Although our knowledge base is expanding, return-to-play decisions in concussed athletes still poses a challenge to the sports community. During the 5th International Conference on Concussion in Sport that took place in Berlin (2016), an advised protocol for management of sports related concussions emerged. This includes that athletes should refrain from physical and cognitive exertion for the 48 hours following urgent medical assessment of the trauma. Thereafter individualised return-to-play decisions should be made by a multi-disciplinary team based on symptom remission and the recovery of neurocognitive performance. Premature return-to-play may result in a more complicated course of recovery.
The 2016 Concussion in Sport Group (CSIG) (McCrory et al, 2016) makes special reference to the use of neuropsychological assessments in concussion. It is described by the CSIG “as a ‘cornerstone’ of SRC management. Neuropsychologists are uniquely qualified to interpret NP tests and can play an important role within the context of a multifaceted-multimodal and multidisciplinary approach to managing SRC. SRC management programmes that use NP assessment to assist in clinical decision- making have been instituted in professional sports, colleges and high schools.”
The return-to-play protocol remains difficult to implement. The reasons for this include:
- lack of education regarding the prevalence and symptoms of concussion;
- athletes not being assessed after concussions due to limited availability of health professionals;
- the limited use of a multidisciplinary approach in the evaluation of concussed athletes;
- denial from athletes due to the drive to compete and succeed on the sport field 4) pressure from unaware coaches, teachers and parents for athletes to return to the sports field; and
- expectation to achieve academically and not considering the complications of continuous cognitive exertion in the recovery period.
Education, awareness and availability of support will improve the management of concussion and limit the complications and detrimental outcome of poor management of athletes following a concussion. Not only athletes, parents and coaches need to have access to resources when a concussion is suffered, but also the health professionals who are treating them.
To enquire about the assessment and treatment of concussions, please contact Sonet Strijdom (Psychologist) at Psicon.
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