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Return to Play after Concussion

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1. Acute plasma tau relates to prolonged return to play after concussion. (PubMed)

Acute plasma tau relates to prolonged return to play after concussion. To determine whether tau changes after sport-related concussion (SRC) relate to return to play (RTP).Collegiate athletes underwent preseason plasma sampling and cognitive testing and were followed. After a SRC (n = 46), athletes and controls (n = 37) had sampling at 6 hours, and at 24 hours, 72 hours, and 7 days after SRC. A sample of 21 nonathlete controls were compared at baseline. SRC athletes were grouped by long (>10 (...) days, n = 23) and short (≤10 days, n = 18) RTP. Total tau was measured using an ultrasensitive immunoassay.Both SRC and athlete controls had significantly higher mean tau at baseline compared to nonathlete healthy controls (F101,3 = 19.644, p < 0.01). Compared to SRC athletes with short RTP, those with long RTP had higher tau concentrations overall, after controlling for sex (F39,1 = 3.59, p = 0.022), compared to long RTP athletes, at 6 (p < 0.01), 24 (p < 0.01), and 72 hours (p = 0.02). Receiver

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2017 Neurology

2. Patient, Injury, Assessment, and Treatment Characteristics and Return-to-Play Timelines After Sport-Related Concussion: An Investigation from the Athletic Training Practice-Based Research Network. (PubMed)

Patient, Injury, Assessment, and Treatment Characteristics and Return-to-Play Timelines After Sport-Related Concussion: An Investigation from the Athletic Training Practice-Based Research Network. To describe the patient, injury, assessment and treatment characteristics, as well as return-to-play timelines and clinical findings at discharge for adolescent patients after sport-related concussion.Retrospective analysis of electronic medical records.Athletic training facilities of secondary school (...) members of the Athletic Training Practice-Based Research Network (AT-PBRN).In total, 1886 patient records were reviewed. [1204 (63.8%) male, 682 (36.2%) female, age = 15.3 ± 1.9 years, height = 169.5 ± 13.5 cm, mass = 70.3 ± 17.0 kg]. Patients were diagnosed with a concussion by an athletic trainer or team/directing physician.None.Descriptive analysis of patient, injury, assessment, treatment, and participation status characteristics, as well as discharge information.Injury demographic forms were

2019 Clinical Journal of Sport Medicine

3. Multiple Concussions Increase Odds and Rate of Lower Extremity Injury in National Collegiate Athletic Association Athletes After Return to Play. (PubMed)

Multiple Concussions Increase Odds and Rate of Lower Extremity Injury in National Collegiate Athletic Association Athletes After Return to Play. Concussion in collegiate athletics is one of the most prevalent sport-related injuries in the United States, with recent studies suggesting persistent deficits in neuromuscular control after a concussion and an associated increase in risk of lower extremity injury.To expand on the relationship between concussion and lower extremity injury by examining (...) the effect of multiple concussions (MC) on rate and odds of future lower extremity injury in collegiate athletes after return to play (RTP) compared with matched controls.Cohort study; Level of evidence, 3.From 2001 to 2016, 48 National Collegiate Athletic Association Division I athletes sustaining multiple concussions at a single institution were identified. Athletes with multiple concussions (MC) were matched directly to athletes with a single concussion (SC) and to athletes with no concussion history

2019 American Journal of Sports Medicine

4. Return to play and risk of repeat concussion in collegiate football players: comparative analysis from the NCAA Concussion Study (1999-2001) and CARE Consortium (2014-2017). (PubMed)

Return to play and risk of repeat concussion in collegiate football players: comparative analysis from the NCAA Concussion Study (1999-2001) and CARE Consortium (2014-2017). We compared data from the National Collegiate Athletic Association (NCAA) Concussion Study (1999-2001) and the NCAA-Department of Defense Concussion Assessment, Research and Education (CARE) Consortium (2014-2017) to examine how clinical management, return to play (RTP) and risk of repeat concussion in collegiate football (...) difference=50.82 days; 95% CI 38.37 to 63.27; p<0.0001).Our findings indicate that concussion in collegiate football is managed more conservatively than 15 years ago. These changes in clinical management appear to have reduced the risk of repetitive concussion during the critical period of cerebral vulnerability after sport-related concussion (SRC). These data support international guidelines recommending additional time for brain recovery before athletes RTP after SRC.© Author(s) (or their employer(s

2019 British Journal of Sports Medicine

5. Reconsidering Return-to-Play Times: A Broader Perspective on Concussion Recovery (PubMed)

Reconsidering Return-to-Play Times: A Broader Perspective on Concussion Recovery Return-to-play protocols describe stepwise, graduated recoveries for safe return from concussion; however, studies that comprehensively track return-to-play time are expensive to administer and heavily sampled from elite male contact-sport athletes.To retrospectively assess probable recovery time for collegiate patients to return to play after concussion, especially for understudied populations, such as women (...) and nonelite athletes.Cohort study; Level of evidence, 3.Medical staff at a military academy logged a total of 512 concussion medical records over 38 months. Of these, 414 records included complete return-to-play protocols with return-to-play time, sex, athletic status, cause, and other data.Overall mean return to play was 29.4 days. Sex and athletic status both affected return-to-play time. Men showed significantly shorter return to play than women, taking 24.7 days (SEM, 1.5 days) versus 35.5 days (SEM

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2018 Orthopaedic journal of sports medicine

6. Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion (PubMed)

Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC.After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP (...) of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non-sport-related activity were excluded.Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002).On average, female athletes took approximately 6 days longer to begin an RTP progression

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2016 Sports health

7. Return to Play after Concussion

Return to Play after Concussion Return to Play after Concussion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Return to Play after (...) Concussion Return to Play after Concussion Aka: Return to Play after Concussion , Concussion Return to Play Guidelines , Graded Return to Play after Concussion From Related Chapters II. Precautions See Early return to play (especially for under age 20 years) risks Patient, parents and coaches should be notified of stipulations and concerns regarding return to play Guidelines are best applied to ages 13 years and older Athletes younger than 13 should be evaluated with greater caution III. Evaluation

2018 FP Notebook

8. Concussion in American Versus European Professional Soccer: A Decade-Long Comparative Analysis of Incidence, Return to Play, Performance, and Longevity. (PubMed)

Concussion in American Versus European Professional Soccer: A Decade-Long Comparative Analysis of Incidence, Return to Play, Performance, and Longevity. The incidence and effect of sports-related concussions (SRCs) within the global sport of professional soccer is poorly described.To comparatively examine the effects of SRC on athletes in Major League Soccer (MLS) and the English Premier League (EPL) in terms of incidence, return to play (RTP), performance, and career longevity.Cohort study (...) performance in terms of games started, assists, shots on goal, and total shots after concussion was significantly reduced at all nongoalie positions for players in the EPL; however, MLS nongoalie positions with concussion had no significant decreases in these categories. Goalies in both leagues had no significant change in performance or games started. The probability of playing a full season after concussion was not significantly decreased when compared with the uninjured pool in both leagues.This study

2019 American Journal of Sports Medicine

9. Patient, Injury, Assessment, and Treatment Characteristics and Return-to-Play Timelines After Sport-Related Concussion: An Investigation from the Athletic Training Practice-Based Research Network. (PubMed)

Patient, Injury, Assessment, and Treatment Characteristics and Return-to-Play Timelines After Sport-Related Concussion: An Investigation from the Athletic Training Practice-Based Research Network. To describe the patient, injury, assessment and treatment characteristics, as well as return-to-play timelines and clinical findings at discharge for adolescent patients after sport-related concussion.Retrospective analysis of electronic medical records.Athletic training facilities of secondary school (...) members of the Athletic Training Practice-Based Research Network (AT-PBRN).In total, 1886 patient records were reviewed. [1204 (63.8%) male, 682 (36.2%) female, age = 15.3 ± 1.9 years, height = 169.5 ± 13.5 cm, mass = 70.3 ± 17.0 kg]. Patients were diagnosed with a concussion by an athletic trainer or team/directing physician.None.Descriptive analysis of patient, injury, assessment, treatment, and participation status characteristics, as well as discharge information.Injury demographic forms were

2017 Clinical Journal of Sport Medicine

10. Functional Connectivity Is Altered in Concussed Adolescent Athletes Despite Medical Clearance to Return to Play: A Preliminary Report (PubMed)

be aberrant in recently concussed, asymptomatic athletes who had been cleared to return to play. A seed-based FC analysis measured the FC of the default mode network (DMN) (seeds = anterior cingulate cortex, posterior cingulate cortex (PCC), right lateral parietal cortex, and left lateral parietal cortex) 30 days after SRC in asymptomatic high school athletes cleared to return to play (n = 13) and was compared to the FC of high school athletes with orthopedic injury (OI) (n = 13). The SRC group (...) Functional Connectivity Is Altered in Concussed Adolescent Athletes Despite Medical Clearance to Return to Play: A Preliminary Report Recovery following sports-related concussion (SRC) is slower and often more complicated in young adolescent athletes than in collegiate players. Further, the clinical decision to return to play is currently based on symptoms and cognitive performance without direct knowledge of brain function. We tested the hypothesis that brain functional connectivity (FC) would

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2016 Frontiers in neurology

11. Return to play in athletes with spinal cord concussion: a systematic literature review. (PubMed)

Return to play in athletes with spinal cord concussion: a systematic literature review. This is a systematic review.The study aimed to evaluate whether spinal cord concussion (SCC) patients can safely return to play sports and if there are factors that can predict SCC recurrence or the development of a spinal cord injury (SCI).Although SCC is a reversible neurologic disturbance of spinal cord function, its management and the implications for return to play are controversial.We conducted (...) reported on patients without stenosis: pediatric cases returned without recurrence, whereas an adult case experienced recurrent SCC after returning to play. Seven studies described patients with stenosis. These studies included cases with and without recurrence after return to play, as well as patients who suffered SCI with permanent neurologic deficits. Three studies reported on patients who underwent an ACDF. Although some patients played after surgery without problems, several patients experienced

2016 The Spine Journal

12. Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes. (PubMed)

levels in the mean number of reported symptoms. Logistic regression models estimated the odds of return to play at less than 24 hours and at least 30 days.Overall, 1429 sports-related concussions were reported among youth, high school, and college-level football athletes with a mean (SD) of 5.48 (3.06) symptoms. Across all levels, 15.3% resulted return to play at least 30 days after the concussion and 3.1% resulted in return to play less than 24 hours after the concussion. Compared with youth (...) , a higher number of concussion symptoms were reported in high school athletes (β = 1.39; 95% CI, 0.55-2.24). Compared with college athletes, the odds of return to play at least 30 days after injury were larger in youth athletes (odds ratio, 2.75; 95% CI, 1.10- 6.85) and high school athletes (odds ratio, 2.89; 95% CI, 1.61-5.19). The odds of return to play less than 24 hours after injury were larger in youth athletes than high school athletes (odds ratio, 6.23; 95% CI, 1.02-37.98).Differences

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2016 JAMA pediatrics

13. Use of the stepwise progression return-to-play protocol following concussion among practicing athletic trainers (PubMed)

Use of the stepwise progression return-to-play protocol following concussion among practicing athletic trainers The purpose of this study was to determine whether practicing athletic trainers (ATs) were using the stepwise progression to make return-to-play (RTP) decisions after concussion and to determine what factors influenced their decision to use the stepwise progression.A total of 166 ATs (response rate = 16.6%) completed a 21-item questionnaire that evaluated participant demographics (...) this study are employing the stepwise progression to safely return athletes to play after sustaining a concussion. This demonstrates that ATs are providing a standard of care for concussed athletes across various athletic training settings; however, having a graduate degree and treating more concussions per year are predictors of whether an AT follows all steps of the stepwise progression.

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2016 Journal of sport and health science

14. Sport-Related Concussions: Symptom Recurrence After Return to Exercise (PubMed)

Sport-Related Concussions: Symptom Recurrence After Return to Exercise Current guidelines dictate a gradual exercise progression after a concussion; however, it is unclear what proportion of athletes experience a recurrence of symptoms once they are symptom free at rest. Estimating the proportion of athletes and predictors of symptom recurrence would help shape return-to-play protocols.To determine the proportion and associated risk factors of athletes who have a recurrence of concussion (...) symptoms with exercise after being symptom free at rest.Case-control study; Level of evidence, 3.Between October 1, 2009 and July 31, 2011, we studied patients from a sport concussion clinic located within a tertiary care regional children's hospital. Patients were queried at every visit using a standardized questionnaire. Our main outcome variable was recurrence of symptoms with exercise after being symptom free at rest at some point in their recovery. Cofactors included age, sex, loss

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2017 Orthopaedic journal of sports medicine

15. E-edition: Return to Play

or accommodations should be followed? A systematic review Laura K Purcell, Gavin A Davis, Gerard A Gioia BLOG – Return to Learn (RTL) and Return to Sport (RTS) Protocols for Youth Athletes and Our Proposed Coordinated Return Protocol INFOGRAPHIC – CONSENSUS STATEMENT ON CONCUSSION IN SPORT: GRADUATED RETURN-TO-SPORT STRATEGY @YLMSportScience External – Review – Return to Throwing after Shoulder or Elbow Injury Terrance A. Sgroi, John M. Zajac PODCAST – To risk, or not to risk: the return to play dilemma Prof (...) E-edition: Return to Play E-edition: Return to Play | BJSM blog - social media's leading SEM voice by This was first seen on the BJSM Website. Following the success of our Pain e-journal, the BJSM digital team has curated a special Return to Play edition . This follows on from our July 2016 virtual conference ( ). Our aim is to present quality updates on a host of areas including ACL rehabilitation, Achilles rupture and concussion. Once again we utilise the benefits of going online to link

2019 British Journal of Sports Medicine Blog

16. Standards for post-concussion care from diagnosis to the interdisciplinary concussion clinic

, and later providing clearance for return to work/school/play. In some cases a nurse practitioner (NP) will be the available medical provider. Nurse practitioners are primary care providers who can diagnose concussion. There are some limitations to NPs that ONF Standards for Post- Concussion Care 18 preclude them for having all of these responsibilities without an involved physician, namely independently ordering imaging (MRI, CT, cervical spine x-rays) when required, and prescription medications (...) and/or would indicate a diagnosis other than concussion. They can assess for readiness and supports required for return to work/school/play but clearance must be provided by a medical practitioner. Physicians and nurse practitioners will need to have completed the necessary training and educational materials so that they are appropriately prepared to act as the primary care provider coordinating and managing post-concussion care. This training should involve knowledge of Clinical Practice Guidelines

2017 CPG Infobase

17. Premature return to play and return to learn after a sport-related concussion: Physician’s chart review (PubMed)

Premature return to play and return to learn after a sport-related concussion: Physician’s chart review To determine what proportion of patients experience an exacerbation of their symptoms as a result of premature return to play (RTP) and return to learn (RTL) following sport-related concussions.Retrospective study of electronic medical records from the office-based practice of one family and sport medicine physician who had systematically provided recommendations for cognitive and physical (...) rest based on existing consensus recommendations. Two blinded authors independently reviewed each chart, which included Sport Concussion Assessment Tool (SCAT) and SCAT2 symptom self-report forms to determine whether an athlete had returned to play or learn prematurely. If there was a discrepancy between the 2 reviewers then a third author reviewed the charts.A sport medicine and family practice in Ontario. The physician assessed sport-related concussions after self-referral or referral from other

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2014 Canadian Family Physician

18. Performance and Style of Play After Returning From Concussion in the National Hockey League. (PubMed)

Performance and Style of Play After Returning From Concussion in the National Hockey League. Few studies have empirically examined outcomes of concussion in the National Hockey League (NHL) and whether these athletes return to games after concussion at a performance level comparable to preconcussion play.NHL players would not demonstrate changes in performance or style of play after returning from a concussion when compared with a group of control athletes.Cohort study; Level of evidence, 3.NHL (...) reasons and were identified as controls. After the exclusion criteria were applied, 94 concussed players were compared with 58 controls. None of the models reached statistical significance, indicating that the concussion and control groups did not differ across performance or style of play after returning from a concussion or non-injury related absence.When compared with a control group, players who returned to consistent play after concussion did not demonstrate changes in performance or style

2016 American Journal of Sports Medicine

19. Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes. (PubMed)

Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes. Previous studies have identified abnormalities in brain and motor functioning after concussion that persist well beyond observed clinical recovery. Recent work suggests subtle deficits in neurocognition may impair neuromuscular control and thus potentially increase risk of lower extremity musculoskeletal injury after concussion.To determine the odds of sustaining (...) an acute lower extremity musculoskeletal injury during the 90-day period after return to play from concussion in a cohort of National Collegiate Athletic Association (NCAA) Division I collegiate athletes.Cohort study; Level of evidence, 3.Included in this study were 87 cases of concussion among 75 athletes (58 men; 17 women) participating in NCAA Division I football, soccer, hockey, softball, basketball, wrestling, or volleyball at a single institution from 2011 to 2014. The 90-day period after return

2016 American Journal of Sports Medicine

20. Systematic Review of Prognosis and Return to Play After Sport Concussion: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. (PubMed)

Systematic Review of Prognosis and Return to Play After Sport Concussion: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. To synthesize the best available evidence on prognosis after sport concussion.MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "sports." Reference lists of eligible articles were also searched.Randomized controlled trials and cohort and case-control studies were selected according (...) records were screened, 52 articles were eligible for this review, and 24 articles (representing 19 studies) with a low risk of bias were accepted. Our findings are based on exploratory studies of predominantly male football players at the high school, collegiate, and professional levels. Most athletes recover within days to a few weeks, and American and Australian professional football players return to play quickly after mild traumatic brain injury. Delayed recovery appears more likely in high school

2014 Archives of physical medicine and rehabilitation

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