New guidelines on concussion treatment contradict previous recommendations.Credit: Rocketclips, Inc / Alamy Stock Photo
Parents, coaches and medical professionals should stop ‘cocooning’ athletes who suffer mild concussions. Easy walking in the first 48 hours, followed by approved aerobic activity between days two to 10, can reduce recovery time by as much as five days.
This new advice which directly contradicts prevailing guidance that patients should rest completely for one to two days is among a range of new recommendations in the International Consensus Statement on Concussion in Sport 2023, published in the British Journal of Sports Medicine.
Consensus Statement co-chair, Jon Patricios, from the University of the Witwatersrand, South Africa, highlighted the positive impact of exercise on the recovery process for athletes, especially those who play high-impact sports such as rugby, American football, soccer and ice hockey. The statement draws on the work of 100 researchers and clinicians. It is accompanied by 10 systematic reviews, summarising six years of related scientific findings.
It offers enhanced guidance on best treatment practices, while announcing new-generation concussion assessment tools for children from as young as eight, to professional adult athletes.
“These have the potential to positively change the management of sport-related concussion,” Patricios said, adding that there was also good evidence to suggest that limiting the use of computers and cellphones in the first 48 hours post-injury can benefit recovery.
The United States Centers for Disease Control estimates that as many as 10% of athletes will experience a concussion during any given sports season. Many of these go unreported and undiagnosed, leading to mismanagement and potential premature return to activity.
A new addition is the Sport Concussion Office Assessment Tool (SCOAT6). Patricios said this would be a powerful aid to doctors, emergency officers, paediatricians and neurologists managing sports-related concussions in the three-to-30-day period post-injury. There is also a new version of the tool for children.
Identifying evidence gaps, the authors warned of limited studies on the management of sport-related concussion in five-to-12 year olds, and in para sport athletes. There was also a dearth of concussion-related research around women athletes, they cautioned.
