A global consensus report provides new guidance on diagnosing and treating concussions.
As concerns about concussions among football players continues to capture the attention of doctors as well as sports officials, an international team of researchers released an update to the Consensus Statement on Concussion in Sport.
It’s the fourth since the original report was developed in Vienna in 2001 to raise public awareness of the risks of concussions. Researchers and clinicians from around the globe presented the latest findings on brain injury and long term damage from concussions occurring during sports, over a two-day meeting held in Zurich, Switzerland last November. A panel of 32 experts then drafted the Consensus based on the research, published in the British Journal of Sports Medicine.
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Written as a guide for athletic trainers, doctors and health care providers, the statement clarifies the definition of a concussion to emphasize that loss of consciousness isn’t necessary to remove players from a game; symptoms can include headaches, memory loss and slow reaction times, immediately after the trauma to the head. Later symptoms could also include irritability and sleep disturbances.
New advice in the Consensus states that children should not return to the field to play on the same day they experience a potential concussion, an acknowledgment that it may take longer for kids to recuperate from blows to the head than adults because their neural connections are still developing.
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“Concussions are an evolving injury,” explains author Dr. Willem Meeuwisse, leader of the University of Calgary’s Brain Injury Initiative.”When you look at it from the moment it occurs to hours and even days later, it tends to change. That’s why, ‘when in doubt, sit them out,’ works.”
Additionally, the authors say there is a lack of evidence that mouth-guards and helmets prevent concussions. These pieces of equipment can protect against injuries to the head and face, but likely do little to ward off the more serious internal damage from a concussion. In fact, they may give players have a false sense of security and encourage them to behave more recklessly and aggressively. In the statement, the authors write:
An important consideration in the use of protective equipment is the concept of risk compensation. This is where the use of protective equipment results in behavioral change such as the adoption of more dangerous playing techniques, which can result in a paradoxical increase in injury rates.
The researchers also added recommended against the blanket tendency for extended rest for people who have been concussed. “About 80% of people improve from rest after eight to ten days,” says Meeuwisse. “For those who are not better in ten days, they need a more thorough assessment and maybe therapy for neck problems or balance.”
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For the first time, the Consensus also includes a guide for untrained individuals such as parents and coaches to recognize and help people who might be concussed as well as an assessment tool designed specifically for children that clinicians can use.
The report is backed by the International Ice Hockey Federation, the International Olympic Committee, FIFA (the international governing body for soccer), and the International Rugby Board, among a number of other international sports organizations.