Best Practice Case Studies-Case 143 Asset 2 AMSSM Position Statement on Concussion

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The AMSSM position statement updates guidance on sport-related concussion (SRC), emphasizing that concussion is a common but complex brain injury that usually resolves clinically within 1–4 weeks. Because there is no single objective diagnostic test, diagnosis remains a careful clinical judgment based on history, symptoms, and examination. The statement recommends that SRC care be provided by healthcare professionals with appropriate concussion expertise, especially for athletes with prolonged or complicated recovery.<br /><br />Key points include: athletes suspected of concussion should be removed from play immediately and not return the same day if concussion is definite or probable. Sideline tools such as the SCAT5 and Child SCAT5 can help, but their results must be interpreted alongside clinical findings. Baseline testing may be useful but is not required standard care. Office evaluations should assess symptoms, cognition, balance, vision, vestibular function, sleep, mood, and cervical spine issues.<br /><br />For treatment, the statement moves away from prolonged strict rest or “cocooning.” Instead, it recommends 24–48 hours of relative rest followed by gradual, symptom-limited physical and cognitive activity. Early, controlled aerobic exercise may help recovery. Nutraceuticals lack human evidence for prevention or treatment. Persistent symptoms should be managed with targeted, multidisciplinary care, including exercise therapy, vestibular/ocular rehabilitation, cervical therapy, sleep management, and psychological support.<br /><br />Return to learn should be individualized with academic accommodations as needed, and return to sport should follow a stepwise progression only after symptoms resolve. The statement also discusses risks of premature return, possible long-term concerns such as depression and chronic traumatic encephalopathy, and the lack of evidence-based retirement rules. Prevention strategies include rule changes, coaching/technique modifications, and some equipment measures, though no method fully prevents concussion.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 143

Topic Neurology

Keywords

sport-related concussion

concussion management

return to play

return to learn

SCAT5

relative rest

aerobic exercise

vestibular rehabilitation

academic accommodations

concussion prevention

4th Edition

4th Edition, Case 143

Neurology