4th International Consensus Conference on Concussion in Sport

This important conference was recently held and although I wish I had attended, I cannot wait for the consensus to be published.
In the meantime, here are some highlights taken from the IIHF website.

• No return to play on same day
• Discussions about SCAT3 (refinement of SCAT2) to exclude neck injury
• Discussions about a revision of the pocket SCAT for non- health care personnel to recognise concussion
• Discussions about a possible Child SCAT

 

• Treatment of Concussion
  • Relative rest (not bed rest)
  • Proactive approach in treatment that could involve low level activity and therapy before symptoms have completely disappeared

 

• Multimodal management of patients after one month
  • Low level activity
  • Psychology
  • Physiotherapy (neck, brain, vestibular)
  • Neuropsychological consult

 

• Baseline Testing not necessary to evaluate patients’ post-concussion but SCAT could serve as an educational tool.
• Computerised Neuropsychological testing is not necessary in most athletes who have a concussion but can be used in those whose concussion persists.

 

• Pediatric Athlete
  • Concussions can last longer
  • Return to learn before return to sport
  • Return to learn a progressive stepwise process

 

• Risk Reduction strategies
  • No evidence that helmets protect against concussion
  • No evidence that mouth guards prevent concussion
  • Evidence that full facemasks may decrease the time of recovery from concussion
  • Neck strengthening may help reduce concussions
  • Rule enforcement and no tolerance on head checking
  • Strict penalties for head checking
  • Body checking in pee wee hockey has led to increased concussions

 

• Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease that has been found in five hockey players and some NFL football players from brain biopsies taken after their death. No proof that there is a causal effect from concussion. More research is needed on the subject.
• Translation of knowledge with new tools (App) and media
• Legislation in 40 states in the U.S. and One province (Ontario) in Canada on concussions.

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