American Medical Society for Sports Medicine Position Statement on Concussion in Sport
Clinical Journal of Sport Medicine
Harmon, K. G., Clugston, J. R., et al. (2019).
Clinical Journal of Sport Medicine, 29(2), 87-100.
This guideline provides recommendations for clinicians on the management of sports-related concussion. Only guidance relating to the fields of speech-language pathology and audiology will be included in this summary.
American Medical Society for Sports Medicine
<p>This guideline is an update of:<br /><br /><span style="color: #05103e; font-family: 'Times New Roman', Inter, 'sans-serif'; font-size: medium; text-indent: -24px;">Harmon, K. G., Drezner, J. A., Gammons, M., Guskiewicz, K. M., Halstead, M., Herring, S. A., Kutcher, J. S., Pana, A., Putukian, M., & Roberts, W. O. (2012). American Medical Society for Sports Medicine position statement: concussion in sport. </span><em style="border: 0px solid #ecedee; box-sizing: border-box; --tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: #3b82f680; --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; color: #05103e; font-family: 'Times New Roman', Inter, 'sans-serif'; font-size: medium; text-indent: -24px;">British Journal of Sports Medicine</em><span style="color: #05103e; font-family: 'Times New Roman', Inter, 'sans-serif'; font-size: medium; text-indent: -24px;">, </span><em style="border: 0px solid #ecedee; box-sizing: border-box; --tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: #3b82f680; --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; color: #05103e; font-family: 'Times New Roman', Inter, 'sans-serif'; font-size: medium; text-indent: -24px;">47</em><span style="color: #05103e; font-family: 'Times New Roman', Inter, 'sans-serif'; font-size: medium; text-indent: -24px;">(1), 15–26. </span><span class="url" style="border: 0px solid #ecedee; box-sizing: border-box; --tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: #3b82f680; --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; word-break: break-all; color: #05103e; font-family: 'Times New Roman', Inter, 'sans-serif'; font-size: medium; text-indent: -24px;">https://doi.org/10.1136/bjsports-2012-091941</span></p>
<div>The following were recommendations regarding evaluation of athletes with sports-related concussion:</div>
<ul>
<li>An initial baseline evaluation should include a symptom checklist, cognitive evaluation, and balance assessment.</li>
<li>A health care professional familiar with the athlete is best suited to conduct sideline assessment.</li>
<li>An office assessment should include a comprehensive history and examination including details of the injury, symptom trajectory, neurocognitive functioning, vestibular function, and balance.</li>
<li>It is important to communicate the usual time course and outcome to patients and caregivers.</li>
<li>Vestibular evaluations should be included in assessment to facilitate management of persistent post-concussive symptoms (PPCS).</li>
<li>It is ideal for those with PPCS to be evaluated by a provider or multidisciplinary team with expertise in managing a complicated concussion recovery.</li>
</ul>
<div>The following were recommendations regarding management of athletes with sports-related concussion:</div>
<ul>
<li>Clinical care is ideally performed by health care professionals with appropriate experience. Athletes with prolonged recovery may require multidisciplinary team care.</li>
<li>Symptom-limited activity may begin as tolerated after 24 to 48 hours of symptom-limited cognitive and physical rest.</li>
<li>Vestibular rehabilitation should be performed by experienced clinicians and focus on specific deficits using an “expose-recover” model. Cognitive work should be modified or limited so as not to exacerbate symptoms.</li>
<li>Athletes with persisting symptoms should receive an individualized accommodation plan that outlines school environment adjustments to allow for symptom-limited learning activity.</li>
<li>Concussion-related symptoms should be resolved before returning to sport.</li>
<li>Currently, there are no widely accepted return to driving protocols; however, it is appropriate to discuss the potential risks and harms.</li>
</ul>
