Management of Sports-Related Concussions: Staying Ahead of the Game, 2nd Edition: Summary 29
It is important to note that while equipment can help, it does not completely eliminate the risk of concussions. Rule Changes and Policy Modifications Several rule changes have been implemented to reduce concussion risk: • Elimination of body checking in youth ice hockey has shown a reduction in concussion incidence • Changes to practice policies have led to a reduction in practice-related concussions • Professional and college football rule changes are expected to trickle down to Educating coaches, parents, and athletes about concussion signs, symptoms, and the importance of reporting is crucial. All 50 states now have youth concussion laws, emphasizing the need for proper management and return- to-play protocols. SIDELINE EVALUATION The sideline evaluation is critical for identifying potential concussions and making immediate decisions about an athlete's ability to continue play. A brief concussion evaluation tool should be used in conjunction with a motor-control evaluation. Standardized Assessment Tools The Sport Concussion Assessment Tool (SCAT) is widely used for sideline evaluation. Clinical utility decreases 3-5 days post injury and should not be performed in less than 10 minutes. The latest version, SCAT6, added the following components: • A longer word list for immediate and delayed memory • Added digits to a string of numbers for concentration section • Added time component to months backwards section • Added timed dual gait task (subtract by 7) • Added more robust observable signs high school and youth levels Education and Awareness
Common Signs and Symptoms of a Concussion • Headache • Neck pain • Nausea/vomiting • Dizziness • Blurred vision • Balance problems • Sensitivity to noise/light • Feeling slowed down/fatigue • Brain fog • Confusion • Trouble sleeping or drowsiness
• More emotional • Nervous/anxious
Challenges in Management Managing sports-related concussions is challenging due to several factors: • Inconsistent definitions across different organizations and time periods • Subjective nature of many symptoms, relying on athlete self-reporting • Team culture that may discourage symptom reporting • Wide age range of affected individuals, from youth to professional athletes • Evolving management techniques and guidelines RISK REDUCTION AND PREVENTION Equipment Recommendations The role of equipment in concussion prevention has evolved over time. While helmets are primarily designed to prevent skull fractures and facial injuries, recent research has shown some promise in concussion reduction: • Mouthguards have shown reduced concussion rates in ice hockey, contrary to earlier beliefs • Helmet sensors are being developed to monitor impacts and potentially provide data for concussion risk assessment
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