Comparing peer relationship ratings among adolescents with sport and Non-sport Related Concussions.

Objective: To evaluate if peer relationship ratings differ among adolescents who sustain a sport-related concussion compared to those who sustain a non-sport-related concussion.

Study design: We conducted a cross-sectional investigation of 123 adolescents who sustained a concussion within 21 days before their initial post-injury evaluation (mean = 9.2 ± 3.9 days post-concussion). Participants reported whether their injury occurred during organized sport participation (sport-related concussion group) or not (non-sport-related concussion group). Participants completed the PROMIS Global Pediatric 25 assessment, as well as the Post-Concussion Symptom Inventory (PCSI) to rate concussion symptom severity and a background/demographic intake form during the evaluation. We compared PROMIS peer relationship ratings between groups using independent t-tests and evaluated the association between peer relationship ratings and sport-related concussion using multiple linear regression after adjusting for covariates including PROMIS anxiety rating, age, sex, concussion and musculoskeletal injury history, loss of consciousness at time of concussion, physical activity participation prior to study evaluation, and concussion symptom severity.

Results: Most (N = 96, 78%) participants reported sustaining a concussion during sports. The group who sustained sport-related concussion reported significantly better post-concussion peer relationship ratings compared to the group who sustained a non-sport-related concussion (52.7 ± 7.7 vs. 47.7 ± 10.4; p = 0.009, Cohen's d = 0.60). After covariate adjustment, those who sustained a sport-related concussion had a significantly greater post-concussion peer relationship rating than those who sustained a non-sport-related concussion (β = 4.19, 95% CI = 0.39, 8.00; p = 0.03). Higher peer relationship ratings were also associated with lower anxiety ratings following concussion (β= -0.21, 95% CI= -0.38, -0.04; p = 0.03).

Conclusion: Adolescents who sustained a concussion during sports reported significantly greater post-concussion peer relationship ratings than those in non-sport settings. Better peer relationship ratings were associated with less anxiety in the post-injury period. These findings suggest the potential effects of contextual factors (e.g. peer support) to facilitate improved outcomes following adolescent concussion.