Citation

Guskiewicz KM, Bruce SL, Cantu RC, Ferrara MS, Kelly JP, McCrea M, Putukian M, McLeod TCV. J. Athl. Train. 2004; 39(3): 280-297.

Affiliation

University of North Carolina at Chapel Hill, Chapel Hill, NC; California University of Pennsylvania, California, PA; Emerson Hospital, Concord, MA; University of Georgia, Athens, GA; University of Colorado, Denver, CO; Waukesha Memorial Hospital, Waukesha

Copyright

(Copyright © 2004, National Athletic Trainers' Association (USA))

DOI

unavailable

PMID

unavailable

Abstract

Sport in today's society is more popular than probably ever imagined. Large numbers of athletes participate in a variety of youth, high school, collegiate, professional, and recreational sports. As sport becomes more of a fixture in the lives of Americans, a burden of responsibility falls on the shoulders of the various organizations, coaches, parents, clinicians, officials, and researchers to provide an environment that minimizes the risk of injury in all sports. For example, the research-based recommendations made for American football between 1976 and 1980 resulted in a significant reduction in the incidence of fatalities and nonfatal catastrophic injuries. In 1968, 36 brain and cervical spine fatalities occurred in high school and collegiate football. The number had dropped to zero in 1990 and has averaged about 5 per year since then. This decrease was attributed to a variety of factors, including (1) rule changes, which have outlawed spearing and butt blocking, (2) player education about the rule changes and the consequences of not following the rules, (3) implementation of equipment standards, (4) availability of alternative assessment techniques, (5) a marked reduction in physical contact time during practice sessions, (6) a heightened awareness among clinicians of the dangers involved in returning an athlete to competition too early, and (7) the athlete's awareness of the risks associated with concussion.

Research in the area of sport-related concussion has provided the athletic training and medical professions with valuable new knowledge in recent years. Certified athletic trainers, who on average care for 7 concussive injuries per year, have been forced to rethink how they manage sport-related concussion. Recurrent concussions to several high-profile athletes, some of whom were forced into retirement as a result, have increased awareness among sports medicine personnel and the general public. Bridging the gap between research and clinical practice is the key to reducing the incidence and severity of sport-related concussion and improving return-to-play decisions.

This position statement should provide valuable information and recommendations for certified athletic trainers (ATCs), physicians, and other medical professionals caring for athletes at the youth, high school, collegiate, and elite levels. The following recommendations are derived from the most recent scientific and clinic-based literature on sport-related concussion. The justification for these recommendations is presented in the summary statement following the recommendations. The summary statement is organized into the following sections: 1) Defining and Recognizing Concussion, 2) Evaluating and Making the Return-to-Play Decision, 3) Concussion Assessment Tools, 4) When to Refer an Athlete to a Physician After Concussion, 5) When to Disqualify an Athlete, 6) Special Considerations for the Young Athlete, 7) Home Care, and 8) Equipment Issues.