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• Sport-related concussion has been thrust to the forefront of medicine in recent years.

• A high degree of variability in clinical presentation and length of recovery has made management of this condition difficult.

• This review examines whether pre-existing risk factors or sign and symptom based variables exist to reliably predict a patient’s likelihood to experience a protracted recovery from concussion.

• The review of literature revealed heterogeneous results.

• This is due, in part, to the variability in the definition of prolonged recovery, ranging from seven to 90 days. Despite this variability, several factors emerged as having useful prognostic value.

• History of previous concussions is a factor that may put individuals at increased risk for prolonged recovery.

• The presenting symptoms of dizziness, migraine symptom cluster, and high symptom burden also provide an indication that a patient is up to 7.3 times (p=0.006) more likely to experience a protracted recovery (Kontos et al, 2013).

• Contrary to traditional assumptions, loss of consciousness is not predictive of prolonged recovery.

• Neurocognitive indicators show promise of having prognostic value but the application in primary care is currently impractical.

• While these factors do not provide means to definitively identify individuals who will suffer from protracted recovery, they do allow for the identification of those at increased risk. Such information can be useful in making timely referrals, effectively managing recovery expectations, and offering anticipatory guidance.

• Early identification of individuals at risk for protracted recovery can aid in the mobilization of additional support resources.


Physician Assistant Studies

Degree Name

Master of Physician Assistant Studies (MPAS)

First Advisor

Jay Metzger

Publication Date



Brain Concussion; Prognosis; Recovery of Function; Risk Factors


Rehabilitation and Therapy

Predictors of Prolonged Recovery from Concussion