Concussion Essentials: A clinical trial for reducing persisting symptoms after child concussion
- Research Opportunity
- Royal Children’s Hospital/Murdoch Childrens Research Institute
|Professor Vicki Anderson||Vicki.Anderson@rch.org.au||+61 3 9345 4679||Personal web page|
Summary A single-centre randomised controlled trial to assess if a novel multimodal intervention can speed recovery from child concussion compared to usual care.
By the age of 10, 1 in 5 children will sustain a concussion and suffer acute post-concussion symptoms (PCS). These PCS resolve spontaneously within 4 weeks in 60% of children and adolescents, who safely return to pre-injury activities, leaving ~40% suffering ‘persisting PCS’ lasting 4 weeks or more. In order to better understand why some children take longer to recover, we started the Take CARe study in 2014. The Take CARe study took a biopsychosocial approach to identify factors that contribute to the development of PCS and examine factors that predict which children are at a higher risk for developing persisting PCS. We also examined the contribution of acute biomarkers for persisting PCS, tapping the key aspects of the postinjury metabolic cascade and associated brain pathology to better understand the mechanisms underlying delayed symptom recovery.
Data analysis is ongoing for the Take CARe study. We have identified psychological and family risk factors for developing persistent PCS and we have developed a clinical cut-off score for a widely used concussion symptom inventory. Importantly, our neuroimaging work has not identified neurobiological correlates of persistent PCS. This supports the notion that persistent PCS reflects a functional disturbance rather than a structural neurobiological injury and ongoing symptoms are better explained by other factors (e.g., mental health, family stress).
With Take CARe as a foundation, our current study, Concussion Essentials (CE), aims to accelerate recovery and safe return to normal activities post-concussion for children and adolescents. Currently, there is no evidence-based treatment for persisting PCS, despite large numbers of children debilitated for many months. We designed CE to address this gap. CE is an innovative, multimodal intervention integrating acute management and symptom-targeted treatment (i.e., physiotherapy, cognitive behaviour therapy, psychoeducation). We will conduct a Randomised Controlled Trial to evaluate the efficacy of CE compared to Usual Care (UC) to accelerate symptom resolution in children aged 8-18 who have sustained a concussion. The primary aim of CE is full symptom resolution and the secondary aims are to accelerate recovery time and return to activity (school, sport) and promote cost-effective care post- concussion.
We are seeking to recruit a high quality graduate to join the Concussion Essentials team and undertake a PhD. This study is run by the MCRI and we welcome applications from students of psychology, medicine, or other related disciplines (e.g., neurosciences).
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Students who are interested in joining this project will need to consider their elegibility as well as other requirements before contacting the supervisor of this research
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Research NodeRoyal Children’s Hospital/Murdoch Childrens Research Institute
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