Subtypes of Sport-Related Concussion: a Systematic Review and Meta-cluster Analysis
Objective Current clinical guidelines provide a unitary approach to manage sport-related concussion (SRC), while heterogeneity in the presentation of symptoms suggests that subtypes of SRC may exist. We systematically reviewed the available evidence on SRC subtypes and associated clinical outcomes....
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Published in | Sports medicine (Auckland) Vol. 50; no. 10; pp. 1829 - 1842 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Cham
Springer International Publishing
01.10.2020
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Objective
Current clinical guidelines provide a unitary approach to manage sport-related concussion (SRC), while heterogeneity in the presentation of symptoms suggests that subtypes of SRC may exist. We systematically reviewed the available evidence on SRC subtypes and associated clinical outcomes.
Data Sources
Ovid Medline, Embase, PsycINFO, and SPORTDiscus
Eligibility Criteria for Selecting Studies
Electronic databases were searched for studies: (i) identifying SRC symptom clusters using classification methodology; or (ii) associating symptom clusters to clinical outcome variables. A total of 6,146 unique studies were identified, of which 75 full texts were independently assessed by two authors for eligibility. A total of 22 articles were included for systematic review.
Data Extraction
Two independent authors performed data extraction and risk of bias analysis using the Cochrane Collaboration tool.
Data Synthesis
Six studies found evidence for existence of SRC symptom clusters. Combining the available literature through Multiple Correspondence Analysis (MCA) provided evidence for the existence of a
migraine
cluster, a
cognitive–emotional
cluster, a
sleep–emotional
cluster, a
neurological
cluster, and an
undefined feelings
cluster. Nineteen studies found meaningful associations between SRC symptom clusters and clinical outcomes. Clusters mapping to the
migraine
cluster were most frequently reported in the literature and were most strongly related to aspects of clinical outcome.
Conclusions
The available literature provides evidence for the existence of at least five subtypes in SRC symptomatology, with clear relevance to clinical outcome. Systematically embedding the differentiation of SRC subtypes into prognosis, clinical management, and intervention strategies may optimize the recovery from SRC. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3 |
ISSN: | 0112-1642 1179-2035 |
DOI: | 10.1007/s40279-020-01321-9 |