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Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents

Overview of attention for article published in JAMA: Journal of the American Medical Association, December 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

news
65 news outlets
blogs
9 blogs
twitter
337 X users
facebook
31 Facebook pages
googleplus
4 Google+ users
reddit
1 Redditor

Citations

dimensions_citation
253 Dimensions

Readers on

mendeley
447 Mendeley
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Title
Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents
Published in
JAMA: Journal of the American Medical Association, December 2016
DOI 10.1001/jama.2016.17396
Pubmed ID
Authors

Anne M. Grool, Mary Aglipay, Franco Momoli, William P. Meehan, Stephen B. Freedman, Keith Owen Yeates, Jocelyn Gravel, Isabelle Gagnon, Kathy Boutis, Willem Meeuwisse, Nick Barrowman, Andrée-Anne Ledoux, Martin H. Osmond, Roger Zemek

Abstract

Although concussion treatment guidelines advocate rest in the immediate postinjury period until symptoms resolve, no clear evidence has determined that avoiding physical activity expedites recovery. To investigate the association between participation in physical activity within 7 days postinjury and incidence of persistent postconcussive symptoms (PPCS). Prospective, multicenter cohort study (August 2013-June 2015) of 3063 children and adolescents aged 5.00-17.99 years with acute concussion from 9 Pediatric Emergency Research Canada network emergency departments (EDs). Early physical activity participation within 7 days postinjury. Physical activity participation and postconcussive symptom severity were rated using standardized questionnaires in the ED and at days 7 and 28 postinjury. PPCS (≥3 new or worsening symptoms on the Post-Concussion Symptom Inventory) was assessed at 28 days postenrollment. Early physical activity and PPCS relationships were examined by unadjusted analysis, 1:1 propensity score matching, and inverse probability of treatment weighting (IPTW). Sensitivity analyses examined patients (≥3 symptoms) at day 7. Among 2413 participants who completed the primary outcome and exposure, (mean [SD] age, 11.77 [3.35] years; 1205 [39.3%] females), PPCS at 28 days occurred in 733 (30.4%); 1677 (69.5%) participated in early physical activity including light aerobic exercise (n = 795 [32.9%]), sport-specific exercise (n = 214 [8.9%]), noncontact drills (n = 143 [5.9%]), full-contact practice (n = 106 [4.4%]), or full competition (n = 419 [17.4%]), whereas 736 (30.5%) had no physical activity. On unadjusted analysis, early physical activity participants had lower risk of PPCS than those with no physical activity (24.6% vs 43.5%; Absolute risk difference [ARD], 18.9% [95% CI,14.7%-23.0%]). Early physical activity was associated with lower PPCS risk on propensity score matching (n = 1108 [28.7% for early physical activity vs 40.1% for no physical activity]; ARD, 11.4% [95% CI, 5.8%-16.9%]) and on inverse probability of treatment weighting analysis (n = 2099; relative risk [RR], 0.74 [95% CI, 0.65-0.84]; ARD, 9.7% [95% CI, 5.7%-13.7%]). Among only patients symptomatic at day 7 (n = 803) compared with those who reported no physical activity (n = 584; PPCS, 52.9%), PPCS rates were lower for participants of light aerobic activity (n = 494 [46.4%]; ARD, 6.5% [95% CI, 5.7%-12.5%]), moderate activity (n = 176 [38.6%]; ARD, 14.3% [95% CI, 5.9%-22.2%]), and full-contact activity (n = 133 [36.1%]; ARD, 16.8% [95% CI, 7.5%-25.5%]). No significant group difference was observed on propensity-matched analysis of this subgroup (n = 776 [47.2% vs 51.5%]; ARD, 4.4% [95% CI, -2.6% to 11.3%]). Among participants aged 5 to 18 years with acute concussion, physical activity within 7 days of acute injury compared with no physical activity was associated with reduced risk of PPCS at 28 days. A well-designed randomized clinical trial is needed to determine the benefits of early physical activity following concussion.

X Demographics

X Demographics

The data shown below were collected from the profiles of 337 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 447 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Korea, Republic of 1 <1%
Japan 1 <1%
Spain 1 <1%
Netherlands 1 <1%
Unknown 443 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 64 14%
Student > Master 60 13%
Other 45 10%
Student > Doctoral Student 44 10%
Researcher 41 9%
Other 110 25%
Unknown 83 19%
Readers by discipline Count As %
Medicine and Dentistry 144 32%
Nursing and Health Professions 58 13%
Sports and Recreations 39 9%
Neuroscience 32 7%
Psychology 23 5%
Other 37 8%
Unknown 114 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 800. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 March 2024.
All research outputs
#23,729
of 25,515,042 outputs
Outputs from JAMA: Journal of the American Medical Association
#556
of 36,546 outputs
Outputs of similar age
#464
of 423,745 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#21
of 372 outputs
Altmetric has tracked 25,515,042 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 36,546 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 72.6. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 423,745 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 372 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.