Archives of Physical Medicine and Rehabilitation
Review articleSystematic Review of Prognosis and Return to Play After Sport Concussion: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis
Section snippets
Methods
The protocol registration, case definition, literature search, critical review strategy, and data synthesis are outlined in detail elsewhere.10, 11 Briefly, the review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.12 The electronic databases MEDLINE, PsycINFO, Embase, CINAHL, and SPORTDiscus were systematically searched from 2001 to 2012, and the reference lists of all reviews and meta-analyses related to
Results
Of 77,914 records screened for our entire review, 121 full-text articles related to sport concussion were assessed for eligibility (fig 1).11 There were 52 English articles that assessed sport concussion and met our eligibility criteria. About half of these (n=24) were accepted as scientifically admissible articles, represented by 19 studies (table 1). These studies form the basis of our best-evidence synthesis.
We accepted 19 cohort studies, of which 10 were phase II and 9 were phase I.
Discussion
The best available evidence on prognosis after sport concussion suggests that most athletes recover within days to a few weeks to preinjury levels in terms of cognitive performance (as measured by objective traditional and computerized neuropsychological tests) and postconcussion symptoms (as measured by self-report). Our findings indicate that younger players (average age, 16y) have a slightly longer recovery (about 21d) than adults. Our limited findings on RTP after concussion, based mainly
Conclusions
The best evidence, all of which is exploratory at this time, indicates that most concussed athletes recover to preinjury levels, with those at the professional level recovering the most quickly. Additionally, we found that decrements in cognitive performance and postconcussion symptoms are largely resolved within days to a few weeks of the injury, and most athletes RTP soon after sport concussion. Although only 2 studies on the risk of recurrent concussion were admitted in our review, these
Acknowledgments
We thank the other members of the International Collaboration on MTBI Prognosis (ICoMP): Jean-Luc af Geijerstam, MD, PhD, Eleanor Boyle, PhD, Jan Hartvigsen, DC, PhD, Lena Holm, DrMedSc, Alvin Li, BHSc, Connie Marras, MD, PhD, and Peter Rumney, MD; Panos Lambiris, MSc, Information Scientist, University Health Network, for assisting in developing, testing and updating the search strategies; and Meijia Zhou, BSc, for assistance with retrieving and screening articles.
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2021, Physical Therapy in SportCitation Excerpt :In addition, through the use of a unified medical record, all providers are active participants in ongoing progression through rehabilitation, culminating in a coordinated discharge. Cancelliere et al. (2014) in a systematic review, reported a mean RTP time of 4.8 days which is substantially lower than the median reported here (29 days in season 1; 13 days in season 2). However, 17 of the 19 admissible studies were from between 2000 and 2010 (Cancelliere et al., 2014), which may have contributed to the lower RTP time given that approaches to diagnosis and care have changed substantially since then.
Supported by the Ontario Neurotrauma Foundation (grant no. 2010-ABI-MTBIWHO-871). The funder was not involved in the design or preparation of the study protocol, or in the management of the project, analysis or interpretation of data, or the preparation of the final article.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
The findings and conclusions in this research are those of the authors alone and do not necessarily represent the official views or policies of the Centers for Disease Control and Prevention or any agency of the United States government. Inclusion of individuals, programs, or organizations in this article does not constitute endorsement by the United States government.