title: The relationship between post-injury measures of cognition, balance, symptom reports and health-related quality-of-life in adolescent athletes with concussion.
abstract: BACKGROUND
  Little is known about the relationship between post-concussion impairments and health-related quality-of-life (HRQoL). The primary purpose of this study was to determine the relationship between traditional concussion assessments and HRQoL in adolescent athletes post-concussion. The secondary purpose was to determine the association between HRQoL deficits and time lost.
  
  
  METHODS
  In total, 1134 athletes completed a baseline assessment battery. HRQoL measures included the Pediatric Quality of Life Inventory (PedsQL), Multidimensional Fatigue Scale (MFS) and Headache Impact Test-6. In total, 122 athletes sustained a concussion and underwent follow-up testing at 3 and 10 days post-injury.
  
  
  RESULTS
  The strongest relationships were between symptom severity and HRQoL. For concurrent regression analyses at Day 3, PedsQL-Physical accounted for 17.9% of the variance in time lost beyond that accounted for by traditional measures. At Day 10, PedsQL-School accounted for 15.2% and symptom severity for 7.1% of this variance. In predictive analyses, at Day 3, PedsQL-Physical accounted for 3.9% and MFS-General for 3.3% of the variance in time lost beyond that accounted for by traditional measures. At Day 10, MFS-Cognitive accounted for 12.0% of this variance.
  
  
  CONCLUSIONS
  HRQoL appears to play a role in time lost post-concussion and should be measured in combination with traditional concussion assessments.
authors.affiliation: a John A. Feagin Jr. Sports Medicine Fellowship , Keller Army Hospital , West Point , NY , USA.
authors.forename: Megan N
authors.initials: MN
authors.lastname: Houston
authors.affiliation: b Department of Interdisciplinary Health Sciences.
authors.forename: R Curtis
authors.initials: RC
authors.lastname: Bay
authors.affiliation: b Department of Interdisciplinary Health Sciences.|c School of Osteopathic Medicine , A.T. Still University , Mesa , AZ , USA.
authors.forename: Tamara C
authors.initials: TC
authors.lastname: Valovich McLeod
mesh_terms: D000293:Adolescent; D056352:Athletes / Q000523:psychology*; D001265:Athletic Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D001924:Brain Concussion / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D003071:Cognition / Q000502:physiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D004856:Postural Balance / Q000502:physiology*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D063189:Symptom Assessment
keywords: Brain injury; assessment; paediatric; patient-reported outcome measures