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Title: Approach to investigation and treatment of persistent symptoms following sport-related concussion: a systematic review.
Austin Authors: Makdissi, Michael;Schneider, Kathryn J;Feddermann-Demont, Nina;Guskiewicz, Kevin M;Hinds, Sidney;Leddy, John J;McCrea, Michael;Turner, Michael;Johnston, Karen M
Affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Alberta Children's Hospital Research Institute, University of Calgary, Calgary,, Alberta, Canada
Department of Neurology, University hospital Zurich, Zurich, Switzerland
Princess Grace Hospital, London, UK
Hotchkiss Brain Institute, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
Olympic Park Sports Medicine Centre, Melbourne, Victoria, Australia
The International Concussion and Head Injury Research Foundation, London, UK
Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
Department of Orthopaedics, SUNY Buffalo, Buffalo, New York, USA
The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Swiss Concussion Center, Zurich, Switzerland
Sports Medicine Research Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
DoD Brain Health Research Program, Blast Injury Research Program Coordinating Office, United States Army Medical Research and Materiel Command, FT Detrick, Maryland, USA
Issue Date: Jun-2017
Date: 2017-05-08
Publication information: British journal of sports medicine 2017; 51(12): 958-968
Abstract: To conduct a systematic review of the literature regarding assessment and treatment modalities in patients with persistent symptoms following sport-related concussion (SRC). We searched Medline, Embase, SPORTSDiscus, PsycINFO, CINAHL, Cochrane library and ProQuest Dissertation & Theses Global electronic databases. Studies were included if they were original research, reported on SRC as the primary source of injury, included patients with persistent postconcussive symptoms (>10 days) and investigated the role of assessment or treatment modalities. Of 3225 articles identified in the preliminary search, 25 articles met the inclusion criteria. 11 articles were concerned with assessment and 14 articles with treatment of persistent symptoms following SRC. There were three randomised control trials and one quasi-experimental study. The remainder consisting of cross-sectional studies, historical cohorts and case series. 'Persistent symptoms' following SRC can be defined as clinical recovery that falls outside expected time frames (ie, >10-14 days in adults and >4 weeks in children). It does not reflect a single pathophysiological entity, but describes a constellation of non-specific post-traumatic symptoms that may be linked to coexisting and/or confounding pathologies. A detailed multimodal clinical assessment is required to identify specific primary and secondary processes, and treatment should target specific pathologies identified. There is preliminary evidence supporting the use of symptom-limited aerobic exercise, targeted physical therapy and a collaborative approach that includes cognitive behavioural therapy. Management of patients with persistent symptoms is challenging and should occur in a multidisciplinary collaborative setting, with healthcare providers with experience in SRC.
DOI: 10.1136/bjsports-2016-097470
Journal: British Journal of Sports Medicine
PubMed URL: 28483928
Type: Journal Article
Subjects: assessment
post-concussion syndrome
Appears in Collections:Journal articles

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