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Title: What is the definition of sports-related concussion: a systematic review.
Austin Authors: McCrory, Paul R;Feddermann-Demont, Nina;Dvořák, Jiří;Cassidy, J David;McIntosh, Andrew;Vos, Pieter E;Echemendia, Ruben J;Meeuwisse, Willem;Tarnutzer, Alexander A
Affiliation: Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
Department of Psychology, University of Missouri - Kansas City, State College, Pennsylvania, USA
The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Division of Epidemiology, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Department of Sport Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark
Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
Monash University Accident Research Centre, Monash University, Melbourne, Australia
UOC Concussion Care Clinic, State College, Pennsylvania, USA
Swiss Concussion Center, Schulthess Clinic, Zurich, Switzerland
Department of Neurology, Schulthess Clinic, Zurich, Switzerland
Division of Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
Department of Neurology, Slingeland Ziekenhuis, Doetinchem, The Netherlands
Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
Issue Date: Jun-2017
Publication information: British journal of sports medicine 2017; 51(11): 877-887
Abstract: Various definitions for concussion have been proposed, each having its strengths and weaknesses. We reviewed and compared current definitions and identified criteria necessary for an operational definition of sports-related concussion (SRC) in preparation of the 5th Concussion Consensus Conference (Berlin, Germany). We also assessed the role of biomechanical studies in informing an operational definition of SRC. This is a systematic literature review. Data sources include MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Clinical Trials and SPORT Discus (accessed 14 September 2016). Eligibility criteria were studies reporting (clinical) criteria for diagnosing SRC and studies containing SRC impact data. Out of 1601 articles screened, 36 studies were included (2.2%), 14 reported on criteria for SRC definitions and 22 on biomechanical aspects of concussions. Six different operational definitions focusing on clinical findings and their dynamics were identified. Biomechanical studies were obtained almost exclusively on American football players. Angular and linear head accelerations linked to clinically confirmed concussions demonstrated considerable individual variation. SRC is a traumatic brain injury that is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces with several common features that help define its nature. Limitations identified include that the current criteria for diagnosing SRC are clinically oriented and that there is no gold/standard to assess their diagnostic properties. A future, more valid definition of SRC would better identify concussed players by demonstrating high predictive positive/negative values. Currently, the use of helmet-based systems to study the biomechanics of SRC is limited to few collision sports. New approaches need to be developed to provide objective markers for SRC.
DOI: 10.1136/bjsports-2016-097393
ORCID: 0000-0001-6116-8462
PubMed URL: 29098981
Type: Journal Article
Subjects: biomechanics.
head injury
systematic review
Appears in Collections:Journal articles

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