Assessment, Management and Knowledge of Sport-Related Concussion: Systematic Review
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REVIEW ARTICLE
Assessment, Management and Knowledge of Sport-Related Concussion: Systematic Review Doug King • Matt Brughelli • Patria Hume Conor Gissane
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Ó Springer International Publishing Switzerland 2013
Abstract Background Sport-related concussions are a subset of mild traumatic brain injuries and are a concern for many sporting activities worldwide. Objective To review and update the literature in regard to the history, pathophysiology, recognition, assessment, management and knowledge of concussion. Methods Searches of electronic literature databases were performed to identify studies published up until April 2013. Results 292 publications focussing on concussion met the inclusion criteria, and so they were quality rated and reviewed. Conclusion Concussion is hard to recognize and diagnose. Initial sideline assessment via the Sports Concussion Assessment Tool 3 (SCAT3), Child-SCAT3 or KingDevick test should be undertaken to identify athletes with concussion as part of a continuum of assessment modalities and athlete management. Sports medicine practitioners should be cognisant of the definition, extent and nature of concussion, and should work with coaches, athletes and trainers to identify and manage concussions. The most common reason for variations in management of D. King M. Brughelli P. Hume Sports Performance Research Institute New Zealand (SPRINZ) at AUT Millennium, Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand D. King (&) Emergency Department, Hutt Valley District Health Board, Private Bag 31907, Lower Hutt 5040, New Zealand e-mail: [email protected] C. Gissane School of Sport, Health and Applied Science, St Mary’s University College, Twickenham, Middlesex, UK
concussion is lack of awareness of—and confusion about— the many available published guidelines for concussion. Future research should focus on better systems and tools for recognition, assessment and management of concussion. Sport participants’ knowledge of concussion should be evaluated more rigorously, with interventions for sports where there is little knowledge of recognition, assessment and appropriate management of concussion.
1 Introduction Known as the ‘silent injury’ [1] and often trivialized by the media and sporting circles as a ‘knock to the head’ [2], sport-related concussions (hereafter called ‘concussion’) are a subset of mild traumatic brain injuries (mTBIs) [3] and have become an increasingly serious concern for all sporting activities worldwide [4–6]. The term ‘concussion’ is a historical term, as it represents low-velocity injuries that cause ‘brain shaking’ resulting in clinical symptoms, and it is often used interchangeably with ‘mTBI’ in the sporting context and in the published literature [3]. In the USA, it is estimated that 1.6–3.8 million sport-related concussions occur annually [7], accounting for 5–9 % of all sport-related injuries [8, 9]. Amongst 15- to 24-yearsolds, concussions are second to road trauma as the most common causes of traumatic brain i
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