Volume 4, Issue 6, December 2019, Page: 56-64
Pediatric Life After Concussion Evaluation Scale (PLACES): Utility of a Survey of Quality of Life During Recovery from Concussion
Ruta Clair, Department of Psychology, Cabrini University, Radnor, United States
Arlene Goodman, Saint Peter’s University Hospital Sports Medicine Institute, Somerset, United States
George McCloskey, Department of Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, United States
Sarah Levin Allen, Brain Behavior Bridge, Haddon Heights, United States
Received: Nov. 12, 2019;       Accepted: Dec. 2, 2019;       Published: Dec. 9, 2019
DOI: 10.11648/j.ijpbs.20190406.11      View  300      Downloads  91
Abstract
Current research indicates that pediatric patients experience quality-of-life (QOL) issues during recovery from concussion. However, measures of health related QOL issues in youth have generally focused on chronic illness and do not address the unique experience of brain injury. The Pediatric Life After Concussion Evaluation Scale (PLACES) was developed to gain a better understanding of youth perspectives on QOL during recovery from concussion. The PLACES is a self-rating instrument examining patient perspectives on cognition, emotion, social life, and school support. Study participants were 277 patients, receiving treatment for concussion at a single regional concussion clinic. Examination of reliability using Cronbach’s alpha indicated strong performance with internal consistency (r =.92). The Post-Concussion Symptom Scale (PCSS) was used for comparison as this measure is commonly used to examine patient symptoms in clinical settings. Convergent and divergent validity of the PLACES was examined. Convergent validity was evident across the two measures (r=.732, p=.001). Exploratory factor analysis identified 5 factors and indicated divergent factors related to emotion, social concerns, and school. Analyses demonstrated that the PLACES domains measure different aspects of quality of life issues during recovery from concussion than traditional symptom scales, thereby offering support for the proposed domain structure of the PLACES. This measure appears to provide additional information that is clinically relevant and not available on symptom scales. Initial psychometrics indicate that the PLACES has the potential to function as a QOL measure specific to concussion and will assist in greater specificity of treatment during recovery.
Keywords
Concussion, Mild Traumatic Brain Injury, Health-Related Quality of Life, Recovery, School
To cite this article
Ruta Clair, Arlene Goodman, George McCloskey, Sarah Levin Allen, Pediatric Life After Concussion Evaluation Scale (PLACES): Utility of a Survey of Quality of Life During Recovery from Concussion, International Journal of Psychological and Brain Sciences. Vol. 4, No. 6, 2019, pp. 56-64. doi: 10.11648/j.ijpbs.20190406.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Burke, M. J., Fralick, M., Nejatbakhsh, N., Tartaglia, M C., & Tator, C. H. (2015). In search of evidence-based treatment for concussion: Characteristics of current clinical trials. Brain Injury, 29 (3), 300–305.
[2]
Purcell, L., Harvey, J., & Seabrook, J. A. (2016). Patterns of recovery following sport-related concussion in children and adolescents. Clinical Pediatrics, 55 (5), 452-458.
[3]
Sady., M. D., Vaughan, C. G., & Gioia, G. E. (2011). School and the concussed youth: Recommendations for concussion education and management. Physical Medicine and Rehabilitation Clinics of North America, 22, 701-719.
[4]
DiBattista, A., Soo, C., Catroppa, C., & Anderson, V. (2012). Quality of life in children and adolescents post-TBI: A systematic review and meta-analysis. Journal of Neurotrauma, 29: 171-1727.
[5]
Houston M. N., Bay R. C., McLeod T. C. V. (2016) The relationship between post-injury measures of cognition, balance, symptom reports and health-related quality-of-life in adolescent athletes with concussion. Brain Injury. 30: 891- 898.
[6]
Moran, L. M., Taylor, H. G., Rusin, J., Bangert, B., Dietrich, A., Nuss, K. E., Wright, M., Minich, N., & Yeates, K. O. (2011). Quality of life in pediatric mild traumatic brain injury and it’s relationship to post concussive symptoms. Journal of Pediatric Psychology, 37 (7), 736-744.
[7]
Novak, Z., Aglipay, M., Barrowman, N., Yeates, K. O., Beauchamp, M. H., Gravel, J., … Novak, R. L. (2016). Association of persistent postconcussion symptoms with pediatric quality of life. JAMA Pediatrics, 170 (12), E1–E8.
[8]
Eisenberg, M., Meehan, W., & Mannix, R. (2014). Duration and course of post-concussive symptoms. Pediatrics, 133 (6), 999-1006.
[9]
Heyer, G. L., Schaffer, C. E., Rose, S. C., Young, J. A., McNally, K. A., & Fischer, A. N. (2016). Specific factors influence postconcussion symptom duration among youth referred to a sports concussion clinic. The Journal of Pediatrics, 174: 33-8.
[10]
Chaput, G., Giguere, J.-F., Chauny, J.-M., Denis, R., & Lavigne, G. (2009). RelationshipAmong subjective sleep complaints, headaches, and mood alterations following a Mild traumatic brain injury. Sleep Medicine, 10 (2009), 713-716.
[11]
Luis, C., & Mittenberg, W. (2002). Mood and anxiety disorders following pediatric traumatic brain injury: A prospective study. Journal of Clinical and Experimental Neuropsychology, 24 (3), 270-279.
[12]
McCrory, P., Meeuwisse, W., Johnston, K., Dvorak, J., Aubrey, M., Molloy, M., & Cantu, R. (2009). Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Journal of Science and Medicine in Sport, 12, 340-351.
[13]
National Center for Injury Prevention and Control. (2007). Facts for Physicians, HeadsUp: Brain Injury in Your Practice. Atlanta, GA: Centers for Disease Control and Prevention.
[14]
Zemek, R. L., Farion, K. J., Sampson, M., & McGahern, C. (2013). Prognosticators of persistent symptoms following pediatric concussion. Journal of the American Medical Association/Pediatrics, 167 (3), 259-265.
[15]
Crowe, L., Collie, A., Hearps, S., Dooley, J., Clausen, H., Maddocks, D., McCrory, P., …Anderson, V. (2016). Cognitive and physical symptoms of concussive injury in children: A detailed longitudinal recovery study. British Journal of Sports Medicine, 50, 311-316.
[16]
Field, M., Collins, M. W., Lovell, M. R., & Maroon, J. (2003). Does age play a role in recovery from sports related concussion: A comparison of high school and collegiate athletes. The Journal of Pediatrics, 142, 546-553.
[17]
Harmon, K. G., Drezner, J. A., Gammons, M., Guskiewicz, K. M., Halstead, M., Herring, S. A., … Roberts, W. O. (2013). American medical society for sports medicine position statement: Concussion in sport. British Journal of Sports Medicine, 47, 15-26.
[18]
Makdissi, M., Davis, G., Jordan, B., Patricios, J, Purcell, L., & Putikian, M. (2013). Revisiting the modifiers: How should the evaluation and management of acute concussions differ in specific groups? British Journal of Sports Medicine, 47, 314-320.
[19]
Raikes, A. C. & Smart, J. (2015). The effects of sport-related concussions sustained during childhood and adolescence, and the need for educational accommodation. Current research Concussion, 2 (1), 25-31.
[20]
McLeod, T. C., Houston, M. N., & Welch, C. E. (2015). A pediatric perspective on sport-related concussion. Kinesiology Review, 4, 131-155.
[21]
Fineblit, S., Selci, E., Loewen, H., Ellis, M., & Russell, K. (2016). Health related quality of life after pediatric mild traumatic brain injury/concussion: A systematic review. Journal of Neurotrauma, 33, 1561-1568.
[22]
McLeod T. C. V, Wagner A. J., Bacon C. E. W. (2017) Lived experiences of adolescent athletes following sport-related concussion. Orthop Journal of Sports Medicine. 2017; 5: 2.
[23]
Pieper, P. & Garvan, C. (2014). Health-related quality-of-life in the first year following achildhood concussion. Brain Injury, 28 (1), 105-113.
[24]
Howell, D. R., Wilson, J. C., Kirkwood, M. W., & Grubenhoff, J. A. (2019). Quality of life and symptom burden 1 month after concussion in children and adolescents. Clinical Pediatrics, 58 (1), 42-49.
[25]
Halstead, M. E., McAvoy, K., Devore, C. D., Carl, R., Lee, M., & Logan, K. (2013). Returning to learning following a concussion. Pediatrics, 2013, 948-957.
[26]
Popoli, D., Burns, T., Meehan, W., & Reisner, A. (2014). CHOA concussion consensus establishing a uniform policy for academic accommodations. Clinical Pediatrics, 53 (2), 217-224.
[27]
Master, C. L., Gioia, G. A., Leddy, J. J, & Grady, M. F. (2012). Importance of ‘return-to-learn’ in pediatric and adolescent concussion. Pediatric Annals, 41 (9), 1-6.
[28]
Testa M. A. & Simonson D. C. Assessment of quality-of-life outcomes. (1996) New England Journal of Medicine. 334: 835-840.
[29]
Varni, J. W., Limbers, C., & Burwinkle, T. M. (2007). Literature review: Health-related quality of life measurement in pediatric oncology: Hearing the voices of the children. Journal of Pediatric Psychology, 32 (9), 1151-1163.
[30]
Varni, J. W., Seid, M. M., & Kurtin, P. S. (2001). PedsqL 4.0: Reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Medical Care, 39 (8), 800-812.
[31]
Clair, R. M., Tresco, K., Goodman, A., Weinberger, I., McCloskey, G., & Allen, S. L. (2016, June). Evaluating quality of life after concussion: The psychometric properties of a recovery profile. Poster session presented at the meeting of the American Academy of Clinical Neuropsychology, Chicago, IL
[32]
Clair, R., Henigan, M., Tresco, K., Goodman, A., Weinberger, I., & Levin Allen, S. (2016, May). The subjective experience of mild traumatic brain injury in pediatric patients. Poster Session presented at the 9th World Congress of Neurorehabilitation, Philadelphia.
[33]
Gerrald, L., Reott, Goodman, A., Levin Allen, S. & Clair, R. (2018). The Relationship Between Preexisting Conditions and Recovery Patterns in Pediatric Concussion Patients. Poster Session presented at International Neuropsychological Society, 46th Meeting, Washington DC.
[34]
Lovell, M. R., Iverson, G. L., Collins, M. W., Podell, K., Johnston, K. M., Pardini, D., … Maroon, J. (2006). Measurement of symptoms following sports-related concussion: Reliability and normative data for the post-concussion scale. Applied Neuropsychology, 13 (3), 166-174.
[35]
Kontos, A. P., Elbin, R. J., Schatz, P., Covassin, T., Henry, L., Pardini, J., & Collins, M. W. (2012). A revised factor structure for the post-concussion symptom scale: Baseline and postconcussion factors. American Journal of Sports Medicine, 40 (10), 2375-2384.
[36]
Chen, J.-K., Johnston, K. M., Collie, A., McCrory, P., & Ptito, A. (2007). A validation of the post concussion symptom scale in the assessment of complex concussion using cognitive testing and functional MRI. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 1231-1238.
[37]
Clair, R., Levin Allen, S., Goodman, A., & McCloskey, G (2019). Gender differences in quality of life during recovery concussion. Applied Neuropsychology: Child, DOI: 10.1080/21622965.2018.1556102.
Browse journals by subject