Attention-Deficit/Hyperactivity Disorder (ADHD) as a Predictor of Prolonged Functional Recovery from Sports-Related Concussion in High School Athletes.

Context: Attention-Deficit/Hyperactivity Disorder (ADHD) has been speculated to prolong concussion recovery; however, the evidence regarding concussion recovery for individuals with ADHD is limited.

Objective: To examine the concussion recovery time based on ADHD status, sex, and age.

Design: Cross-Sectional Study.

Setting: High school.

Participants: 935 (female n=382, 40.1%) concussions including 78 (female n=13, 20.0%) self-identified ADHD data were analyzed.

Main Outcome Measures: A Poisson regression was utilized to estimate the Return- to-Learn (RTL) and Return-to-Sport (RTS) recovery outcomes with three predicting variables: ADHD status, sex, and age.

Results: The mean RTL days of the ADHD and non-ADHD groups were 12.86 ± 10.89 (Median 11.0; IQR=8; 7.0-15.25) and 1.43 ± 8.39 (Median 9.0; IQR=9.0; 6.0-14.0), respectively. The mean RTS days of the ADHD and non-ADHD groups were 20.82 ± 15.25 days (Median 17.0; IQR=9; 12.0-21.0) and 18.03 ± 11.42 days (Median 15.0; IQR=10.0; 11.0-21.0), respectively. For RTL, the ADHD status (RR=1.16, 95%CI:1.08, 1.24, p<.001) and female sex (RR=1.13, 95%CI: 1.08, 1.17, p<.001) were significant variables for longer recovery, while the age was not (RR=0.995, 95%CI: 0.98, 1.01, p=.056). For RTS, the ADHD status (RR=1.17, 95%CI:1.12,1.23, p<.001), female sex (RR=1.07, 95%CI:1.04, 1.11, p<.001), and younger age (RR=0.98, 95%CI:0.96, 0.99, p<.001) were all significant variables for longer recovery.

Conclusions: Healthcare providers must be aware of the elevated risk of prolonged concussion recovery among high school athletes with ADHD.