To determine if there is a relationship between concussion recovery and airplane travel soon after injury in collegiate athletes and military cadets.

Concussions are a common occurrence in young athletes. Very few studies have examined how flying may influence the clinical progression of a concussive injury.

This is a prospective cohort study comprised of 3480 college athletes and cadets with concussion obtained from the Concussion Assessment, Research and ºÃÉ«ÏÈÉú (CARE) Consortium and divided in two groups: those who flew and those who did not fly after concussion. Those with unknown flight status were excluded. Demographics between groups were compared using Chi Square analysis. Symptom burden was calculated by subtracting baseline Sports Concussion Assessment Tool (SCAT3) symptom scores from the post-injury score after flying. Significance between outcome measures and flight status were evaluated using a paired t-test.   Analysis of Variance (ANOVA) was used to determine if number of time zones crossed during flight influenced outcomes.

165 athletes flew 31.8±52.3 [SD] hours after injury, 2235 athletes did not fly, and 1080 had unknown flight status. There were no significant study group differences for age, sex, sport, history of prior concussion, and history of headache. No significant group differences were found in days to return to unrestricted play (p=0.11), days after injury to start graded exertion (p=0.50), duration of concussion symptoms (p=0.23), days until return to normal academic performance (p=0.75), and symptom burden (p=0.47). Number of time zones crossed did not affect any outcomes.

Airplane travel early after concussion did not significantly affect recovery or severity of concussion symptoms in college athletes and cadets. Further studies need to investigate the possible effects of flying more acutely after injury. These data may help guide future recommendations on flight travel after concussion in athletes.