Our proposed study aims to compare concussion recovery in those supplementing creatine
and those not supplementing creatine. Specific aim 1: To compare number of days until
asymptomatic between those taking creatine vs. those not taking creatine following a
concussion. Hypothesis: The investigators hypothesize that individuals taking creatine
will become asymptomatic sooner than those not taking creatine. Specific aim 2: To
compare typical concussion assessment scores (i.e., symptom score, mental status,
neurocognition, balance, motor coordination, and visual performance) between those taking
creatine vs those not taking creatine following a concussion once asymptomatic.
Hypothesis: The investigators hypothesize that individuals taking creatine will have
better symptom scores, balance, mental status, and neurocognition assessment scores than
those not taking creatine once asymptomatic.
Once the research team is contacted about a potential injury, the investigators will
ensure the participant meets inclusion criteria prior to meeting and schedule a meeting
if meet inclusion criteria to explain study details, obtain informed consent, administer
a symptom checklist (Sport Concussion Office Assessment Tool-5, SCOAT-6) and demographic
questionnaire, and provide creatine. The investigators will use the following components
of the SCAOT-6: Removal from play and description, (Current Injury; p. 652), Symptom
Evaluation (p. 654-655), Verbal Cognitive Tests (p. 655), Digits Backwards (p. 656),
Months in Reverse (p. 656), Orthostatic Vital Signs (p.657), Balance (p. 658), Timed
Tandem Gait (p. 658), Complex Tandem Gait (p. 659), Dual Task Gait (p.659), Modified
Vestibular/Ocular-Motor Screen (p. 660), Anxiety Screen (p. 660), Depression Screen (p.
660), sleep screen (p. 661), Delayed Word Recall (p. 662) (requires approximately 1
hour). Participants will be randomly assigned to the intervention or control group (10
participants targeted for each group; participant identification numbers will be
predetermined and allocated once enrolled). The intervention group will consume their
usual diet plus 5 grams of creatine for the first four days following the initial
meeting, and then 3 grams of creatine once per day thereafter until asymptomatic. The
control group will be asked to consume their usual diet and no creatine. The
investigators will then remain in contact with the participant to ensure compliance, and
assess when the participant is asymptomatic. When the investigators contact the
participant will vary depending on recovery process (e.g., if a participant has high
symptom burden, they may allow a few days between contact; whereas if a participant is
nearing asymptomatic, they contact the participant more frequently).
Once the participant becomes asymptomatic, the investigators will meet to administer a
SCAOT-6, a computerized neurocognitive assessment (CNS Vital Signs), visual assessment
(King-Devick) and note days from injury to asymptomatic. CNS Vital Signs requires
approximately 20-25 minutes and assesses the domains of verbal and visual memory,
psychomotor speed, reaction time, complex attention, cognitive flexibility, processing
speed, executive function, simple attention, and motor speed. King-Devick is a visual
assessment asking participants to read three test cards with numbers as fast as possible
without committing errors. The investigators anticipate the assessment requiring
approximately 1.5 hours.
The investigators will calculate descriptive statistics for all demographic, days to
asymptomatic, and concussion assessments. For specific aim 1, the investigators will
calculate a t-test to determine if days to asymptomatic differed in those taking creatine
vs. those not taking creatine. For specific aim 2, the investigators will calculate
t-tests with Bonferonni corrections to determine if concussion assessment scores (SCOAT-6
assessments, CNS Vital Signs, visual assessment) differed in those taking creatine vs.
those not taking creatine.