ISBN-10:
0309288002
ISBN-13:
9780309288002
Pub. Date:
03/04/2014
Publisher:
National Academies Press
Sports-Related Concussions in Youth: Improving the Science, Changing the Culture

Sports-Related Concussions in Youth: Improving the Science, Changing the Culture

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Overview

In the past decade, few subjects at the intersection of medicine and sports have generated as much public interest as sports-related concussions - especially among youth. Despite growing awareness of sports-related concussions and campaigns to educate athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in many areas. Currently, diagnosis is based primarily on the symptoms reported by the individual rather than on objective diagnostic markers, and there is little empirical evidence for the optimal degree and duration of physical rest needed to promote recovery or the best timing and approach for returning to full physical activity.

Sports-Related Concussions in Youth: Improving the Science, Changing the Culture reviews the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. This report recommends actions that can be taken by a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents - to improve what is known about concussions and to reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms.

The culture of sports negatively influences athletes' self-reporting of concussion symptoms and their adherence to return-to-play guidance. Athletes, their teammates, and, in some cases, coaches and parents may not fully appreciate the health threats posed by concussions. Similarly, military recruits are immersed in a culture that includes devotion to duty and service before self, and the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, if the youth sports community can adopt the belief that concussions are serious injuries and emphasize care for players with concussions until they are fully recovered, then the culture in which these athletes perform and compete will become much safer. Improving understanding of the extent, causes, effects, and prevention of sports-related concussions is vitally important for the health and well-being of youth athletes. The findings and recommendations in this report set a direction for research to reach this goal.

Product Details

ISBN-13: 9780309288002
Publisher: National Academies Press
Publication date: 03/04/2014
Pages: 356
Product dimensions: 6.00(w) x 8.80(h) x 1.00(d)

Table of Contents

Abbreviations and Acronyms xvii

Summary 1

1 Introduction 19

Committee's Approach to Its Charge 22

Overview of Core Issues 25

Report Organization 46

Findings 47

References 48

2 Neuroscience, Biomechanics, and Risks of Concussion in the Developing Brain 55

Normal Brain Development 55

Biomechanics of Concussion 59

Neurochemistry of Concussion 67

Risk Factors for Concussion in the Developing Brain 80

Findings 83

References 84

3 Concussion Recognition, Diagnosis, and Acute Management 99

Sideline Assessment 99

Clinical Evaluation 102

Neuropsychological Testing 114

Acute Concussion Management 154

Findings 162

References 164

4 Treatment and Management of Prolonged Symptoms and Post-Concussion Syndrome 181

Diagnostic Definition 182

Short-Term Predictors of a Prolonged Symptomatic Period Post Concussion 182

Symptomatology in Prolonged Recovery and Post-Concussion Syndrome 185

Clinical Management of Prolonged Symptoms and Post-Concussion Syndrome 191

Effects of Prolonged Recovery on Family 193

Access to Care for Individuals with Prolonged Recovery 194

Findings 195

References 195

5 Consequences of Repetitive Head Impacts and Multiple Concussions 203

Neuropsychological and Neurophysiological Consequences 203

Multiple Concussions and Depression and Suicide 212

Experimental Models 215

Biomarkers and Risk Factors 218

Long-Term Neurodegenerative Consequences 220

Findings 226

References 227

6 Protection and Prevention Strategies 239

Protective Equipment 239

Sports Rules 257

Concussion Education 260

State Concussion Legislation 265

Findings 272

References 273

7 Conclusions and Recommendations 285

Surveillance 285

Evidence-Based Guidelines for Concussion Diagnosis and Management 286

Short-and Long-Term Consequences of Concussions and Repetitive Head Impacts 287

Age-Appropriate Rules and Playing Standards 288

Biomechanics, Protective Equipment, and Safety Standards 289

Culture Change 289

Partnerships 290

Appendixes

A Public Workshop Agendas 293

B Biographical Sketches of Committee Members 299

C Clinical Evaluation Tools 309

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