Research based recommendations on management of sport related concussion: summary of the National Athletic Trainers' Association position statement.

S port related concussion has received considerable attention in both the lay media and medical literature in recent years. As a result, clinicians, coaches, parents, and athletes at all levels of competition are becoming educated about the necessity to treat concussions seriously. In time, this will help to create a safer playing environment for athletes at all levels of competition. Despite an array of complexities associated with studying sport related concussion, new scientific research and clinically based literature have provided sports medicine professions with a wealth of updated information on the treatment of sport related concussion. For example, there is now sufficient literature supporting the notion that once you experience a concussion, you are more likely to sustain future concussions ; and a strong likelihood exists that the symptoms following these repeat concussions may be more serious and resolve at a slower rate. 3 Several recent research papers and consensus statements indicate the necessity to use a systematic approach to evaluating the severity and duration of all possible signs and symptoms after a concussion, and to be cautious of not returning players to competition too quickly. Loss of consciousness and amnesia are two important parameters associated with cerebral concussion, but headaches, dizziness/balance deficits, concentration deficits, and feeling ‘‘slowed down’’ are more common. 2 6 9 14 17– 20 Extensive research has also been conducted on neuropsychological testing 19–34 and postural stability testing, 35–37 both of which are considered to be key markers for tracking recovery after cerebral concussion. Recent concussion publications on topics such as physician referral and home care, 38 youth athletes, 40 and protective equipment have also provided clinicians with a better understanding of how better to manage sport related concussion. To provide certified athletic trainers (ATCs), doctors, and other medical professionals with a comprehensive list of recommendations for managing concussions, the National Athletic Trainers’ Association (NATA) formed a committee charged with developing a research based position statement derived from these most recent studies. The recommendations are intended for the treatment of concussed athletes at the youth, high school, collegiate, and elite levels. The writing committee consisted of a team doctor, a neurosurgeon, a neurologist, a neuropsychologist, and four ATCs. The following summary includes recommendations that can be found in the full article published in the Journal of Athletic Training 2004;39:278–95. The full text and complete reference list for this peer reviewed position statement is also available at http://www.pubmedcentral. nih.gov and http://www.nata.org/ publicinformation/position.htm. The summary statement is organised into the following sections: Defining and recognising the concussion; Evaluating and making the return to play decision; Concussion assessment tools; When to refer to a physician; When to disqualify an athlete; Special considerations for young athletes; Home care; Equipment issues.