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Beyond helmets: concussions require proactive, individualized monitoring and rehab

footballNew Concussion Guidelines Stress Individual Treatment (The New York Times):
“The American Academy of Neurology said Monday that it had revised its guidelines for handling concussions to emphasize treating athletes case by case rather than according to a predetermined scale…In noting that more than a million American athletes experienced concussions each year, the authors of the study noted that the risk of concussion was greatest in football and rugby, followed by hockey and soccer, and that the risk of concussion for young women and girls was greatest in soccer and basketball…Critically, the authors found “no clear evidence that one type of football helmet can better protect against concussion over another kind of helmet.”

Study: Summary of evidence-based guideline update: Evaluation and management of concussion in sports (Neurology)

  • Objective: To update the 1997 American Academy of Neurology (AAN) practice parameter regarding sports concussion, focusing on 4 questions: 1) What factors increase/decrease concussion risk? 2) What diagnostic tools identify those with concussion and those at increased risk for severe/prolonged early impairments, neurologic catastrophe, or chronic neurobehavioral impairment? 3) What clinical factors identify those at increased risk for severe/prolonged early postconcussion impairments, neurologic catastrophe, recurrent concussions, or chronic neurobehavioral impairment? 4) What interventions enhance recovery, reduce recurrent concussion risk, or diminish long-term sequelae?
  • Results: Specific risk factors can increase or decrease concussion risk. Diagnostic tools to help identify individuals with concussion include graded symptom checklists, the Standardized Assessment of Concussion, neuropsychological assessments, and the Balance Error Scoring System. Ongoing clinical symptoms, concussion history, and younger age identify those at risk for postconcussion impairments. Risk factors for recurrent concussion include history of multiple concussions, particularly within 10 days after initial concussion…Data are insufficient to show that any intervention enhances recovery or diminishes long-term sequelae postconcussion.

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