Concussion: recognition and managementNo Opinions
Concussion is an important issue that must be recognised and managed correctly for the health and safety of all those who play sport. In 2013, it was found that in Victoria, Australia, more people are being hospitalised for sports-related concussion than in the past (Finch et al, 2013). This could be due to better healthcare, more people knowing about concussion, the importance of being monitored for symptoms, and the changes in the way in which sport is played (Finch et al, 2013).
The consensus statement on concussion in sport (McCrory et al, 2013)was updated in November 2012 at the 4th International Conference on Concussion in Sport held in Zurich. The associated tools are freely available online as the Sideline Concussion Assessment Tool (SCAT 3rd Edition) http://bjsm.bmj.com/content/47/5/259.full.pdf+html?sid=9bc7100b-7288-42f4-a968-7fa84cf292fc, and the Child SCAT3. These also include return-to-play guidelines after a diagnosed concussion.
Experts agree that the research that the guidelines are based on is of high quality (White et al, 2014b), but also believe that more needs to be done to put these measures into practice more widely (White et al, 2014a). General knowledge about concussion is good in coaches and sports trainers from community-level clubs, but there are still gaps that should be addressed with regards to the actual use of the guidelines (White et al, 2014a). It has been found that coaches and sports trainers who feel strongly about their responsibility for the health and safety of their athletes are more likely to actually make use of the guidelines (Newton et al, 2013). This is also true for coaches and sports trainers who feel confident that they can use the concussion guidelines correctly (Newton et al, 2013).
This has three implications for clubs (Newton et al, 2013):
- The importance of using the concussion management guidelines by coaches and sports trainers to safeguard the health and wellbeing of players must be stressed by clubs and sports governing bodies
- Hands-on training, and the opportunity to observe how to use the guidelines in training or match settings, must be provided by clubs and sports governing body for coaches and sports trainers. The more practice they get in using them before the season starts, the easier it will be to use them during the season itself
- Education and training programs aimed at addressing the above points should be developed by sports governing bodies, and delivered by clubs, so that coaches and sports trainers can manage concussion correctly
Some key messages that need to be stressed by clubs, and carried out by coaches and sports trainers, are (White et al, 2014a):
- The concussion guidelines must be used at all times when coaches and sports trainers are dealing with a suspected concussion
- Athletes with a suspected concussion must be referred to a medical doctor for an urgent medical assessment
- Athletes must be symptom-free when they return to sport
- Athletes must return to sport gradually after concussion
- Younger athletes take longer to recover from concussion than adults do
Concussion in sport can, and should, be prevented by sports governing bodies, clubs, coaches and sports trainers. This is of importance for the health and safety of everyone who plays sport. There is also a cost to the healthcare system and to people who need treatment for their concussion, which could be reduced (Finch et al, 2013). A clear need exists for better adoption of concussion management guidelines and education for all sports where there is a risk of serious head injury.
Finch, C.F., Clapperton, A.J. & McCrory, P., 2013. Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia. Medical Journal of Australia, 198(8), pp.427-430.
McCrory, P. et al., 2013. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. British Journal of Sports Medicine, 47(5), pp.250-258.
Newton, J.C. et al., 2013. Intention to use sport concussion guidelines among community-level coaches and sports trainers. Journal of Science and Medicine in Sport, Published online first as: doi: 10.1016/j.jsams.2013.10.240.
White, P. et al., 2014a. Knowledge about sports-related concussion: is the message getting through to coaches and trainers? British Journal of Sports Medicine, 48, pp.119-124.
White, P.E., Wong Shee, A. & Finch, C.F., 2014b. Independent appraiser assessment of the quality, methodological rigour and transparency of the development of the 2008 international consensus statement on concussion in sport. British Journal of Sports Medicine, 48, pp.130-134.
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About Sheree Bekker
Sheree Bekker is a PhD scholar researching sport injury prevention and safety promotion at the Australian Centre for Research Into Injury in Sport and its Prevention