Preliminary Safety and Efficacy of Head and Neck Cooling Therapy After Concussion in Adolescent Athletes: A Randomized Pilot Trial

Joseph Congeni, Tamara Murray, Peyton Kline, Rachida Bouhenni, Danielle Morgan, Christopher Liebig, Alexandria Lesak, Neil L McNinch, Joseph Congeni, Tamara Murray, Peyton Kline, Rachida Bouhenni, Danielle Morgan, Christopher Liebig, Alexandria Lesak, Neil L McNinch

Abstract

Objective: To determine the safety and efficacy of head and neck cooling when applied up to 8 days after concussion among adolescent athletes.

Design: A randomized nonblinded pilot trial.

Setting: Sports Medicine Clinic in a tertiary hospital.

Patients: Adolescent athletes aged 12 to 17 years diagnosed with a concussion within 1 week of injury.

Interventions and main outcome measures: The control group (n = 27) received standard treatment (short term brain rest), whereas the treatment group (n = 28) received standard treatment and head and neck cooling. Head and neck cooling treatment was applied to patients at the postinjury assessment visit and at 72 hours post-injury. The SCAT5 (Sport Concussion Assessment Tool) total symptom severity score was collected at postinjury assessment visit, pre- and post-treatment at 72 hours, and at 10 days, and 4 weeks post-treatment.

Results: Athletes who received head and neck cooling had a faster symptom recovery ( P = 0.003) and experienced significant reduction in symptom severity scores after treatment ( P < 0.001). Sport type and gender did not influence the treatment outcome ( P = 0.447 and 0.940, respectively).

Conclusions: This pilot study demonstrates feasibility of head and neck cooling for the management of acute concussion in adolescent athletes.

Conflict of interest statement

The authors report no conflicts of interest.

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1.
Figure 1.
A CONSORT flow diagram outlining the flow of patients through the Pro-2cool pilot study according to the criteria recommended in the CONSORT Guidelines.
Figure 2.
Figure 2.
A image showing the Pro-2cool device in use. Red arrow: Garments, black arrow: chiller with quick hose connect, blue arrow: power supply, *: Hood, and accessories: (A) garment transport cylinder, (B) disinfecting wipes and coolant solution, (C) head sleeve insulator, and (D) thyroid cartilage insulator.
Figure 3.
Figure 3.
A line graph showing the mean absolute difference between SCAT5 scores from the post-injury assessment visit to follow-up visits (post-injury assessment visit post-treatment, 72 hours visit pre-treatment, 72 hours post-treatment, and 10 days and 28 days post-treatment). Repeated measures ANOVA followed by post-hoc pairwise analysis was used to determine the significance in treatment effect, time effect, and interaction of treatment by time effect. *P < 0.05 indicates a significant decrease in the absolute difference in the SCAT5 symptom severity score in each group compared with the post-injury assessment visit values. Values are shown as mean ± SD.

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