PM&R
Volume 1, Issue 5 , Pages 406-420 , May 2009

Consensus Statement on Concussion in Sport – The 3rd International Conference on Concussion in Sport Held in Zurich, November 2008

  • Paul McCrory

      Affiliations

    • Neurologist, Director, Centre for Health, Exercise & Sports Medicine, University of Melbourne, Parkville, Australia 3010
    • Corresponding Author InformationAddress correspondence to: P.M.
    • ,
  • Willem Meeuwisse

      Affiliations

    • Sports Physician, Sport Medicine Centre, Faculty of Kinesiology, and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
    • ,
  • Karen Johnston

      Affiliations

    • Neurosurgeon and Director, Sport Concussion Clinic, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
    • ,
  • Jiri Dvorak

      Affiliations

    • Neurologist, Director, FIFA Medical Assessment and Research Center (F-MARC) and Schulthess Clinic, Zurich, Switzerland
    • ,
  • Mark Aubry

      Affiliations

    • Chief Medical Officer, International Ice Hockey Federation and Hockey Canada, Co-Director, Ottawa Sport Medicine Centre, Ottawa, Canada
    • ,
  • Mick Molloy

      Affiliations

    • Chief Medical Officer, International Rugby Board, Huguenot House, 35-38 St Stephen's Green, Dublin 2, Ireland
    • ,
  • Robert Cantu

      Affiliations

    • Neurosurgeon, Emerson Hospital, Concord, MA

Received 13 March 2009 ,Accepted 13 March 2009.

References 

  1. Aubry M, Cantu R, Dvorak J, et al. Summary and agreement statement of the First International Conference on Concussion in Sport, Vienna 2001 (Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries). Br J Sports Med. 2002;36:6–10
  2. McCrory P, Johnston K, Meeuwisse W, Aubry M, Cantu R, Dvorak J, et al. Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. Br J Sports Med. 2005;39:196–204
  3. Maddocks D, Dicker G. An objective measure of recovery from concussion in Australian rules footballers. Sport Health. 1989;7(Supplement):6–7
  4. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5:32–35
  5. McCrea M. Standardized mental status assessment of sports concussion. Clin J Sport Med. 2001;11:176–181
  6. McCrea M, Kelly J, Randolph C, Kluge J, Bartolic E, Finn G, et al. Standardised assessment of concussion (SAC): On site mental status evaluation of the athlete. J Head Trauma Rehab. 1998;13:27–36
  7. McCrea M, Randolph C, Kelly J. The Standardized Assessment of Concussion (SAC): Manual for Administration, Scoring and Interpretation. 2nd ed.. 2000;Waukesha, WI
  8. McCrea M, Kelly JP, Kluge J, Ackley B, Randolph C. Standardized assessment of concussion in football players. Neurology. 1997;48:586–588
  9. Chen J, Johnston K, Collie A, McCrory P, Ptito A. A validation of the Post Concussion Symptom Scale in the assessment of complex concussion using cognitive testing and functional MRI. J Neurol Neurosurg Psychiatry. 2007;78:1231–1238
  10. Chen J, Johnston K, Frey S, Petrides M, Worsley K, Ptito A. Functional abnormalities in symptomatic concussed athletes: an fMRI study. Neuroimage. 2004;22(1):68–82
  11. Chen JK, Johnston KM, Collie A, McCrory P, Ptito A. (14) Association between symptom severity, cogsport tests results, and functional MRI activation in symptomatic concussed athletes. Clin J Sport Med. 2004;14:379
  12. Chen JK, Johnston KM, Collie A, McCrory P, Ptito A. Behavioural and functional imaging outcomes in symptomatic concussed athletes measured with cogsport and functional MRI. BJ Sport Med Oct. 2004;38:659
  13. Ptito A, Chen JK, Johnston KM. Contributions of functional magnetic resonance imaging (fMRI) to sport concussion evaluation. NeuroRehabilitation. 2007;22:217–227
  14. Guskiewicz K. Postural stability assessment following concussion. Clin J Sport Med. 2001;11:182–190
  15. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Current Sports Medicine Reports. 2003;2:24–30
  16. Guskiewicz KM, Ross SE, Marshall SW. Postural stability and neuropsychological deficits after concussion in collegiate athletes. Journal of Athletic Training. 2001;36:263–273
  17. Cavanaugh JT, Guskiewicz KM, Giuliani C, Marshall S, Mercer V, Stergiou N. Detecting altered postural control after cerebral concussion in athletes with normal postural stability. British J Sports Med. 2005;39:805–811
  18. Cavanaugh JT, Guskiewicz KM, Giuliani C, Marshall S, Mercer VS, Stergiou N. Recovery of postural control after cerebral concussion: new insights using approximate entropy. Journal of Athletic Training. 2006;41:305–313
  19. Cavanaugh JT, Guskiewicz KM, Stergiou N. A nonlinear dynamic approach for evaluating postural control: new directions for the management of sport-related cerebral concussion. Sports Medicine (Auckland, NZ). 2005;35:935–950
  20. Fox ZG, Mihalik JP, Blackburn JT, Battaglini CL, Guskiewicz KM. Return of postural control to baseline after anaerobic and aerobic exercise protocols. Journal of Athletic Training. 2008;43:456–463
  21. Collie A, Darby D, Maruff P. Computerised cognitive assessment of athletes with sports related head injury. Br JSports Med. 2001;35:297–302
  22. Collie A, Maruff P. Computerised neuropsychological testing. Br J Sports Med. 2003;37:2–3
  23. Collie A, Maruff P, McStephen M, Darby DG. Psychometric issues associated with computerised neuropsychological assessment of concussed athletes. Br JSports Med. 2003;37:556–559
  24. Collins MW, Grindel SH, Lovell MR, et al. Relationship between concussion and neuropsychological performance in college football players [see comments]. JAMA. 1999;282:964–970
  25. Lovell MR. The relevance of neuropsychologic testing for sports-related head injuries. Current Sports Medicine Reports. 2002;1(1):7–11
  26. Lovell MR, Collins MW. Neuropsychological assessment of the college football player. J Head Trauma Rehab. 1998;13:9–26
  27. Bleiberg J, Cernich AN, Cameron K, et al. Duration of cognitive impairment after sports concussion. Neurosurgery. 2004;54:1073–1078discussion 1078-1080
  28. Bleiberg J, Warden D. Duration of cognitive impairment after sports concussion. Neurosurgery. 2005;56:E1166
  29. Broglio SP, Macciocchi SN, Ferrara MS. Neurocognitive performance of concussed athletes when symptom free. JAthletic Training. 2007;42:504–508
  30. Broglio SP, Macciocchi SN, Ferrara MS. Sensitivity of the concussion assessment battery. Neurosurgery. 2007;60:1050–1057discussion 1057-1058
  31. Gioia G, Janusz J, Gilstein K, Iverson GL. Neuropsychological management of concussion in children and adolescents: effects of age and gender on ImPact. (abstract) Br J Sports Med. 2004;38:657
  32. McCrory P, Collie A, Anderson V, Davis G. Can we manage sport related concussion in children the same as in adults?. Br JSports Med. 2004;38:516–519
  33. Kristman VL, Tator CH, Kreiger N, et al. Does the apolipoprotein epsilon 4 allele predispose varsity athletes to concussion? (A prospective cohort study). Clin J Sport Med. 2008;18:322–328
  34. Terrell TR, Bostick RM, Abramson R, et al. APOE, APOE promoter, and Tau genotypes and risk for concussion in college athletes. Clin J Sport Med. 2008;18:10–17
  35. Vagnozzi R, Tavazzi B, Signoretti S, et al. Temporal window of metabolic brain vulnerability to concussions: mitochondrial-related impairment—part I. Neurosurgery. 2007;61:379–388discussion 388-389
  36. Hang CH, Chen G, Shi JX, Zhang X, Li JS. Cortical expression of nuclear factor kappa B after human brain contusion. Brain Res. 2006;1109:14–21
  37. Peng RY, Gao YB, Xiao XY, et al. [Study on the expressions of basic fibroblast growth factor and nervous growth factor genes in rat cerebral concussion]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2003;15:213–216
  38. Yunoki M, Kawauchi M, Ukita N, et al. Effects of lecithinized SOD on sequential change in SOD activity after cerebral contusion in rats. Acta Neurochir Suppl. 1998;71:142–145
  39. Hinkle DA, Baldwin SA, Scheff SW, Wise PM. GFAP and S100beta expression in the cortex and hippocampus in response to mild cortical contusion. J Neurotrauma. 1997;14:729–738
  40. Holmin S, Schalling M, Hojeberg B, Nordqvist AC, Skeftruna AK, Mathiesen T. Delayed cytokine expression in rat brain following experimental contusion. J Neurosurgery. 1997;86:493–504
  41. Sandberg Nordqvist AC, von Holst H, Holmin S, Sara VR, Bellander BM, Schalling M. Increase of insulin-like growth factor (IGF)-1, IGF binding protein-2 and -4 mRNAs following cerebral contusion. Brain Res Mol Brain Res. 1996;38:285–293
  42. Fukuhara T, Nishio S, Ono Y, Kawauchi M, Asari S, Ohmoto T. Induction of Cu,Zn-superoxide dismutase after cortical contusion injury during hypothermia. Brain Research. 1994;657:333–336
  43. Boutin D, Lassonde M, Robert M, Vanassing P, Ellemberg D. Neurophysiological assessment prior to and following sports-related concussion during childhood: a case study. Neurocase. 2008;14:239–248
  44. De Beaumont L, Brisson B, Lassonde M, Jolicoeur P. Long-term electrophysiological changes in athletes with a history of multiple concussions. Brain Inj. 2007;21:631–644
  45. De Beaumont L, Lassonde M, Leclerc S, Theoret H. Long-term and cumulative effects of sports concussion on motor cortex inhibition. Neurosurgery. 2007;61:329–336discussion 336-337
  46. Gaetz M, Weinberg H. Electrophysiological indices of persistent post-concussion symptoms. Brain Inj. 2000;14:815–832
  47. Gosselin N, Theriault M, Leclerc S, Montplaisir J, Lassonde M. Neurophysiological anomalies in symptomatic and asymptomatic concussed athletes. Neurosurgery. 2006;58:1151–1161discussion 1161
  48. Lavoie ME, Dupuis F, Johnston KM, Leclerc S, Lassonde M. Visual p300 effects beyond symptoms in concussed college athletes. J Clin Exp Neuropsychol. 2004;26:55–73
  49. Rousseff RT, Tzvetanov P, Atanassova PA, Volkov I, Hristova I. Correlation between cognitive P300 changes and the grade of closed head injury. Electromyogr Clin Neurophysiol. 2006;46:275–277
  50. Begaz T, Kyriacou DN, Segal J, Bazarian JJ. Serum biochemical markers for post-concussion syndrome in patients with mild traumatic brain injury. J Neurotrauma. 2006;23:1201–1210
  51. de Boussard CN, Lundin A, Karlstedt D, Edman G, Bartfai A, Borg J. S100 and cognitive impairment after mild traumatic brain injury. J Rehabil Med. 2005;37:53–57
  52. Lima DP, Simao Filho C, Abib Sde C, de Figueiredo LF. Quality of life and neuropsychological changes in mild head trauma (Late analysis and correlation with S100B protein and cranial CT scan performed at hospital admission). Injury. 2008;39:604–611
  53. Ma M, Lindsell CJ, Rosenberry CM, Shaw GJ, Zemlan FP. Serum cleaved tau does not predict postconcussion syndrome after mild traumatic brain injury. Am J Emerg Med. 2008;26:763–768
  54. Stalnacke BM, Tegner Y, Sojka P. Playing ice hockey and basketball increases serum levels of S-100B in elite players: a pilot study. Clin J Sport Med. 2003;13:292–302
  55. Stalnacke BM, Tegner Y, Sojka P. Playing soccer increases serum concentrations of the biochemical markers of brain damage S-100B and neuron-specific enolase in elite players: a pilot study. Brain Inj. 2004;18:899–909
  56. Townend W, Ingebrigtsen T. Head injury outcome prediction: a role for protein S-100B?. Injury. 2006;37:1098–1108
  57. Johnston K, Bloom G, Ramsay J, et al. Current Concepts in Concussion Rehabilitation. Current Sports Medicine Reports. 2004;3:316–323
  58. Guskiewicz KM, Bruce SL, Cantu RC, et al. National Athletic Trainers' Association Position Statement: Management of Sport-Related Concussion. J Athletic Training. 2004;39:280–297
  59. Herring S, Bergfeld J, Boland A, et al. Concussion (mild traumatic brain injury) and the team physician: a consensus statement. Med SciSports Exercise. 2006;38:395–399
  60. Kelly JP, Rosenberg JH. The development of guidelines for the management of concussion in sports. J Head Trauma Rehabilitation. 1998;13:53–65
  61. Pellman EJ, Viano DC, Casson IR, Arfken C, Feuer H. Concussion in professional football: players returning to the same game—part 7. Neurosurgery. 2005;56:79–90discussion -2
  62. Guskiewicz KM, McCrea M, Marshall SW, et al. Cumulative effects associated with recurrent concussion in collegiate football players. JAMA. 2003;290:2549–2555
  63. Lovell M, Collins M, Bradley J. Return to play following sports-related concussion. Clinics in Sports Med. 2004;23:421–441ix
  64. Collins M, Field M, Lovell M, et al. Relationship between postconcussion headache and neuropsychological test performance in high school athletes. Am J Sports Med. 2003;31:168–173
  65. Collins M, Grindel S, Lovell M, et al. Relationship between concussion and neuropsychological performance in college football players. JAMA. 1999;282:964–970
  66. Collins MW, Lovell MR, Iverson GL, Cantu RC, Maroon JC, Field M. Cumulative effects of concussion in high school athletes. Neurosurgery. 2002;51:1175–1179discussion 1180-1181
  67. McCrea M, et al. Acute effects and recovery time following concussion in collegiate football players. JAMA. 2003;290:2556–2563
  68. McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. 2004;14(1):13–17
  69. Bloom G, Horton A, McCrory P, Johnston K. Sport psychology and concussion: new impacts to explore. Br J Sports Med. 2004;38:519–521
  70. Weiss MR, Gill DL. What goes around: Re-emerging themes in sport and exercise psychology. Res Q Exerc Sport. 2005;76:S71–S87
  71. McCrory P. Should we treat concussion pharmacologically? (The need for evidence based pharmacological treatment for the concussed athlete). Br J Sports Med. 2002;36:3–5
  72. McCrory P. Preparticipation assessment for head injury. Clin J Sport Med. 2004;14:139–144
  73. Johnston KM, Lassonde M, Ptito A. A contemporary neurosurgical approach to sport-related head injury: The McGill concussion protocol. J Am Coll Surg. 2001;192:515–524
  74. Delaney J, Lacroix V, Leclerc S, Johnston K. Concussions during the 1997 Canadian Football League season. Clin J Sport Med. 2000;10:9–14
  75. Delaney J, Lacroix V, Leclerc S, Johnston K. Concussions among university football and soccer players. Clin J Sport Med. 2002;12:331–338
  76. Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. Concussions among United States high school and collegiate athletes. J Athletic Training. 2007;42:495–503
  77. Dvorak J, Junge A, Fuller C, McCrory P. Medical issues in women's football. Br J Sports Med. 2007;41(Suppl 1):i1
  78. Dvorak J, McCrory P, Kirkendall DT. Head injuries in the female football player: incidence, mechanisms, risk factors and management. Br J Sports Med. 2007;41(Suppl 1):i44–i46
  79. Jennett B, Bond M. Assessment of outcome after severe brain damage: A practical scale. Lancet. 1975;1:480–484
  80. Leninger B, Gramling S, Farrell A, Kreutzer J, Peck E. Neuropsychological deficits in symptomatic minor head injury patients after concussion and mild concussion. J Neurol Neurosurg Psych. 1990;53:293–296
  81. Lovell M, Iverson G, Collins M, McKeag D, Maroon J. Does loss of consciousness predict neuropsychological decrements after concussion. Clin J Sport Med. 1999;9:193–199
  82. McCrea M, Kelly J, Randolph C, Cisler R, Berger L. Immediate neurocognitive effects of concussion. Neurosurgery. 2002;50:1032–1042
  83. Cantu RC. Posttraumatic retrograde and anterograde amnesia: Pathophysiology and implications in grading and safe return to play. J Athletic Training. 2001;36:244–248
  84. Lovell MR, Collins MW, Iverson GL, et al. Recovery from mild concussion in high school athletes. J Neurosurg. 2003;98:296–301
  85. McCrory PR, Ariens T, Berkovic SF. The nature and duration of acute concussive symptoms in Australian football. Clin J Sport Med. 2000;10:235–238
  86. Yarnell P, Lynch S. The ‘ding’: amnestic state in football trauma. Neurology. 1973;23:196–197
  87. Yarnell PR, Lynch S. Retrograde memory immediately after concussion. Lancet. 1970;1(7652):863–864
  88. McCrory PR, Berkovic SF. Video analysis of acute motor and convulsive manifestations in sport-related concussion. Neurology. 2000;54:1488–1491
  89. McCrory PR, Bladin PF, Berkovic SF. Retrospective study of concussive convulsions in elite Australian rules and rugby league footballers: phenomenology, aetiology, and outcome. BMJ (Clinical research ed.). 1997;314(7075):171–174
  90. Fleminger S. Long-term psychiatric disorders after traumatic brain injury. Eur J Anaesthesiol Suppl. 2008;42:123–130
  91. Chen JK, Johnston KM, Petrides M, Ptito A. Neural substrates of symptoms of depression following concussion in male athletes with persisting postconcussion symptoms. Arch Gen Psychiatry. 2008;65:81–89
  92. Bryant RA. Disentangling mild traumatic brain injury and stress reactions. N Engl J Med. 2008;358:525–527
  93. Vanderploeg RD, Curtiss G, Luis CA, Salazar AM. Long-term morbidities following self-reported mild traumatic brain injury. J Clin Exp Neuropsychol. 2007;29(6):585–598
  94. Guskiewicz KM, Marshall SW, Bailes J, et al. Recurrent concussion and risk of depression in retired professional football players. Med Sci Sports Exercise. 2007;39:903–909
  95. Kashluba S, Casey JE, Paniak C. Evaluating the utility of ICD-10 diagnostic criteria for postconcussion syndrome following mild traumatic brain injury. J Int Neuropsychol Soc. 2006;12:111–118
  96. Iverson GL. Misdiagnosis of the persistent postconcussion syndrome in patients with depression. Arch Clin Neuropsychol. 2006;21:303–310
  97. Chamelian L, Feinstein A. The effect of major depression on subjective and objective cognitive deficits in mild to moderate traumatic brain injury. J Neuropsychiatry Clinical Neurosciences. 2006;18:33–38
  98. Mooney G, Speed J, Sheppard S. Factors related to recovery after mild traumatic brain injury. Brain Inj. 2005;19:975–987
  99. Broshek DK, Freeman JR. Psychiatric and neuropsychological issues in sport medicine. Clinics in Sports Med. 2005;24:663–679x
  100. Pellman EJ. Background on the National Football League's research on concussion in professional football. Neurosurgery. 2003;53:797–798
  101. Purcell L, Carson J. Sport-related concussion in pediatric athletes. Clin Pediatr (Phila). 2008;47:106–113
  102. Lee LK. Controversies in the sequelae of pediatric mild traumatic brain injury. Pediatric Emergency Care. 2007;23:580–583quiz 584-586
  103. Schnadower D, Vazquez H, Lee J, Dayan P, Roskind CG. Controversies in the evaluation and management of minor blunt head trauma in children. Current Opinion in Pediatrics. 2007;19(3):258–264
  104. Wozniak JR, Krach L, Ward E, et al. Neurocognitive and neuroimaging correlates of pediatric traumatic brain injury: a diffusion tensor imaging (DTI) study. Arch Clin Neuropsychol. 2007;22:555–568
  105. Hayden MG, Jandial R, Duenas HA, Mahajan R, Levy M. Pediatric concussions in sports; a simple and rapid assessment tool for concussive injury in children and adults. Childs Nerv Syst. 2007;23:431–435
  106. Lee MA. Adolescent concussions—management recommendations: a practical approach. Connecticut Medicine. 2006;70:377–380
  107. Kirkwood MW, Yeates KO, Wilson PE. Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population. Pediatrics. 2006;117:1359–1371
  108. Guskiewicz KM, Marshall SW, Bailes J, et al. Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery. 2005;57:719–726discussion -726
  109. Nandoe RD, Scheltens P, Eikelenboom P. Head trauma and Alzheimer's disease. J Alzheimers Dis. 2002;4:303–308
  110. Stern MB. Head trauma as a risk factor for Parkinson's disease. Mov Disord. 1991;6:95–97
  111. Omalu BI, DeKosky ST, Hamilton RL, et al. Chronic traumatic encephalopathy in a national football league player: Part II. Neurosurgery. 2006;59:1086–1092discussion 1092-1093
  112. Omalu BI, DeKosky ST, Minster RL, Kamboh MI, Hamilton RL, Wecht CH. Chronic traumatic encephalopathy in a National Football League player. Neurosurgery. 2005;57:128–134discussion 134
  113. Hagel BE, Pless IB, Goulet C, Platt RW, Robitaille Y. Effectiveness of helmets in skiers and snowboarders: case-control and case crossover study. BMJ (Clinical research ed.). 2005;330(7486):281
  114. McCrory P. The role of helmets in skiing and snowboarding. Br J Sports Med. 2002;36:314
  115. Mueller BA, Cummings P, Rivara FP, Brooks MA, Terasaki RD. Injuries of the head, face, and neck in relation to ski helmet use. Epidemiology. 2008;19:270–276
  116. Sulheim S, Holme I, Ekeland A, Bahr R. Helmet use and risk of head injuries in alpine skiers and snowboarders. JAMA. 2006;295:919–924
  117. Delaney JS, Al-Kashmiri A, Drummond R, Correa JA. The effect of protective headgear on head injuries and concussions in adolescent football (soccer) players. Br J Sports Med. 2008;42:110–115discussion 115
  118. Viano DC, Pellman EJ, Withnall C, Shewchenko N. Concussion in professional football: performance of newer helmets in reconstructed game impacts—Part 13. Neurosurgery. 2006;59:591–606discussion 591-606
  119. Finch C, Braham R, McIntosh A, McCrory P, Wolfe R. Should football players wear custom fitted mouthguards? (Results from a group randomised controlled trial). Inj Prev. 2005;11:242–246
  120. McIntosh A, McCrory P. The dynamics of concussive head impacts in rugby and Australian rules football. Med Sci Sports Exercise. 2000;32:1980–1985
  121. McIntosh A, McCrory P. Impact energy attenuation performance of football headgear. Br J Sports Med. 2000;34:337–342
  122. McIntosh A, McCrory P. Effectiveness of headgear in a pilot study of under 15 rugby union football. BrJ Sports Med. 2001;35:167–170
  123. McIntosh A, McCrory P, Finch C, Best J, Chalmers D. Rugby Headgear Study Report. School of Safety Science, The University of New South Wales, Sydney, Australia, May 2005.
  124. Finch C, Newstead S, Cameron M, Vulcan A. Head injury reductions in Victoria two years after the introduction of mandatory bicycle helmet use. Melbourne: Monash University Accident Research Centre; July 1993;Report No.: 51
  125. Curnow WJ. Bicycle helmets and public health in Australia. Health Promot J Austr. 2008;19:10–15
  126. Hewson PJ. Cycle helmets and road casualties in the UK. Traffic Inj Prev. 2005;6:127–134
  127. Davidson JA. Epidemiology and outcome of bicycle injuries presenting to an emergency department in the United Kingdom. Eur J Emerg Med. 2005;12:24–29
  128. Hansen KS, Engesaeter LB, Viste A. Protective effect of different types of bicycle helmets. Traffic Inj Prev. 2003;4:285–290
  129. Andersen T, Arnason A, Engebretsen L, Bahr R. Mechanism of head injuries in elite football. Br J Sports Med. 2004;38:690–696
  130. Hagel B, Meewisse W. Editorial: Risk compensation: A “side effect” of sport injury prevention?. Clin J Sport Med. 2004;14:193–196
  131. Finch C, Mcintosh AS, McCrory P, Zazryn T. A pilot study of the attitudes of Australian Rules footballers towards protective headgear. J Sci Med Sport. 2003;6:505–511
  132. Finch CF, McIntosh AS, McCrory P. What do under 15 year old schoolboy rugby union players think about protective headgear?. BrJ Sports Med. 2001;35:89–94
  133. Finch C, McIntosh AS, McCrory P. What evidence base for the use of protective headgear and mouthguards in Australian football. Sport Health. 2000;18:35–38
  134. Reece RM, Sege R. Childhood head injuries: accidental or inflicted?. Arch Pediatr Adolesc Med. 2000;154:11–15
  135. Shaw NH. Bodychecking in hockey. CMAJ. 2004;170(1):15–16author reply 16, 88
  136. Denke NJ. Brain injury in sports. J Emerg Nurs. 2008;34:363–364
  137. Gianotti S, Hume PA. Concussion sideline management intervention for rugby union leads to reduced concussion claims. NeuroRehabilitation. 2007;22:181–189
  138. Guilmette TJ, Malia LA, McQuiggan MD. Concussion understanding and management among New England high school football coaches. Brain Inj. 2007;21:1039–1047
  139. Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athletic Training. 2007;42:311–319
  140. Valovich McLeod TC, Schwartz C, Bay RC. Sport-related concussion misunderstandings among youth coaches. Clin J Sport Med. 2007;17:140–142
  141. Sye G, Sullivan SJ, McCrory P. High school rugby players' understanding of concussion and return to play guidelines. BrJ Sports Med. 2006;40:1003–1005
  142. Theye F, Mueller KA. “Heads up”: concussions in high school sports. Clin Med Res. 2004;2:165–171
  143. Kashluba S, Paniak C, Blake T, Reynolds S, Toller-Lobe G, Nagy J. A longitudinal, controlled study of patient complaints following treated mild traumatic brain injury. Arch Clin Neuropsychol. 2004;19:805–816
  144. Gabbe B, Finch CF, Wajswelner H, Bennell K. Does community-level Australian football support injury prevention research?. J Sci Med Sport. 2003;6(2):231–236
  145. Kaut KP, DePompei R, Kerr J, Congeni J. Reports of head injury and symptom knowledge among college athletes: implications for assessment and educational intervention. Clin J Sport Med. 2003;13:213–221
  146. Davidhizar R, Cramer C. “The best thing about the hospitalization was that the nurses kept me well informed.” Issues and strategies of client education. Accid Emerg Nurs. 2002;10:149–154
  147. McCrory P. What advice should we give to athletes postconcussion?. Br J Sports Med. 2002;36:316–318
  148. Bazarian JJ, Veenema T, Brayer AF, Lee E. Knowledge of concussion guidelines among practitioners caring for children. Clin Pediatr (Phila). 2001;40:207–212

 This article will also appear in American Journal of Sports Medicine, British Journal of Sports Medicine (with review papers), Clinical Journal of Sport Medicine, Journal of Athletic Training, Journal of Clinical Neuroscience, Journal of Clinical Sports Medicine (Japanese), Journal of Science and Medicine in Sport, Physician and Sportsmedicine, Neurosurgery, Scandinavian Journal of Science & Medicine in Sport, South African Sports Medicine Journal, and Canadian Medical Association Journal.

PII: S1934-1482(09)00310-4

doi: 10.1016/j.pmrj.2009.03.010

PM&R
Volume 1, Issue 5 , Pages 406-420 , May 2009

Article Tools