Sport-Related Concussion

Hallock, Harry; Mantwill, Maron; Vajkoczy, Peter; Wolfarth, Bernd; Reinsberger, Claus; Lampit, Amit; Finke, Carsten

doi:10.1212/cpj.0000000000200123

Cited by 20 publications

(20 citation statements)

References 57 publications

(81 reference statements)

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“…45 Consequently, studies of rehabilitation methods must carefully balance their study populations to provide usable results, 34,46,47 especially with these interindividual differences. 48 The assessments help with diagnostics and RTP grading of an SRC, but it could be argued that it doesn't help players holistically. For example, for muscle or tendon injuries, there is a clear guideline that actively (isometric contraction, tens, stretching, strengthening) rehabilitees the injured tissue before returning to play.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic tools for return-to-play decisions in sports-related concussion

Wellm

Zentgraf

2023

Journal of Concussion

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Research has improved the understanding of sports related concussion (SRC), and several classification systems and guidelines are available in the literature. The exact timing and clearing of athletes for return-to-play (RTP) is still based primarily on subjective reports of concussion symptoms, however symptoms link poorly to objective recovery. Current literature suggest that symptoms alone cannot accurately identify either all concussed athletes or their recovery. The difficult task of interpreting which symptoms are directly related to concussion, and which are related to other conditions, speaks for an increased focus on the RTP process itself. This study examines the literature on neurocognitive assessments and their importance as indicators of accurate timing of when athletes can return to either ball training with duels or the playing field. Entries in three electronic databases (PubMed, Web of Science, and SURF) were searched from January 2000 to June 2022. Search terms were concussion, mild traumatic brain injury (mTBI), sport, athlete, expert, elite, professional, diagnostic, testing, return to play, management, neurocognitive, and cognitive. Inclusion criteria comprised performance-based participation in a team sport and being in the age range of possible peak performance (18–40 years). In addition, only studies with pre-post designs were considered. The PEDro scale was used to assess methodological quality. The methodological quality of the fifteen included studies ranged from 5 (one study) to 6 (fourteen studies) from a maximum of 10. Despite being symptom-free, athletes in all fifteen studies showed lower performance compared to controls on tests of visual and verbal memory (approx. 3–5% deficit) and on processing speed (approx. 6% deficit) after mTBI. All studies report specific neurocognitive deficits after mTBI, although the athletes were declared clinically symptom-free. Therefore, the systematic consideration of neurocognitive parameters in RTP decision making is recommended, especially in light of subsequent muscular injuries of the lower musculoskeletal system, recurrence of mTBI, and residual neurodegenerative disorders.

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Section: Discussionmentioning

confidence: 99%

Diagnostic tools for return-to-play decisions in sports-related concussion

Wellm

Zentgraf

2023

Journal of Concussion

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“…Much of the current research surrounding concussions stems from data on sports-related concussions (SRC). Sports-related concussions are common, but only account for 20% – 25% of all 3.7 million patients who present to casualty with a head injury in the United States annually, despite high participation rates (Harmon et al 2013, cited in Hallock et al 2023 ). Although the true incidence is not known, it has been estimated that about 33 million children worldwide sustain concussions annually (Davis et al 2017 ).…”

Section: A Little Background Into Concussionmentioning

confidence: 99%

“…The refinement of this approach could eventually lead to a non-invasive, sideline adjunct test for SRC (Hicks et al 2023 ). Currently, it is reported that at least 50% of concussions remain undiagnosed (Harmon et al 2013 cited in Hallock et al 2023 ).…”

Section: A Little Background Into Concussionmentioning

confidence: 99%

The role of the physiotherapist in concussion

Robertson,

McLoughlin

2024

South African Journal of Physiotherapy

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In the last decade, concussion research has exploded in multiple fields of scientific research. This has helped to clarify what causes, influences, and perpetuates human concussion, and displays the integral role physiotherapists play in concussion management. In this article we discuss the latest research relevant to the key role of physiotherapy in concussion management. A narrative review of the literature on concussion was conducted. The current review analyses how concussion has influenced physiotherapy in several categories: assessment, treatment, management, research rigour and building the profile of the profession. Scientific concussion research has largely converged in support of the role of physiotherapists utilising specific components including: (1) autonomic, (2) cervicogenic, (3) vestibulo-ocular and (4) psychological approaches to management. Latest research supports the critical role of physiotherapy in concussion care in the assessment, management, and prevention of concussion with scope for further interdisciplinary collaborations.Clinical implications: Concussion is complex. A basic mental health, Vestibular Ocular Motor Screening (VOMS) and four key components relating to concussion management (autonomic, cervicogenic, vestibular oculomotor, and psychological approaches to management) should be included in the undergraduate and postgraduate curriculum. This will aid clinical physiotherapists to support their patients. A call to advance more intradisciplinary physiotherapy teamwork should be encouraged as valuable knowledge sharing is potentially lost within the framework of ‘specialisation’. If needed, the skills of a greater interdisciplinary team are imperative to facilitate patient management and recovery from this multi-faceted injury.

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confidence: 99%

“…This research developed insight on PD/PN's (1) awareness, knowledge and (2) implementation of nutritional supports in concussion recovery with athletes. There was a clear contrast between participants who had an awareness and knowledge of the importance of nutrition in supporting brain recovery after a concussion and those who did not.…”

mentioning

confidence: 99%

Nutrition in acute concussion recovery – how is this currently being managed by performance dietitians and nutritionists?

Finnegan,

Daly,

Ryan

2023

Proc. Nutr. Soc.

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The incidence of sport-related concussion (SRC) has increased in many team-based sports (1,2,3) , such as rugby, Gaelic (camogie, hurling and football), and hockey in Ireland (3,4) . Following SRC, the brain becomes injured, its function disrupted, and an "energy crisis" (5) occurs. In response, the brain requires energy and nutrient support to restore cognitive function, reduce symptoms and support healing (2) . Performance dietitians (PN) and nutritionists (PN) play a critical role in supporting athletes' acute injury nutritional demands via fuelling and supplementation. Specific supplementation protocols with nutrients such as omega-3 fatty acids (Docosahexaenoic (DHA), a combination of DHA and Eicosapentaenoic (EPA) acid), magnesium, and N-acetyl cysteine (NAC) may help with SRC recovery. However, their application is unclear and requires further investigation (2) .Therefore, this study aimed to investigate Irish PD and PN knowledge and implementation of nutritional strategies to manage and support their athletes following an acute SRC diagnosis.In-depth, semi-structured, audio-recorded interviews were conducted with 17 PDs and PNs recruited from professional registrations (SENR), sporting bodies (IRFU, GAA, Sports Ireland) and networks. Participants practiced/had practiced with amateur and/or professional athletes within the last ten years. A reflexive thematic analysis approach was implemented whereby the data were transcribed, coded, and emerging themes were identified and discussed by all authors.This research developed insight on PD/PN's (1) awareness, knowledge and (2) implementation of nutritional supports in concussion recovery with athletes. There was a clear contrast between participants who had an awareness and knowledge of the importance of nutrition in supporting brain recovery after a concussion and those who did not. Participants presenting a practical understanding mentioned reemphasising certain foods and supplements already prescribed to their athletes to increase specific nutrient intake in the event of concussion for brain healing. PD/PNs were keeping up to date with nutrition research on concussion, but limited evidence has prevented them from utilising protocols in practice. Meanwhile, participants mentioned trialling or recommending nutritional protocols from personal or athlete experience, such as carb-reloading by increasing carbohydrate-rich foods, reducing omega-6 intake, and acutely supplementing creatine, omega 3's high in DHA, and probiotics; to support the brain healing post-concussion.PD/PN's use of nutrition protocols with athletes following acute SRC was linked to their knowledge and the scientific evidence available. Nutrition implementation, as a result, may be overlooked or implemented with uncertainty due to limited evidence, which could negatively affect the potential for optimal SRC recovery outcomes. From PD/PN's practices, it is evident that there is a need for research to uncover safe and practical nutritional protocols that they can use to mitigate the effects of SR...

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Sport-Related Concussion

Cited by 20 publications

References 57 publications

Diagnostic tools for return-to-play decisions in sports-related concussion

Diagnostic tools for return-to-play decisions in sports-related concussion

The role of the physiotherapist in concussion

Nutrition in acute concussion recovery – how is this currently being managed by performance dietitians and nutritionists?

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