American Medical Society for Sports Medicine position statement: concussion in sport

A concussion is considered a subset of a mild traumatic brain injury. Research has found that a second hit to the brain before it has had adequate time to heal may result in worsening of metabolic changes within the cells of the brain. Research has also found that an early return to increased cognitive or physical load may cause the brain to be vulnerable to prolonged dysfunctions. Short-term risks for premature return to play include decreased reaction time and an increased risk of a repeat concussion or injury. Long-term effects include secondary neurological conditions. There is currently no validated return to play guidelines for concussions. It is found that athlete diagnosed with a concussion should never return the same day or should return to sport if they are still symptomatic. It is concluded that treating concussions requires a multifaceted approach. It is important for the athlete to be honest with their symptoms and for all parties involved to be able to recognize signs and symptoms of the injury.  It is then recommended that a healthcare provider that is familiar with the athlete and knowledgeable in recognition and evaluation of concussions be used to properly diagnose a concussion. To see full article and a list of signs and symptoms of a concussion

Impacts post concussion with dual-task gait balance control

As there is a continuation of recognition of concussions in the adolescent populations there is still not current agreed upon regulations for return to activity post concussion. It has previously been hypothesized that gait stability during dual-task walking may be particularly sensitive to long-term disruptions after concussions. This study looked at a cohort of adolescents who returned to activity within 2 months of their injury. The participant’s cognition, symptom severity, and balance control during single-task and dual-task walking was observed before and after returning to pre-injury activities. In regards to balance, this study found the participants to have an increased medial/lateral center of mass displacement and velocity during dual-task walking after they returned to their pre-injury activities. See full study

Diagnostic Tests for Concussions: Is Vision Part of the Puzzle?

The Centers for Disease Control and Prevention have estimated that 1.4- 3.8 million sports-related mild traumatic brain injures (mTBI) annually in the United States. Not including mTBI not reported or ones seen in the out-patient setting. Sustaining one concussion during a sports season gives an athlete a 3 times greater risk for a second concussion. This article seeks to look at the visual impairments associated with concussions. This can help both with screening and monitoring the recovery of mTBI. In summary concussions and mTBI can have multiple of effects on the visual system. The authors of this article suggest adding a visual component to the current sideline tests in identifying sports-related concussions. See full article 

Use of Modified Acute Concussion Evaluation Tools in the Emergency Department in a Pediatric Population

In the pediatric population, mild traumatic brain injuries (concussions) make up 75%-90% of all acquired brain injuries evaluated in emergency departments (ER) in the US.  The Acute Concussion Evaluation (ACE) system published by the Centers for Disease Control and Prevention was developed to assist in identification and diagnosis of concussions. The ACE Care Plan tool was developed to guide management, including individualized recommendations for daily life, school, work and return to play. This tool was originally felt to be too time consuming for ER physicians. For this study a modified version was created and preformed on a patient population between ages 5-21. A primary concern of post ED management of concussions was the importance of ongoing outpatient rehabilitation, in this study it was found that this tool improved reported follow-up post-implementation for all patients. It also found an improvement in parent recall of concussion education. For full study.

Concussion rehab focusing on the inner ear and cervical spine

As the impact of concussions become more known in sports a major factor to look at has been time to return to sport. The researchers at the Sports Injury Prevention Research Center of University of Calgary looked at the effects of rehabilitating the cervical spine and vestibular system in a cohort of post-concussed athletes between the ages of 12-30 and the amount of time until they were medically cleared to return to sport.  18 males and 13 females were randomized between the control group and the intervention group. The intervention group received cervical spine and vestibular rehabilitation for 8-weeks or until they were medically cleared. Of the patients receiving therapy 73% were medically cleared to return to their sport in 8 weeks compared to only 4% of the control group.  An article discussing this study was written in the Globe and Mail or See original study