The Take CARe Projects - Concussion Assessment and Recovery Research


6th September, 2018 "...take c.a.r.e. STUDY Helping Children Recover Better after Concussion"

The Take CARe Projects encompass a number of concussion studies taking place at the Murdoch Children’s Research Institute (MCRI) and The Royal Children’s Hospital (RCH).

Take CARe Biomarkers
Take CARe Biomarkers is a prospective longitudinal observational study examining children aged 5 to 18 years old who present to the Emergency Department (ED) at the RCH for a concussion. The control group include children with an uncomplicated upper-limb orthopaedic injury who present to the ED. Both groups are assessed at four time points across three months post-injury.

The study aims to examine recovery pathways of post concussive symptoms, cognition, physical function, mental health and quality of life. The study also incorporates advanced neuroimaging and collection of venous blood samples to evaluate the contribution of acute biomarkers to delayed recovery post-injury. The objective is to translate these findings into clinical guidelines and community practice. Early results implicate subtle acute brain changes, more severe acute symptoms, pre- and post- concussion anxiety and parent anxiety.

SCAT5 Validation Study
The latest iteration of the Sports Concussion Assessment Tool, the SCAT5, was published early in 2017, based on findings and information emerging from the 5th International Consensus Conference on Concussion in Sport held in Berlin in 2016. This study aims to validate both the ChildSCAT5 and SCAT5 as tools to diagnose concussion in children aged 5 to 16 years. Children presenting to the ED at the RCH for a concussion are recruited during evenings and weekends, and are compared to children presenting to the ED with mild upper-limb injuries and well children. The SCAT3 was previously validated through a similar study in the RCH ED.

­­­­MCRI and RCH concussion clinicians and researchers are developing a smartphone app for parents. The HeadCheck concussion app is based on the latest concussion research from the Take CARe studies. It supports parents, teachers and coaches to recognise if a child needs medical attention and assists to manage the child’s recovery after the injury. HeadCheck uses the Post Concussion Symptom Inventory (PCSI) to monitor the child’s symptoms. The parent is shown a personalised recovery program based on the individual child’s symptoms.

The HeadCheck team has been working in collaboration with the AFL and piloted HeadCheck in a number of Victorian community football leagues. Further feedback will be sought from parents of children who have presented to the RCH ED. The HeadCheck concussion app will be rolled out nationally through AFL community leagues in season 2018.

Take CARe Active Intervention
Take CARe Active is a randomised control trial comparing standardised multimodal treatment with the HeadCheck concussion app for children with persisting post concussion symptoms at one month post-injury. The multimodal treatment is an individualised intervention program completed onsite at the RCH, where children receive education and advice about physical activity, fatigue, sleep and lifestyle, as well as treatment by a physiotherapist and/or psychologist depending on the child’s symptoms. The HeadCheck app will be delivered at home where parents answer questions about their children’s symptoms and are provided education about symptoms, fatigue, physical activity and return to school.

Some publications from the team:
Bressan, S., Takagi, M., Anderson, V., et al. Protocol for a prospective, longitudinal, cohort study of postconcussive symptoms in children: the Take C.A.Re (Concussion Assessment and Recovery Research) study. BMJ Open. 2016;6(1):e009427.

Davis GA, Anderson V, Babl F, et al. What is the difference in concussion management in children as compared to adults? A systematic review. British Journal of Sports Medicine. 2017;51(12):949-957.

Hearps SJC, Takagi M, Babl FE, et al. Validation of a score to determine time to postconcussive recovery. Pediatrics. 2017.



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