Return-to-Play Criteria After Athletic Concussion

Lester Mayers, MD

Arch Neurol. 2008;65(9):1158-1161.

Management of a sport-related concussion, especially involving return-to-play decisions, is one of the most important challenges confronting sports medicine professionals. Current guidelines result from thoughtful consensus recommendations by expert committees but are chiefly based on the resolution of symptoms and the results of neuropsychological testing, if available. Adherence to this paradigm results in most injured athletes resuming competition in 1 to 2 weeks.

Author Affiliation: Athletics Department, Goldstein Fitness Center, Pace University, Pleasantville, New York.

RELATED LETTERS

National Football League Experiences With Return to Play After Concussion
Ira R. Casson, Elliot J. Pellman, and David C. Viano
Arch Neurol. 2009;66(3):419-420.
EXTRACT | FULL TEXT

Convolutions of the Silent Sports Concussion: A Neuropsychologist’s Response to the Dark Ages of Rule-Based Return-to-Play Decisions
Ann B. Shuttleworth-Edwards
Arch Neurol. 2009;66(3):420-421.
EXTRACT | FULL TEXT

Convolutions of the Silent Sports Concussion: A Neuropsychologist’s Response to the Dark Ages of Rule-Based Return-to-Play Decisions—Reply
Lester Mayers
Arch Neurol. 2009;66(3):421.
EXTRACT | FULL TEXT

Alterations to locomotor navigation in a complex environment at 7 and 30 days following a concussion in an elite athlete.

Brain Inj. 2009 Mar 9:1-8

Alterations to locomotor navigation in a complex environment at 7 and 30 days following a concussion in an elite athlete.

Fait P, McFadyen BJ, Swaine B, Cantin JF.

Faculty of Medicine, Department of Rehabilitation, Laval University, Quebec, Canada.

Primary objective: To compare the locomotor capacity during (1) unobstructed walking and (2) the circumvention of fixed obstacles with and without a simultaneous visual task in an elite athlete before and after a sports-related concussion. Research design: Case report. Methods and procedures: Gait analysis and clinical neuropsychological measures were taken pre- and at 7 and 30 days post-injury in an 18 year old male junior hockey player. The task consisted of walking along an unobstructed or obstructed path with or without a visual interference task. Measurements included dual tasks costs, response errors, maximal gait speed and minimal clearance with the obstacle. Main outcome and results: Although the athlete was symptom-free and neuropsychological test results returned to baseline relatively quickly, he showed continued errors in the interference task, abnormally small obstacle clearance distances and decreased maximal gait speed up to 30 days after the concussion.

Conclusions: Concussion can result in persistent planning and attention deficits in ecologically valid, complex environments. This report suggests that functional assessment within an ecological context could be an innovative way to evaluate concussed athletes before sending them back to play, even in the absence of medically related symptoms or abnormal neuropsychological test results.

Merry Christmas Everybody

Happy Christmas Docs

Thanks to all who have contributed to the discussion. This year has been an interesting one, it’s been the year of amongst other things the dreaded groin pain the Achilles heel and PMETB!

For those who want to view the archives for 2008

http://lists.sportsinjurymanager.co.uk/mailman/private/ukadis/2008/subject.html

I hope the discussions continue and perhaps we will bring something new to the blog in 2009 all ideas welcome.

Best wishes to all for 2009. Enjoy the break for those who get one, have a drink or two, eat plenty of pies and then of course take plenty of moderate intensity exercise in January.

JB

Wrightington Sports Shoulder Conference 2009

Wrightinton Sports Shoulder Conference

Dates: 18-20 June 2009

Venue: Wrightington Conference Centre, Wrightington Hospital

International Guest Faculty:
Guiseppe Porcellini - Italy
Joe DeBeer - South Africa
Dan Guttmann - USA
Ehud Rath - Israel
Anne Cools - Belguim
Paolo Paladini - Italy
UK Faculty: Stuart Cosgrove, David Jones, Jo Gibson, Nick Granthan, Jonathan Harris, Mike Loosemore, Lennard Funk, Ian Trail, John Haines, Robert Conlon, Sarah Russell.

The latest advances in the management of sports injuries of the shoulder.
The conference welcomes all clinicians and therapists with an interest or experience of managing shoulder disorders in athletes.
The international faculty includes experts from the fields of orthopaedic surgery, physiotherapy, sports medicine and radiology. All are experienced in treating athletes.
The course comprises a mixture of lectures , case discussions , workshops and live surgery . Emphasis is on the particular issues of athletic shoulder injuries, including pathology recognition, diagnosis, non-operative and operative interventions. We will concentrate on innovative methods of return to play as soon as possible, drawing on current evidence and the faculties experience.
In order to ensure plenty of opportunity for participation and discussion, we will restrict delegate numbers. Therefore, early application is recommended in order to avoid disappointment.

• Download the Course Programme here (pdf)
• For more information and to apply click here