This study examined how often college students prematurely returned to normal activity before becoming asymptomatic after experiencing mild traumatic brain injuries (mTBIs) throughout their lifetime. The researchers surveyed 84 college students about their mTBI history and recovery. They found that 71% of the time after experiencing a mTBI, students returned to normal activity while still experiencing symptoms, rather than waiting until asymptomatic. High school students were more likely than other age groups to wait until asymptomatic before returning to normal activity. Premature return to activity increases the risk of long-term cognitive problems.

1. Emma Gootée, Kyle Vynorius, & Daniel Seichepine
Neuropsychology Laboratory, University of New Hampshire at Manchester
INTRODUCTION
 Mild traumatic brain injury (mTBI), also known as concussion,
occurs when an impact to the head or body results in functional
changes to neurons. This disruption in neuronal function can
result in a wide variety of symptoms.
 When individuals return to normal activity before
asymptomatic, they put themselves at risk for cognitive
problems such as dementia and chronic traumatic
encephalopathy, which occur with repetitive mTBIs.
 These cognitive problems interfere with the ability to carry out
daily tasks such as driving, cooking, bathing, and working.
 To mitigate the effects of these injuries, current treatment
protocol recommends that individuals rest until completely
asymptomatic before returning to normal activity.
 The present study examines how often injured individuals
return to normal activity prior to becoming completely
asymptomatic following mTBI.
METHODS
Participants
DISCUSSION
 Most individuals prematurely returned to normal activity,
placing the brain at increased risk for long-term cognitive
problems and neurodegeneration.
 Individuals in high school were the most likely to wait
until asymptomatic to return to normal activity.
 It is unclear why high school age participants were the
most likely to wait until asymptomatic before returning to
normal activity. It may be that support systems provided to
high school age students encourage rest.
 Perhaps, more support systems targeting other age groups
could help improve long-term outcomes.
Premature return to normal activity following mild traumatic brain
injuries throughout the lifetime of healthy college students
 Eighty-four undergraduate students (female=61) participated in
this study (mean age = 22.2 years, SD = 4.3).
 All participants completed an anonymous online survey
assessing mTBI history and how often they prematurely
returned to normal activity.
 Participants were excluded if they were: under the age of 18;
non-fluent English speakers; or have a history of other
neurological conditions or cancer.
 Participants were provided a description of mTBI consistent
with the American Academy of Neurology’s current guideline.
 The following mTBI definition was provided:
“There is a misconception that concussions (also known as “mild
traumatic brain injury”) only happen when you lose consciousness
after being hit on the head or when the symptoms last for a long time.
However, a concussion occurs anytime you have an impact to the head
that causes neurological symptoms for any amount of time (e.g.
seconds or longer). Common symptoms of concussion include:
sensitivity to light or noise, headache, dizziness, balance problems,
nausea, vomiting, trouble sleeping, fatigue, confusion, difficulty
remembering, difficulty concentrating, or loss of consciousness.”
RESULTS (contd.)
Return Time
1 mTBI (n=26)
2 mTBIs (n=9)
3 mTBIs (n=7)
4 mTBIs (n=8)
5+ mTBIs
(n=5)
mTBI
(n=55)
no
mTBI
(n=29)
mTBI Frequency
Age of Exposure to mTBI
Elementary
School Age
Middle School
Age
High School
Age
Adult
Mean number
of mTBI
1.20 (SD=.41) 1.11 (SD=.33) 1.59 (SD=1.1) 1.65 (SD=.93)
RESULTS
 Fifty-five of eighty-four participants reported
experiencing at least one mTBI (range=1-7) in their
lifetime, with 59% being formally diagnosed.
 A chi-square goodness of fit test showed a statistically
significant difference in the proportion of individuals who
returned to normal activity while symptomatic versus
those who waited until asymptomatic (x2=24.9, p<.001).
 Of 128 mTBIs, 71% of the time individuals returned to
normal activity prior to becoming asymptomatic.
 There was a significant difference in rate of return
between the four age groups, with the high school age
group more likely to wait until asymptotic (x2=10.1,
p<.05).
35% waited until asymptomatic to return to normal activity
65% did not wait until asymptomatic to return to normal activity
0%
25%
50%
75%
100%
Elementary School Age Middle School Age High School Age Adult
Appropriate Return
Premature Return