An international group of researchers has put together an easy-to-follow guide for parents and coaches to recognize concussions in young athletes and respond appropriately.
The journal article is open access and freely available to the public. It was published Nov. 5 in response to concerns that a qualified athletic trainer is not always on hand at youth sporting events, so coaches and parents should know the signs of concussion and what to do if they see them.
The bottom line is "recognize and remove," the authors say. Evidence shows that earlier recognition and removal of the athlete is correlated with a quicker return to competition.
"So if you're telling parents that you can reduce your child's recovery time by half, that's probably pretty good motivation to remove them and get them into a health care provider as quick as possible," said co-author John Leddy, a sports medicine physician at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. "They don't have to diagnose it. They just have to suspect it. If they suspect it, then the advice is to take that athlete out of the sport, remove them from further risk, and get them seen by a medical professional who knows how to evaluate this condition."
Plain language
Lead author Ruairi Connolly, a physiatrist at Cork University Hospital in Ireland, said that while the article is based on two leading scientific documents in the field, the team purposely wrote the guide using accessible language. They collected feedback on the wording in their draft from coaches and parents before the article was published in the Archives of Physical Medicine and Rehabilitation.
The article also includes a QR code that links to a two-page Concussion Recognition Tool that can be used by non-medically trained individuals to identify and manage a suspected concussion.
One co-author, associate professor and occupational therapist Jaclyn Stephens at Colorado State University , said she sometimes gets asked to assess blows to the head at local athletic events because some parents and coaches know she is a concussion researcher.
"I'm able to provide more guidance than a non-trained professional," she said. "But as an OT, I cannot diagnose concussions. And what happens when somebody like me is not at this game? How do we help parents and coaches feel more prepared and educated on what to do?"
Designating a parent
Co-author Jennifer Wethe, former director of the Mayo Clinic Arizona Concussion Program, suggested that parents adopt a "safety officer model" in which there is a designated parent who knows what to look for.
"Coaches are very busy. Getting this into the hands of motivated parents is how I think this information can make it to the grassroots level," she said. "Don't underestimate the power of highly motivated parents who are concerned about something like this. I see a lot of explaining away injuries unless there is something very specific to follow. Parents and coaches need a protocol, something they can go through step by step."
The researchers stress that concussions happen in many sports besides football. Wethe cited ice hockey, biking, soccer, volleyball – even cheer squads. Connolly cited rugby and something as simple as "someone falling over outside playing in the schoolyard."
Female sports
Stephens, who is in CSU's Department of Health and Exercise Science , emphasized that young women athletes also need to be considered, since some studies have shown a higher prevalence of concussion among female athletes, which may be related to differences in neck muscle strength.
"If we only think about concussion as a professional football problem, we're failing to consider female athletes," she said.
Stephens and co-author Ann Guernon, an associate professor of speech-language pathology at Lewis University, recently co-chaired the Athlete Development and Sports Rehabilitation Networking Group for the American Congress of Rehabilitation Medicine.
The researchers' article is based on the ACRM's definition of concussion/mild traumatic brain injury as well as the 6th International Consensus Statement on Concussion in Sport.
In addition to Connolly, Guernon, Leddy, Stephens and Wethe, the authors represent a variety of fields, from physical therapists to medical doctors to neuropsychologists to speech therapists. They include Aoife Murray, Julia Drattell, Jacob McPherson, Karen McCulloch, Quratulain Khan, Akuadasuo Ezenyilimba, Zainab Al Lawati, Will Panenka, Samir Belagaje, Tracey Wallace and Noemi Lansang.
