Key points that are new in the 5th International Consensus statement on concussion in sport:
- If a concussion is suspected, the athlete should be removed from the sporting environment and a comprehensive assessment should be conducted in a standardized way by a qualified health care provider.
- A brief period of rest (24-48 hours) after injury is appropriate. After this time, patients should be encouraged to become gradually and progressively more active while staying below their physical and cognitive thresholds.
- Most individuals recover in the initial 10-14 days. Treatments including psychological, cervical and vestibular rehabilitation are now recognized as important components of recovery in some people. Submaximal and sub-symptom threshold exercise may also be of benefit.
- Advanced neuroimaging, fluid biomarkers and genetic testing are important research tools but require further research before they can be used in clinical decision making.
- The expected symptom duration in children is up to four weeks.
- Children should not return to sport until they have successfully returned to school. However, early introduction of symptom-limited physical activity is appropriate.
- The literature on long-term consequences of exposure to head trauma is inconsistent. Thus, further research in this area is needed to answer these important questions.
- Helmets in skiing/snowboarding have been shown to reduce the risk of traumatic brain injury (including concussion). In addition, policy disallowing body checking in youth ice hockey reduces the risk of concussion in 11-12 year old ice hockey players.
Key points related to concussion for the general public:
- A concussion should be suspected if any symptoms (such as headache, dizziness, blurred vision, etc) and/or visible signs of a concussion (lying motionless, slow to get up, disorientation, balance disturbances, etc) occur following a blow to the head.
- Athletes should be removed from play and not allowed to return to play until medically assessed and cleared by a physician to return to sport.
- Initially, a period of rest (24-48 hours) is recommended. After this time individuals are encouraged to become gradually more active and remain below their symptom threshold.
- Most adults recover in 10-14 days and most children recover in the initial 30 days. Treatment should be directed based on individualized comprehensive assessments and could include treatments such as psychological, cervical and vestibular rehabilitation. Submaximal exercise may be of benefit.
- Children should return to school prior to returning to sport.
- A gradual return to sport protocol should be completed prior to medical clearance to return to sport.