Concussion and Concussion Management Quick Overview

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An estimated 3.8 million sport and recreational-related concussions occur each year in the United States as a result of sport and physical activity. Experts at the University of Pittsburgh Medical Center (UPMC) define a concussion as an injury caused by direct or indirect forces that cause neurochemical and cellular changes in the brain. Given the popularity of hockey throughout the world and its aggressive nature, sports-related concussion is now widely viewed as a developing public health predicament.

Approximately 50% of individuals report dizziness as a symptoms in the first few days following the trauma. Symptoms of balance impairment may include unstable vision, difficulty focusing, motion discomfort and difficulty in visual environments. It is important to assess an individual’s balance due to the fact that these functions have been shown to be effected in conjunction with cognitive weakening.

The rising concern for both short-term and long-term potential complications from these injuries continues to press the need for accurate diagnosis and meaningful management strategies for athletes of all ages and levels of competition. Thus, educating our coaches, athletes and parents on concussion management is paramount in hockey and other contact sports. The issue becomes prevalent when individuals are cleared to return to their sport or activity without appropriately being assessed. Clearing an athlete to return-to-play too soon is a significant concern that athletes and health care professionals are faced with on a daily basis.

The National Athletic Trainers’ Association (NATA) has mapped out recommendations for return-to-play (RPT) that recommends a variety of assessments. The baseline and post-injury examinations should be administered in similar environments that maximize the athlete’s abilities, and all baseline examinations should be reviewed for sub-optimal performance. Any athlete suspected of sustaining a concussion should be immediately removed from participation and evaluated by the appropriate health care professional. Once a concussion diagnosis has been made, the individual should undergo a daily focused examination to monitor the course of recovery. Immediately following a concussion, daily testing of cognitive function and motor control is unnecessary until the athlete is symptom-free. Once an athlete is symptom free, they are able to move forward with the appropriate concussion management.

By James Stavitz, MS, ATC/LAT, ROT, FMSC
Doctoral Student; Seton Hall University; Health Science
Instructor; East Stroudsburg University; College of Health Science

References

Broglio, S., Cantu, R., Gioia, G., Guskiewicz, K., Kutcher, J., Palm, M., & Valovich McLeod, T. (2014). National athletic trainers’ association position statement: Management of sport concussion. Journal of Athletic Training, 49(2), 245-265.

Meyer, C. (2015, October 17). Rest not best for concussion recovery, experts conclude during UPMC concussion conference. Pittsburgh Post.

Collins, M., Kontos, A., Reynolds, E., Murawski, C., & Fu, F. (2014). A comprehensive, targeted approach to the clinical care of athletes following sport-related concussion. Knee Surgery, Sports Traumatology, Arthroscopy, 22(2), 235-246.

Kutcher, J. S., McCrory, P., Davis, G., Ptito, A., Meeuwisse, W. H., & Broglio, S. P. (2013). What evidence exists for new strategies or technologies in the diagnosis of sports concussion and assessment of recovery? British Journal of Sports Medicine, 47(5), 1-6.

Chang, J., Levy, S., Seay, S., & Goble, D. (2014). An alternative to the balance error scoring system: Using a low-cost balance board to improve the validity/reliability of sports-related concussion balance testing. Clinical Journal of Sports Medicine, 24(3), 256-262.

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