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Same-day return to play common after concussion

Concussion guidelines published over the past decade—and laws in all states—now discourage youth athletes from returning to play if they display any signs of concussion after an injury. However, new research confirms athletes often head back into the game on the same day.


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The research abstract, “Same-Day Return to Play After Pediatric Athletes Sustain Concussions,” was presented at the American Academy of Pediatrics 2016 National Conference & Exhibition in San Francisco on October 22.

Shane M Miller, MD, FAAP, a pediatric sports medicine specialist at Texas Scottish Rite Hospital for Children in Plano, Texas, noticed a significant number of his patients reported they returned to play after a concussion before being cleared by a medical professional, despite medical guidelines, state law, and educational efforts.

He and Meagan Sabatino, senior clinical research coordinator at the same hospital, analyzed records for 185 patients between the ages of 7 and 18 treated for concussion at a Texas pediatric sports clinic during a 10-month period in 2014. Nearly half (47 percent) of the athletes sustained a concussion while playing football; the next most common sport among concussion patients was soccer (16 percent).

Of these patients, 71 (38 percent) reported returning to play on the same day as their initial injury. Patients who immediately returned to play after their injury reported less severe symptoms of dizziness and balance problems immediately after being hurt.

By the time they were seen in the clinic, however, these patients were statistically more likely to report the presence and increased severity of nausea, dizziness, balance problems, sensitivity to light and noise, feeling “slowed down,” pressure in the head, confusion and trouble with both concentrating and falling asleep.

Over all, the majority of the concussion patients studied were male (72 percent), but the researchers said there were no statistical differences noted in age, gender, presence of concussion symptoms on day of injury, sport, mechanism of injury or impact location between those who returned to play on the same day and those who did not.

The authors said this is the largest study to date looking at return to play patterns in young athletes with concussions.

“Our findings suggest that we still have work to do to change behaviors to protect short- and long-term brain health of youth athletes,” Mrs Sabatino said.

Dr Miller emphasized the ongoing need for concussion education. “We need to emphasize the message, When in doubt, sit them out—and keep them out—until full recovery,” he said.

Paul Katula is the executive editor of the Voxitatis Research Foundation, which publishes this blog. For more information, see the About page.

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