Sport-Related Concussion in Children and Adolescents

Abstract

Sport-related concussion is an important topic in nearly all sports and at all levels of sport for children and adolescents. Concussion knowledge and approaches to management have progressed since the American Academy of Pediatrics published its first clinical report on the subject in 2010. Concussion's definition, signs, and symptoms must be understood to diagnose it and rule out more severe intracranial injury. Pediatric health care providers should have a good understanding of diagnostic evaluation and initial management strategies. Effective management can aid recovery and potentially reduce the risk of long-term symptoms and complications. Because concussion symptoms often interfere with school, social life, family relationships, and athletics, a concussion may affect the emotional well-being of the injured athlete. Because every concussion has its own unique spectrum and severity of symptoms, individualized management is appropriate. The reduction, not necessarily elimination, of physical and cognitive activity is the mainstay of treatment. A full return to activity and/ or sport is accomplished by using a stepwise program while evaluating for a return of symptoms. An understanding of prolonged symptoms and complications will help the pediatric health care provider know when to refer to a specialist. Additional research is needed in nearly all aspects of concussion in the young athlete. This report provides education on the current state of sport-related concussion knowledge, diagnosis, and management in children and adolescents.

The relationship between post-injury measures of cognition, balance, symptom reports and health-related quality-of-life in adolescent athletes with concussion

“…Current recommendations suggest that a period of physical and cognitive rest be prescribed following the concussion and the nature and duration of rest be modified as the patient recovers [36][37][38]. With recent emphasis on cognitive rest and academic accommodations [39][40][41], the findings reinforce the need to capture general fatigue, cognitive fatigue and school functioning, among other HRQoL measures.…”

Effects of Physical Self-Concept, Emotional Isolation, and Family Functioning on Attitudes towards Physical Education in Adolescents: Structural Equation Analysis

“…In reference to attitudes towards PE, the most highly rated dimension is agreement with subject management relating to PE [52], in contrast to the usefulness of this subject which demonstrated a trend towards considering PE as of little use [53,54]. On the contrary, numerous studies positively rate the usefulness of engaging in sport and PA on a daily basis [55,56]. This positive evaluation of the usefulness of PE leads to intrinsic motivation for engaging in PA, both inside and outside of the school timetable [57].…”

Concussion-Symptom Rating Correlation Between Pediatric Patients and Their Parents

“…Without pathognomonic imaging findings or laboratory tests available, health care professionals who diagnose and treat pediatric patients with concussion rely heavily on self-reported symptom inventories to gauge injury severity and develop management strategies. 3 Although longitudinal research 4 indicated that most youth who sustained concussions did not demonstrate long-term symptoms or neurocognitive impairment, investigators 5 have proposed that children and adolescents are more likely to experience prolonged recovery periods than adults. In the small subset of youth who experienced prolonged symptoms or neurocognitive problems, negative effects on various domains of health-related quality of life have been well described.…”