Concussion Recognition: A Guide for Parents and Coaches.

Sports concussion: time for a culture change.

Background: The focus of this qualitative research was to interview current and retired Gaelic games athletes to ascertain how athletes viewed concussion recognition and management. Methods: A grounded theory methodology design was utilised to investigate concussion recognition and management experiences of a cohort of Gaelic games athletes (n = 22). Data for the study were collected using a semi-structured interview format. Results: Two major themes were identified: (1) an inconsistent identification of concussion as an injury and the absence of standardised procedures for removal from play, and (2) the impact of athlete-driven decision making on concussion management. Concussions were experienced by all the participants on multiple occasions while playing Gaelic games. However, concussion recognition and removal rarely occurred, as many athletes chose not to disclose their injuries or self-managed their concussions. Conclusions: The recognition and management of concussions in Gaelic games are currently inadequate, and they may be posing significant risks to athletes' long-term health. This research highlights the need for more stringent protocols for concussion recognition and removal at pitch side. In addition, Gaelic games require a more objective injury management plan during acute and chronic concussion recovery.

Objective: Persisting concussion symptoms may adversely affect return to work and functioning in daily activities. This study compared adults who were initially evaluated < 30 days versus those evaluated ≥ 30 days following a concussion at a specialty concussion clinic to determine if delayed initial evaluation is associated with persisting symptoms during recovery. Method: Participants (N = 205) 18 years of age and older who sustained a concussion and presented to a North Texas Concussion Registry (ConTex) clinic were evaluated at two time points: initial clinical visit and three-month follow-up. Participants provided medical history, injury related information, and completed the Sport Concussion Assessment Tool-5 Symptom Evaluation, Generalized Anxiety Disorder 7-item scale (GAD-7), and Patient Health Questionnaire (PHQ-8). Participants were divided into two groups: early and delayed evaluation (±30 days post injury). Results: Number and severity of concussion symptoms were similar between both groups at their initial clinical visit. However, linear regression models showed that a delayed clinical evaluation was associated with a greater number and severity of concussion symptoms along with greater aggravation of symptoms from physical and cognitive activity at three-month follow-up. Conclusions: Individuals who sought care at specialty concussion clinics regardless of previous care 30 or more days following their injury reported more serious persisting concussion symptoms at three month follow-up than those who sought care sooner. Education to improve adults’ recognition of concussions when they occur and obtaining earlier clinical evaluation may represent important opportunities in promoting better recovery and reducing persisting concussion symptoms.

Assessing the awareness and recognition of concussion is im- portant at all levels of athletics, especially youth sports. This study assessed the knowledge base of youth athletes and their parents regarding concussion and their ability to recognize it. Seventy-three youth athletes (age range, 10-14 years) and 100 parents responded to the survey. An athlete or parent version of a previously published survey about concussion was complet- ed by each participant. Athletes and parents did not differ ( P = .94) in their ability to recognize concussion symptoms. Youth athletes who reported having their bell rung did no better (P = .36) in recognizing concussion symptoms than those who had not. Parents with first aid certification or general medical train - ing recognized significantly more symptoms ( P = .01 and .01, respectively) than those without training. A knowledge deficit exists regarding symptom recognition and issues about sport- related concussion among youth athletes and their parents.

Sport-related concussions are a subset of mild traumatic brain injuries and are a concern for many sporting activities worldwide. To review and update the literature in regard to the history, pathophysiology, recognition, assessment, management and knowledge of concussion. Searches of electronic literature databases were performed to identify studies published up until April 2013. 292 publications focussing on concussion met the inclusion criteria, and so they were quality rated and reviewed. Concussion is hard to recognize and diagnose. Initial sideline assessment via the Sports Concussion Assessment Tool 3 (SCAT3), Child-SCAT3 or King-Devick test should be undertaken to identify athletes with concussion as part of a continuum of assessment modalities and athlete management. Sports medicine practitioners should be cognisant of the definition, extent and nature of concussion, and should work with coaches, athletes and trainers to identify and manage concussions. The most common reason for variations in management of concussion is lack of awareness of-and confusion about-the many available published guidelines for concussion. Future research should focus on better systems and tools for recognition, assessment and management of concussion. Sport participants' knowledge of concussion should be evaluated more rigorously, with interventions for sports where there is little knowledge of recognition, assessment and appropriate management of concussion.

Abstract:Sport-related concussion (SRC) is a common injury in recreational and organized sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment, and managemen

PurposeTo gain an understanding of referee concussion knowledge, what sporting organizations were doing to prepare their referees to recognize concussions in youth sport, and what role referees could play in overall concussion safety.Materials and MethodsA total of 134 referees participated in the study across four provincial sporting organizations (rugby, soccer, ice hockey, and football). Participants completed a concussion knowledge questionnaire that explored knowledge about concussion education, recognition, management, preparedness, and the role of the referee in overall concussion management.ResultsOverall, the sample was found to be moderately knowledgeable about concussions. Referees that received previous formal concussion education had statistically significant higher average scores when compared to those without formalized concussion education (P=0.001). However, only 24% of respondents reported receiving any formal education from their sporting body or referee organization. About 85% felt that referees could play an important role in concussion recognition in youth sport, but only 41% felt they were adequately equipped with the knowledge and skills to recognize these injuries.ConclusionThe findings from this study suggest that national, provincial, and individual sporting organizations should ensure that all stakeholders (including referees) are formally educated about concussions to encourage a safety-first environment for youth athletes. Educational sessions should focus on the general aspects of SRC while also focusing on the specific role of the referee in concussion recognition.

The Concussion Recognition and Response App: Coach and Parent version. Concussion, health. Requires iOS 4.0 or later (compatible with iPhone, iPad and iPod touch). Requires Android 3.2 and up. Free—in-app...

Increasing numbers of sports-related concussions have been reported in a number of countries.1, 2 Of several international guidelines to guide care after concussions,3-5 the Concussion in Sport Group consensus statement 20123 is the basis of many management recommendations and field side assessment tools propagated by sporting organisations in Australia and overseas. Some of the tools available to assist with recognising the symptoms of concussion have significant shortcomings: they are designed specifically for adults and elite sports professionals; they are paper based and do not necessarily provide a clear means of interpreting the information and guiding management; and are not always user friendly on the sidelines. Recent studies from Australia indicate that trainers and coaches have limited knowledge about concussion.6 Young athletes presenting to the emergency department did not follow head injury guidelines (e.g. were not taken off the field after a concussion, returned to play the same day), and parents and players were unaware of head injury guidelines from their sporting organisations.7 Based on reviews of the topic,8, 9 there was a need for an accessible, affordable, user-friendly, reliable and valid tool for use by those entrusted with the care of adult and child athletes at risk of concussive injuries. In a collaboration of child concussion experts at the Murdoch Childrens Research Institute (MCRI), the Royal Children's Hospital and the University of Melbourne, along with Curve Tomorrow, a software development and design company with expertise in the child health sector, a smartphone app, HeadCheck, was developed to help adults recognise the signs and symptoms of concussion in children. Although the primary focus of the app was for use in school-aged children and adolescents, the app is sufficiently robust for use in adult players as well. HeadCheck dynamically guides users through a series of concise questions to quickly assist in recognising symptoms of concussion ( Figure 1). The HeadCheck algorithm prioritises the information the user needs to understand, ensuring logical steps are followed in a potentially stressful situation. Depending on the severity of the individual's symptoms, the app may automatically re-direct the user to call the Australian emergency services phone number, ‘000’. Screen shot of HeadCheck concussion recognition app. The individual items examined in HeadCheck are consistent with the outcomes from deliberations at the 4th International Conference on Concussion in Sport,3 including the widely used and endorsed Sports Concussion Assessment Tool (SCAT-3), the ChildSCAT3 and the Pocket Concussion Recognition Tool (Pocket CRT). HeadCheck avoids medical jargon and uses plain and simple language. The smartphone format is more accessible and concise than the paper Pocket CRT currently used by coaches/parents to recognise concussive symptoms in children. HeadCheck is available as a free download from the Apple AppStore and is compatible with the iPhone (http://itunes.apple.com/au/app/headcheck/id887756402?mt=8). HeadCheck can easily be updated to incorporate future advances from concussion research and users can download updates to the app. User trials have been conducted for HeadCheck and researchers at MCRI (not involved in the project) also trialled the app while being observed by the software development and design team; their feedback was used to improve the functionality and usability of HeadCheck. HeadCheck has received endorsement from the Australian Football League; other national football codes have also shown interest in endorsing HeadCheck. An android version is being developed. Sideline validated, easy-to-use, interactive tools may improve concussion recognition and care. Ongoing collaboration between clinicians with expertise in concussion management and experts in technology, as well as feedback from the public, are instrumental in ensuring that such tools are of high quality and up to date.

Current injury monitoring and player education practices in Irish amateur rugby union

<h3>Statement of Purpose</h3> This study aimed to assess the feasibility and preliminary efficacy of Make Play Safe (MPS), a virtual reality (VR) app intervention to improve concussion recognition and reporting among youth soccer athletes ages 9 to 12. <h3>Methods/Approach</h3> We first assessed the feasibility and acceptability of MPS, a VR app intervention to educate youth soccer athletes about concussion and the importance of concussion reporting. We collected data from healthy soccer athletes ages 9–12 (n=11) via a workshop and from their parents and coaches (n=8) via a focus group. We then assessed the preliminary efficacy of MPS in concussion recognition among youth soccer athletes by asking youth soccer athletes to view the VR app and complete pre- and post-MPS surveys about concussion-related knowledge, attitudes, and reporting intentions. <h3>Results</h3> Healthy youth soccer athletes were eager to learn about concussion. They liked MPS because the scenarios presented in virtual environment were realistic, making them feel like they were actually on the soccer field. Parents and coaches noted that MPS would facilitate their communication about concussion safety, enhancing their child’s concussion reporting. Results from pre- and post-MPS surveys showed, on average, youth soccer athletes correctly identified 76% (SD=9%) of concussion symptoms at baseline. Changes in knowledge, attitudes, and reporting intention scores after MPS showed 7%, 11%, and 4% increases, respectively, from pre- to post-MPS. <h3>Conclusion</h3> These preliminary results confirm the VR app intervention could positively impact youth’s concussion recognition, and their concussion-related attitudes and reporting intentions. <h3>Significance</h3> Our results demonstrate the VR app intervention is feasible and offers initial evidence of efficacy. The VR app intervention improved youth soccer athletes’ concussion symptom recognition and concussion-related attitudes and reporting intentions. In addition, the VR app intervention motivated parents and coaches to talk to their children and teams, respectively, about concussion safety.

Parental knowledge of concussion: Evaluation of the CDC's “Heads up to parents” educational initiative

BackgroundMobile technologies are steadily replacing traditional assessment approaches for the recognition and assessment of a sports concussion. Their ease of access, while facilitating the early identification of a concussion, also...

To determine the compliance of schools and school nurses in the United States with national recommendations for cognitive rest in students who sustain a concussion. Cross-sectional questionnaire based. Members of the National Association of School Nurses working at the high school level. A questionnaire, developed by the authors and based on recommendations for cognitive rest, was electronically distributed 3 times during the 2012 to 2013 academic year. Self-reported responses were collected regarding demographics and compliance of schools and school nurses with recommendations for the management of the postconcussion student, including the presence of specific guidelines for individualized care and the responsibility of the nurse for the prevention, detection, and management of concussions. Analysis was performed on 1033 completed questionnaires (36% usable response rate). Fifty-three percent of schools have guidelines to assist students when returning to school after a concussion. These guidelines include extension of assignment deadlines (87%), rest periods during the school day (84%), postponement or staggering of tests (75%), reduced workload (73%), and accommodation for light or noise sensitivity (64%). Sixty-six percent of nurses in our sample have had special training in the recognition and management of concussions. Nurses reported involvement in the following roles: identifying suspected concussions (80%), providing emotional support for recovering students dealing with concussion-related depression (59%), and guiding the student's postconcussion graduated academic and activity re-entry process (58%). We detected a wide variability in compliance of schools and school nurses with national recommendations for cognitive rest. Ensuring that schools have policies established for a student's return to learning, having specific guidelines to provide an individualized approach to return to learning based on postconcussion signs/symptoms, training school nurses in the recognition and management of concussions, and involving school nurses in the re-entry process are identified areas for improvement. Schools in the United States should be aware of these recommendations to guide a student's postconcussion graduated academic re-entry process.

Chapter 8 - Sideline assessment of concussion