Carol Cancelliere1, Cesar A Hincapié2, Michelle Keightley3, Alison K Godbolt4, Pierre Côté5, Vicki L Kristman6, Britt-Marie Stålnacke7, Linda J Carroll8, Ryan Hung9, Jörgen Borg4, Catharina Nygren-de Boussard4, Victor G Coronado10, James Donovan11, J David Cassidy12. 1. Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address: ccancell@uhnresearch.ca. 2. Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 3. Departments of Occupational Science and Occupational Therapy, Psychology and Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada. 4. Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden. 5. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Toronto, Ontario, Canada. 6. Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada; Institute for Work and Health, Toronto, Ontario, Canada. 7. Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden. 8. School of Public Health and Alberta Centre for Injury Control and Research, University of Alberta, Edmonton, Alberta, Canada. 9. Department of Rehabilitation and Complex Continuing Care, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 10. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. 11. Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada. 12. Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark.
Abstract
OBJECTIVE: To synthesize the best available evidence on prognosis after sport concussion. DATA SOURCES: MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "sports." Reference lists of eligible articles were also searched. STUDY SELECTION: Randomized controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 concussion cases. DATA EXTRACTION: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. DATA SYNTHESIS: Evidence was synthesized qualitatively according to modified SIGN criteria, and studies were categorized as exploratory or confirmatory based on the strength of their design and evidence. After 77,914 records were screened, 52 articles were eligible for this review, and 24 articles (representing 19 studies) with a low risk of bias were accepted. Our findings are based on exploratory studies of predominantly male football players at the high school, collegiate, and professional levels. Most athletes recover within days to a few weeks, and American and Australian professional football players return to play quickly after mild traumatic brain injury. Delayed recovery appears more likely in high school athletes, in those with a history of previous concussion, and in those with a higher number and duration of postconcussion symptoms. CONCLUSIONS: The evidence concerning sports concussion course and prognosis is very preliminary, and there is no evidence on the effect of return-to-play guidelines on prognosis. Our findings have implications for further research. Well-designed, confirmatory studies are urgently needed to understand the consequences of sport concussion, including recurrent concussion, across different athletic populations and sports.
OBJECTIVE: To synthesize the best available evidence on prognosis after sport concussion. DATA SOURCES: MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "sports." Reference lists of eligible articles were also searched. STUDY SELECTION: Randomized controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 concussion cases. DATA EXTRACTION: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. DATA SYNTHESIS: Evidence was synthesized qualitatively according to modified SIGN criteria, and studies were categorized as exploratory or confirmatory based on the strength of their design and evidence. After 77,914 records were screened, 52 articles were eligible for this review, and 24 articles (representing 19 studies) with a low risk of bias were accepted. Our findings are based on exploratory studies of predominantly male football players at the high school, collegiate, and professional levels. Most athletes recover within days to a few weeks, and American and Australian professional football players return to play quickly after mild traumatic brain injury. Delayed recovery appears more likely in high school athletes, in those with a history of previous concussion, and in those with a higher number and duration of postconcussion symptoms. CONCLUSIONS: The evidence concerning sports concussion course and prognosis is very preliminary, and there is no evidence on the effect of return-to-play guidelines on prognosis. Our findings have implications for further research. Well-designed, confirmatory studies are urgently needed to understand the consequences of sport concussion, including recurrent concussion, across different athletic populations and sports.
Authors: James Donovan; J David Cassidy; Carol Cancelliere; Erik Poulsen; Mette Jensen Stochkendahl; Jørgen Kilsgaard; Marc-André Blanchette; Jan Hartvigsen Journal: J Can Chiropr Assoc Date: 2015-03
Authors: Xin Wang; Hong Xie; Andrew S Cotton; Kristopher R Brickman; Terrence J Lewis; John T Wall; Marijo B Tamburrino; William R Bauer; Kenny Law; Samuel A McLean; Israel Liberzon Journal: J Neurotrauma Date: 2016-06-27 Impact factor: 5.269
Authors: Laura D Crocker; Amber V Keller; Sarah M Jurick; Jessica Bomyea; Chelsea C Hays; Elizabeth W Twamley; Amy J Jak Journal: J Int Neuropsychol Soc Date: 2018-11-16 Impact factor: 2.892
Authors: Deepa P Rao; Steven McFaull; Wendy Thompson; Gayatri C Jayaraman Journal: Health Promot Chronic Dis Prev Can Date: 2018-03 Impact factor: 3.240
Authors: Joseph H Miller; Clarence Gill; Elizabeth N Kuhn; Brandon G Rocque; Joshua Y Menendez; Jilian A O'Neill; Bonita S Agee; Steven T Brown; Marshall Crowther; R Drew Davis; Drew Ferguson; James M Johnston Journal: J Neurosurg Pediatr Date: 2015-12-18 Impact factor: 2.375
Authors: Avinash Chandran; Zachary Y Kerr; Patricia R Roby; Aliza K Nedimyer; Alan Arakkal; Lauren A Pierpoint; Scott L Zuckerman Journal: Neurosurgery Date: 2020-09-01 Impact factor: 4.654
Authors: Erin B Wasserman; Jeffrey J Bazarian; Mark Mapstone; Robert Block; Edwin van Wijngaarden Journal: Am J Public Health Date: 2016-05-19 Impact factor: 9.308
Authors: Grant L Iverson; Noah D Silverberg; Rebekah Mannix; Bruce A Maxwell; Joseph E Atkins; Ross Zafonte; Paul D Berkner Journal: JAMA Pediatr Date: 2015-12 Impact factor: 16.193