@article{ref1,
title="A systematic review of criteria used to define recovery from sport-related concussion in youth athletes",
journal="British journal of sports medicine",
year="2018",
author="Haider, Mohammad Nadir and Leddy, John J. and Pavlesen, Sonja and Kluczynski, Melissa and Baker, John G. and Miecznikowski, Jeffrey C. and Willer, Barry S.",
volume="52",
number="18",
pages="1179-1190",
abstract="OBJECTIVE: The Concussion in Sport Group guidelines recommend a multifaceted approach to help clinicians make return to sport decisions. The purpose of this study was to identify the most common multifaceted measures used to define clinical recovery from sport-related concussion in young athletes (high school and/or college level) and to summarise existing knowledge of criteria used to make return to sport decisions. <br><br>DESIGN: Systematic review. DATA SOURCES: The PubMed (MEDLINE), SPORTDiscus and Embase electronic databases were searched from 1 January 2000 to 1 March 2017 by three independent reviewers. ELIGIBILITY CRITERIA: Inclusion criteria: elementary, high school and college age groups, and a specific definition of clinical recovery that required two or more measures. EXCLUSION CRITERIA: review articles, articles using the same sample population, case studies, non-English language and those that used one measure only or did not specify the recovery measures used. STUDY QUALITY: Study quality was assessed using the Downs and Black Criteria. <br><br>RESULTS: Of 2023 publications, 43 met inclusion criteria. Included articles reported the following measures of recovery: somatic symptom resolution or return to baseline (100%), cognitive recovery or return to baseline (86%), no exacerbation of symptoms on physical exertion (49%), normalisation of balance (30%), normal special physical examination (12%), successful return to school (5%), no exacerbation of symptoms with cognitive exertion (2%) and normalisation of cerebral blood flow (2%). Follow-up to validate the return to sport decision was reported in eight (19%) articles. Most studies were case-control or cohort (level of evidence 4) and had significant risk of bias. <br><br>CONCLUSION: All studies of sport-related concussion use symptom reports to define recovery. A minority of studies used multiple measures of outcome or had clearly defined recovery criteria, the most common being a combination of a self-reported symptom checklist and a computerised neurocognitive test. Future studies ideally should define recovery a priori using objective physiological measures in addition to symptom reports.<br><br>© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.  Keywords: American football; Soccer<p /> <p>Language: en</p>",
language="en",
issn="0306-3674",
doi="10.1136/bjsports-2016-096551",
url="http://dx.doi.org/10.1136/bjsports-2016-096551"
}