Sport-related concussion, one of the most complex injuries in sports medicine, is the focus of a new special issue of the Journal of Athletic Training, the scientific publication of the National Athletic Trainers’ Association.
“Over the last 20 years, our understanding of concussion mechanics, injury assessment and management has increased dramatically. We’ve made great strides with regard to education, research and legislation,” says special issue Guest Editor Steven Broglio, PhD, ATC, director, Neurotrauma Research Laboratory, University of Michigan. “Having the right multidisciplinary medical team in place, including the athletic trainer, who plays an important role in injury prevention and treatment, is vital. Our universal goal is to reduce the risk of injury and ensure a gold standard of care should concussion occur.”
Concussions during sport and recreation occur as often as 3.8 million times a year,1 resulting in up to seven injuries per minute every day of the year in the United States. Although each patient requires individual management, 90 percent of concussed athletes recover by day seven after injury.2 Concussive injuries compose 8.9 percent of all high school and 5.8 percent of all college athletic injuries.3
Key points from select studies published in the issue:
- Head-impact sensors have limited applications to concussion diagnosis but may provide sideline staff with estimates of athlete exposure and real-time data to monitor players.
- Given that concussion risk is inﬂuenced by many factors in addition to impact biomechanics, viewing an athlete’s head-impact data may provide context for the clinician working on the sidelines, but impact sensors should not replace clinical judgment.
- Amnesia was the predictor that most inﬂuenced clinical recovery from concussion.
- Loss of consciousness, concussion history and acute symptom group did not substantially affect symptom, cognitive or balance outcomes.
- Most injured athletes recovered within the normal timelines established by the Graded Symptom Checklist, Standardized Assessment of Concussion and Balance Error Scoring System.
- Compared with high school athletes who had access to an athletic trainer, those without such access were less knowledgeable about concussion.
- Access to an athletic trainer was not linked to high school athletes’ concussion-reporting percentages. However, such access was related to 10 reasons for not reporting a concussion.
- The most common reasons for not reporting a concussion were not wanting to lose playing time, not thinking the injury was serious enough to require medical attention and not wanting to let the team down.
- Per 10,000 athlete-exposures, the rates of sport-related concussion were highest in football (9.21), boys’ lacrosse (6.65), and girls’ soccer (6.11).
- Among sex-comparable sports, the rate of sport-related concussion was 56 percent higher in girls than in boys.
- Most athletes with sport-related concussions returned to play after seven days, despite resolution of symptoms in a smaller proportion within one week.
“No sports medicine topic is more polarizing than concussion, and today’s standard of care supersedes where we were just a decade ago,” says Broglio. “With validated measures, more and more of the guesswork is being removed from the process. While many questions persist about more sophisticated diagnostic measures, rehabilitation and long-term effects of injury, we continue to make great progress, remain current on research and new techniques and provide the best possible care for our patients at any level of sport or activity.”
Other suggested articles in the special issue:
- “If You’re Not Measuring, You’re Guessing: The Advent of Objective Concussion Assessments”
- “A Multifactorial Approach to Sport-Related Concussion Prevention and Education: Application of the Socioecological Framework”
- “Rest and Return to Activity After Sport-Related Concussion: A Systematic Review of the Literature”
1Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006;21(5):375–378.
2McCrea M, Guskiewicz KM, Randolph C, et al. Incidence, clinical course, and predictors of prolonged recovery time following sportrelated concussion in high school and college athletes. J Int Neuropsychol Soc. 2013;19(1):22–33.
3Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. Concussions among United States high school and collegiate athletes. J Athl Train. 2007;42(4):495–503.