title: Protocol for a prospective, longitudinal, cohort study of postconcussive symptoms in children: the Take C.A.Re (Concussion Assessment and Recovery Research) study.
abstract: BACKGROUND
  A substantial minority of children who sustain a concussion suffer prolonged postconcussive symptoms. These symptoms can persist for more than 1 month postinjury and include physical, cognitive, behavioural and emotional changes. Those affected can develop significant disability, diminishing their quality of life. The precise prevalence of postconcussive symptoms following child concussion is unclear, with heterogeneous and at times conflicting results published regarding factors that predict children at risk for developing long-lasting postconcussive symptoms. The aim of the Take C.A.Re (Concussion Assessment and Recovery Research) study is to provide an in-depth multidimensional description of the postconcussive recovery trajectories from a physical, neurocognitive and psychosocial perspective in the 3 months following concussion, with a focus on the early postconcussive period, and identification of factors associated with prolonged recovery.
  
  
  METHODS
  Take C.A.Re is a prospective, longitudinal study at a tertiary children's hospital, recruiting and assessing patients aged 5-<18 years who present to the emergency department with a concussion and following them at 1-4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: postconcussive symptoms, balance and coordination, neurocognition, behaviour, quality of life, fatigue, post-traumatic stress symptoms, parental distress and family burden. 'Delayed recovery' is operationalised as the presence of ≥ 3 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline. Main analyses comprise analysis of variance (recovery trajectories, delayed vs normal recovery groups) and regression analyses of predictors of recovery (preinjury, acute and family factors).
  
  
  BACKGROUND
  Ethical approval has been obtained through the Royal Children's Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.
  
  
  BACKGROUND
  ACTRN12615000316505.
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Women's and Children's Health, University of Padova, Padova, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Bressan
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia School of Psychological Sciences, University of Melbourne, Victoria, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Takagi
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia School of Psychological Sciences, University of Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Psychology Service, The Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Gavin A
authors.initials: GA
authors.lastname: Davis
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Emergency Department, Royal Children's Hospital Melbourne, Victoria, Australia.
authors.forename: Ed
authors.initials: E
authors.lastname: Oakley
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Department of Rehabilitation Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Dunne
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Cathriona
authors.initials: C
authors.lastname: Clarke
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Doyle
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hearps
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Vera
authors.initials: V
authors.lastname: Ignjatovic
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Marc
authors.initials: M
authors.lastname: Seal
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Emergency Department, Royal Children's Hospital Melbourne, Victoria, Australia.
authors.forename: Franz E
authors.initials: FE
authors.lastname: Babl
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001924:Brain Concussion / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D017281:Cost of Illness; D006801:Humans; D008137:Longitudinal Studies; D010290:Parents / Q000523:psychology; D038223:Post-Concussion Syndrome / Q000523:psychology; D004856:Postural Balance; D011446:Prospective Studies; D011788:Quality of Life; D012107:Research Design; D013315:Stress, Psychological
keywords: MENTAL HEALTH; REHABILITATION MEDICINE; TRAUMA MANAGEMENT