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Arch Phys Med Rehabil · Mar 2014
ReviewPsychosocial consequences of mild traumatic brain injury in children: results of a systematic review by the International Collaboration on Mild Traumatic Brain Injury Prognosis.
- Michelle L Keightley, Pierre Côté, Peter Rumney, Ryan Hung, Linda J Carroll, Carol Cancelliere, and J David Cassidy.
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada; Departments of Occupational Science and Occupational Therapy, Psychology and Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada. Electronic address: mkeightley@hollandbloorview.ca.
- Arch Phys Med Rehabil. 2014 Mar 1;95(3 Suppl):S192-200.
ObjectiveTo synthesize the best available evidence regarding psychosocial consequences of mild traumatic brain injury (MTBI) in children.Data SourcesMEDLINE, Embase, CINAHL, PsycINFO, and SPORTDiscus were searched (2001-2012). Inclusion criteria included published peer-reviewed reports in English, French, Norwegian, Spanish, Swedish, and Danish. References were also identified from relevant reviews and meta-analyses, and the bibliographies of eligible articles.Study SelectionThis article presents an update of a previous review with a much larger scope, of which this topic is a small subset of the questions addressed by that review. Controlled trials and cohort and case-control studies were selected according to predefined criteria. Two independent reviewers used modified Scottish Intercollegiate Guidelines Network criteria to critically appraise eligible studies. A total of 77,914 records were screened; 101 of these articles were deemed scientifically admissible, of which 6 investigated the psychosocial consequences of MTBI in children.Data ExtractionTwo reviewers independently extracted data from accepted studies into evidence tables.Data SynthesisWe conducted a best-evidence synthesis by linking our conclusions to the evidence tables. Most accepted studies were exploratory rather than confirmatory. Preliminary evidence suggests that most children recover within 3 months post-MTBI. After 1 year, the prevalence of postconcussion symptoms and syndrome is similar between children with MTBI and children with orthopedic injuries. The functional status of children with MTBI improves over a 30-month follow-up period, but further research is needed to investigate the possibility that children with MTBI experience greater rates of psychiatric illness during the 3 years after their injury.ConclusionsThe prognosis of MTBI is favorable in children. Most appear to recover functionally from a physical and psychological perspective. However, future research should investigate the risk for psychiatric illness.Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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