Abstract
Guidelines for returning a concussed player to sport had been somewhat controversial and nebulous until the emergence of a series of international consensus meetings and statements initiated in 2001. The Vienna (2001), Prague (2004) and Zurich (2009 statements as well as the American National Athletic Trainers Association (2004) and the American College of Sports Medicine (2005) position stands have given all clinicians better guidance that is more evidence-based than the somewhat subjective guidelines of the latter 20th century. Some impetus to research and the re-evaluation of assessment and management guidelines has been provided by the emergence of computerised neuropsychological test batteries as a useful barometer of cognitive recovery. However, the clinical evaluation of a concussed player remains the cornerstone of management and should incorporate a thorough symptom analysis, general, cognitive and neurological examination, and balance testing. The Sports Concussion Assessment Tool (SCAT) 2 card is a clinical evaluation tool intended to summarise the most significant aspects of clinical assessment. In addition, and as an essential ‘final stress’ test, the athlete must be subjected to a series of graded exercise sessions, increasing in severity, before being returned to contact or collision sport. A structured clinical evaluation is particularly important in the South African context, where computerised testing may not be accessible to many. This article serves to collate and highlight the evidence-based and consensus data available for management of the concussed rugby player in 2010.
Highlights
Concussion is a trauma-induced change in mental state that may or may not involve loss of consciousness.[1]
The watershed occurred at the First International Conference on Concussion in Sport, Vienna 2001.1 During this conference, a comprehensive systematic approach to concussion was formulated for application in sport, which included computer-based neuropsychological testing as an integral part of a comprehensive clinical concussion evaluation.[1]
Since consolidation of the Vienna guidelines has taken place at the Second International Conference on Concussion in Sport (Prague 2004),[7] and the National Athletic Trainers Association (USA, 2004)[8] and the American College of Sports Medicine (2005)[9] have published clinical management guidelines based on these consensus meetings
Summary
Concussion is a trauma-induced change in mental state that may or may not involve loss of consciousness.[1] It is a form of mild traumatic brain injury. The prevalence of concussion was reported as high as 50% in schoolboy rugby players, as the majority of mild head injuries are often not recognised and reported in this age group. Scientific research into many aspects of concussion has been impaired as much by differences in definition as by the ethical and practical issues involved in inducing and monitoring brain injury.[1] From this has stemmed controversy regarding the ideal management of concussion in sport and a lack of objective data guiding return-to-play decisions,[1] resulting in sports organisations
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
