussion injury (eg, symptoms), and external (eg, site) factors associated with symptom duration and RTA-protocol duration after concussion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Three US military service academies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients or Other Participants<\/jats:title><jats:p>A total of 10\u200a604 cadets at participating US military service academies enrolled in the study and completed a baseline evaluation and up to 5 postinjury evaluations. A total of 726 cadets (451 men, 275 women) sustained concussions during the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure(s)<\/jats:title><jats:p>Number of days from injury (1) until the participant became asymptomatic and (2) to complete the RTA protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Varsity athlete cadets took less time than nonvarsity cadets to become asymptomatic (hazard ratio [HR] = 1.75, 95% confidence interval = 1.38, 2.23). Cadets who reported less symptom severity on the Sport Concussion Assessment Tool, third edition (SCAT3), within 48 hours of concussion had 1.45 to 3.77 times shorter symptom-recovery durations than those with more symptom severity. Similar to symptom duration, varsity status was associated with a shorter RTA-protocol duration (HR = 1.74, 95% confidence interval = 1.34, 2.25), and less symptom severity on the SCAT3 was associated with a shorter RTA-protocol duration (HR range = 1.31 to 1.47). The academy that the cadet attended was associated with the RTA-protocol duration (P &amp;lt; .05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The initial total number of symptoms reported and varsity athlete status were strongly associated with symptom and RTA-protocol durations. These findings suggested that external (varsity status and academy) and injury (symptom burden) factors influenced the time until RTA.<\/jats:p><\/jats:sec>","DOI":"10.4085\/1062-6050-10-19","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T21:56:30Z","timestamp":1592517390000},"page":"658-665","source":"Crossref","is-referenced-by-count":18,"title":["Concussion-Recovery Trajectories Among Tactical Athletes: Results From the CARE Consortium"],"prefix":"10.4085","volume":"55","author":[{"given":"Kathryn L.","family":"Van Pelt","sequence":"first","affiliation":[{"name":"NeuroTrauma Research Laboratory, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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Feagin Jr. Sports Medicine Fellowship, Keller Army Community Hospital, West Point, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren E.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Brigham Young University, Provo, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"D'Lauro","sequence":"additional","affiliation":[{"name":"United States Air Force Academy, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuming","family":"He","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan N.","family":"Houston","sequence":"additional","affiliation":[{"name":"John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Community Hospital, West Point, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"United States Air Force Academy, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim F.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Intercollegiate Athletics, United States Military Academy at West Point, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"McGinty","sequence":"additional","affiliation":[{"name":"United States Air Force Academy, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean K.","family":"Meehan","sequence":"additional","affiliation":[{"name":"University of Waterloo, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick G.","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"US Coast Guard Academy, New London, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Y.","family":"Peck","sequence":"additional","affiliation":[{"name":"John A. 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