A Prospective Study on Injury Assessment, Return to Play and Outcome Following Concussion in Athletes.

Principle Investigator: Kevin M. Guskiewicz, Ph.D.

Institution: University of North Carolina

Title: A Prospective Study on Injury Assessment, Return to Play and Outcome Following Concussion in Athletes

Abstract: Deciding when an athlete can safely return to participation following a concussion represents perhaps the most challenging task of any sports medicine clinician. Athletic trainers and team physicians are often forced to make such decisions while having little or no objective information on which to base their decision. It is difficult to determine the severity of the injury, especially when there is no loss of consciousness or amnesia. Research reports a high incidence of repeated head injury in sports, and suggests that serious sequelae likely increases with repeated head injury. The school athletes, including routine clinical examination, the Standardized Assessment of Concussion (SAC), the Balance Error Scoring System (BESS), a brief neurophychological test battery, and post-concussion symptom checklist. The relationship between injury assessment, management, return to play and outcome will be empirically addressed as part of the study. Sports medicine personnel from 20 high schools during the 1999-2000 and 2000-2001 academic years. The schools will be evenly divided into two groups: 1) Assessment Group, which will utilize the SAC, BESS, and neurophychological battery, in addition to completing the Concussion Index and Concussion Symptom Checklist as part of 8 post injury assessments; and 2) Reporting Group, which will only complete the Concussion Index and Concussion Symptom Checklist. Baseline screenings will also be compared to injured subjects across each postinjury assessment day. This study is expected to result in 1) validation of a safe, practical and cost effective method for assessing concussion and preventing the serious effects of subsequent head injuries in collegiate athletes; and 2) validation of a safe and practical concussion grading scale and return to play guideline based on symptom resolution and objective testing.