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Neurology1456 papers

Repeated concussion

Last edited: 4/23/2026

Overview

Sport-related concussion (SRC) is a traumatic brain injury resulting from biomechanical forces leading to temporary impairment of neurological function without detectable structural damage 1417.

Diagnosis

  • Clinical Assessment: Symptom evaluation using standardized tools like the Sport Concussion Assessment Tool (SCAT) 11621.
  • Neurocognitive Testing: Computerized assessments such as ImPACT for baseline and post-injury comparisons 1151.
  • Physical Examination: Including vestibular and oculomotor function tests 1430.
  • Imaging: Typically normal; CT or MRI reserved for suspicion of more severe injury 117.
  • Management

  • Initial Rest: Short period of physical and cognitive rest followed by gradual return to activities 2427.
  • Gradual Return to Play: Phased reintroduction to physical activities guided by symptom resolution 2411.
  • Multimodal Rehabilitation: Incorporating physical therapy, vestibular rehabilitation, and cognitive strategies 3533.
  • Aerobic Exercise: Early introduction of low-intensity aerobic exercise may promote recovery 324.
  • Neuromuscular Training: Post-recovery training to improve motor and psychosocial outcomes 23.
  • Special Populations

  • Pediatrics: Emphasis on shared decision-making between clinicians and families 219. Longer recovery periods and more cautious return-to-play protocols 1127.
  • Elderly: Increased vigilance for comorbid conditions affecting recovery and management 22.
  • Comorbidities: Tailored management considering additional health issues 22.
  • Key Recommendations

  • Implement Graduated Return-to-Play Protocol: Gradually reintroduce physical activities based on symptom resolution (Evidence: Strong 2411).
  • Use Multifaceted Assessment Tools: Combine clinical evaluation, neurocognitive testing, and physical assessments for comprehensive diagnosis (Evidence: Strong 11621).
  • Promote Early Low-Intensity Exercise: Introduce low-intensity aerobic exercise early in recovery to enhance healing (Evidence: Moderate 324).
  • Involve Shared Decision-Making: Especially critical in pediatric populations to ensure informed decisions about return to sport (Evidence: Moderate 219).
  • Monitor for Prolonged Symptoms: Utilize specific symptom triage tools to predict prolonged recovery (Evidence: Moderate 16).
  • References

    Showing 100 most recent of 272 indexed papers.

    1 Miller JJ, Hansen K, Dorman J, Jensen K, Gurumoorthy A, Combs J. Sports Medicine Physician Confidence in Concussion Assessments for Postconcussion Return-to-Play Decisions. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 2025. link 2 Kroshus-Havril E, Opel DJ, Jinguji TM, Steiner MK, Senturia K, MacDonald JP et al.. Shared Decision-Making About Returning to Sport After Recovery From Pediatric Concussion: Clinician Perspectives. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 2025. link 3 McPherson JI, Miecznikowski JC, Chizuk H, Sparks P, Leddy JJ, Haider MN et al.. Feasibility trial protocol assessing the use of aerobic exercise to promote recovery from work-related concussion. PloS one 2025. link 4 Pearce AJ, Wirth P, Fitts M. Just a head knock? Emergency physicians need to get serious about concussion. Emergency medicine Australasia : EMA 2024. link 5 Broglio SP, Register-Mihalik JK, Guskiewicz KM, Leddy JJ, Merriman A, Valovich McLeod TC. National Athletic Trainers' Association Bridge Statement: Management of Sport-Related Concussion. Journal of athletic training 2024. link 6 Romeas T, Croteau F, Leclerc S. Where is the research on sport-related concussion in Olympic athletes? A descriptive report and assessment of the impact of access to multidisciplinary care on recovery. British journal of sports medicine 2024. link 7 McNamee M, Anderson LC, Borry P, Camporesi S, Derman W, Holm S et al.. Sport-related concussion research agenda beyond medical science: culture, ethics, science, policy. Journal of medical ethics 2024. link 8 Schneider KJ, Critchley ML, Anderson V, Davis GA, Debert CT, Feddermann-Demont N et al.. Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review. British journal of sports medicine 2023. link 9 Inclan PM, Kuhn AW, Chang PS, Mack C, Solomon GS, Sills AK et al.. Validity of Research Based on Publicly Obtained Data in Sports Medicine: A Quantitative Assessment of Concussions in the National Football League. Sports health 2023. link 10 Cusack B, Cash M, Tuohy K, Brady-Olympia J, Olympia RP. Management of Acute Injury and Illness in Pediatric Athletes by Athletic Trainers: Compliance With Emergency Medicine and Athletic Trainer Evidence-Based Guidelines. Pediatric emergency care 2023. link 11 Memmini AK, Kinnett-Hopkins DL, Hasson RE, Rifat SF, Broglio SP. Considerations for Implementing the Post-Concussion Collegiate Return-to-Learn Protocol in the National Collegiate Athletic Association Power 5 Conferences. The Journal of head trauma rehabilitation 2023. link 12 Lempke LB, Bergeron G, O'Connor S, Lynall RC, Resch JE, Walton SR. Concussion Assessment and Management Practices Among Irish and Canadian Athletic Therapists: An International Perspective. Journal of athletic training 2023. link 13 Miller SM, Zynda AJ, Sabatino MJ, Jo C, Ellis HB, Dimeff RJ. A Pilot Randomized Controlled Trial of Docosahexaenoic Acid for the Treatment of Sport-Related Concussion in Adolescents. Clinical pediatrics 2022. link 14 Harris SA, Dempsey AR, Mackie K, King D, Hecimovich M, Murphy MC. Do Sideline Tests of Vestibular and Oculomotor Function Accurately Diagnose Sports-Related Concussion in Adults? A Systematic Review and Meta-analysis. The American journal of sports medicine 2022. link 15 Corwin DJ, Root JM, Zonfrillo MR, Thomas DG. Concussion Referral and Practice Patterns by Pediatric Emergency Medicine Providers. Pediatric emergency care 2022. link 16 Robinson M, Johnson AM, Fischer LK, MacKenzie HM. Two Symptoms to Triage Acute Concussions: Using Decision Tree Modeling to Predict Prolonged Recovery After a Concussion. American journal of physical medicine & rehabilitation 2022. link 17 Bytomski J. Sports Medicine: Concussion. FP essentials 2022. link 18 McPherson JI, Saleem GT, Haider MN, Leddy JJ, Torres D, Willer BS. Development of a Telehealth Examination for Sport-Related Concussion in the Outpatient Setting. Neurology 2022. link 19 Skeel R, Maffett A, Feder A, Mitzkovitz C, Lesica S. Youth Concussion Management Practices Among Athletic Trainers: A Vignette-Based Survey. Journal of sport rehabilitation 2022. link 20 McLarnon M, Boyce SH, Fisher N, Heron N. 'It's All Downhill from Here': A Scoping Review of Sports-Related Concussion (SRC) Protocols in Downhill Mountain Biking (DHI), with Recommendations for SRC Policy in Professional DMB. International journal of environmental research and public health 2022. link 21 Master CL, Bacal D, Grady MF, Hertle R, Shah AS, Strominger M et al.. Vision and Concussion: Symptoms, Signs, Evaluation, and Treatment. Pediatrics 2022. link 22 Piedade SR, Hutchinson MR, Ferreira DM, Cristante AF, Maffulli N. The management of concussion in sport is not standardized. A systematic review. Journal of safety research 2021. link 23 Howell DR, Seehusen CN, Walker GA, Reinking S, Wilson JC. Neuromuscular training after concussion to improve motor and psychosocial outcomes: A feasibility trial. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine 2021. link 24 . Moderate Activity After Concussion Improves Healing. The American journal of nursing 2021. link 25 Sohlberg MM, Mashima PA. Editors' Foreword: Knowledge and Skill Competencies for Speech-Language Pathology Management of Concussion. American journal of speech-language pathology 2021. link 26 Root JM, Fong J, Badolato G, Madati PJ. Rest-Based Concussion Management of Pediatric Emergency Medicine Providers. Pediatric emergency care 2021. link 27 Pickett B, Bytomski JR, Zafonte RD. Evidence based management of sports related concussion. Journal of osteopathic medicine 2021. link 28 Herring S, Kibler WB, Putukian M, S Solomon G, Boyajian-O'Neill L, Dec KL et al.. Selected Issues in Sport-Related Concussion (SRC | Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement. Current sports medicine reports 2021. link 29 Kriz PK, Roberts WO. Prevention of Sport-Related Concussion. Clinics in sports medicine 2021. link 30 Quintana CP, McLeod TCV, Olson AD, Heebner NR, Hoch MC. Vestibular and Ocular/Oculomotor Assessment Strategies and Outcomes Following Sports-Related Concussion: A Scoping Review. Sports medicine (Auckland, N.Z.) 2021. link 31 Casper ST, Bachynski KE, Buckland ME, Comrie D, Gandy S, Gates J et al.. Toward Complete, Candid, and Unbiased International Consensus Statements on Concussion in Sport. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics 2021. link 32 Gibb TS, Redinger K, Fealko C, Parikh S. Considerations for Pediatric Retirement from Athletics Following Repetitive Concussive Traumatic Brain Injury: Incorporating the Right to an Open Future. International journal of environmental research and public health 2021. link 33 Herring S, Kibler WB, Putukian M, Solomon GS, Boyajian-O'Neill L, Dec KL et al.. Selected issues in sport-related concussion (SRC|mild traumatic brain injury) for the team physician: a consensus statement. British journal of sports medicine 2021. link 34 Giza CC, McCrea M, Huber D, Cameron KL, Houston MN, Jackson JC et al.. Assessment of Blood Biomarker Profile After Acute Concussion During Combative Training Among US Military Cadets: A Prospective Study From the NCAA and US Department of Defense CARE Consortium. JAMA network open 2021. link 35 Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, Landel R, Alsalaheen BA, Hanke TA et al.. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. The Journal of orthopaedic and sports physical therapy 2020. link 36 Bazarian JJ, Raukar N, Devera G, Ellis J, Feden J, Gemme SR et al.. Recommendations for the Emergency Department Prevention of Sport-Related Concussion. Annals of emergency medicine 2020. link 37 Gravel J, Ledoux AA, Tang K, Yeates KO, Craig W, Osmond M et al.. Early versus delayed emergency department presentation following mild Traumatic Brain Injury and the presence of symptom at 1, 4 and 12 weeks in children. Emergency medicine journal : EMJ 2020. link 38 Misch MR, Raukar NP. Sports Medicine Update: Concussion. Emergency medicine clinics of North America 2020. link 39 Northam WT, Cools MJ, Chandran A, Alexander A, Mihalik JP, Guskiewicz KM et al.. Sports Medicine Fellowship Training Improves Sport-related Concussion Evaluation. Current sports medicine reports 2020. link 40 Apple RW, Stran BM, Tross B. Psychologists' Role in Concussion Assessments for Children and Adolescents in Pediatric Practice. International journal of environmental research and public health 2020. link 41 Anderson M, Petit KM, Bretzin AC, Elbin RJ, Stephenson KL, Covassin T. Sport Concussion Assessment Tool Symptom Inventory: Healthy and Acute Postconcussion Symptom Factor Structures. Journal of athletic training 2020. link 42 Mang CS, Whitten TA, Cosh MS, Dukelow SP, Benson BW. Assessment of Postural Stability During an Upper Extremity Rapid, Bimanual Motor Task After Sport-Related Concussion. Journal of athletic training 2020. link 43 Davis GA, Makdissi M, Bloomfield P, Clifton P, Cowie C, Echemendia R et al.. Concussion Guidelines in National and International Professional and Elite Sports. Neurosurgery 2020. link 44 Yue JK, Phelps RRL, Chandra A, Winkler EA, Manley GT, Berger MS. Sideline Concussion Assessment: The Current State of the Art. Neurosurgery 2020. link 45 Yeo PC, Yeo EQY, Probert J, Sim SHS, Sirisena D. A Systematic Review and Qualitative Analysis of Concussion Knowledge amongst Sports Coaches and Match Officials. Journal of sports science & medicine 2020. link 46 Patsimas T, Howell DR, Potter MN, Provance AJ, Kirkwood MW, Wilson JC. Concussion-Symptom Rating Correlation Between Pediatric Patients and Their Parents. Journal of athletic training 2020. link 47 Kroshus E, Cameron KL, Coatsworth JD, D'Lauro C, Kim E, Lee K et al.. Improving concussion education: consensus from the NCAA-Department of Defense Mind Matters Research & Education Grand Challenge. British journal of sports medicine 2020. link 48 Lempke LB, Schmidt JD, Lynall RC. Concussion Knowledge and Clinical Experience Among Athletic Trainers: Implications for Concussion Health Care Practices. Journal of athletic training 2020. link 49 Bowman TG, Singe SM, Pike Lacy AM, Register-Mihalik JK. Challenges Faced by Collegiate Athletic Trainers, Part II: Treating Concussed Student-Athletes. Journal of athletic training 2020. link 50 Lempke LB, Schmidt JD, Lynall RC. Athletic Trainers' Concussion-Assessment and Concussion-Management Practices: An Update. Journal of athletic training 2020. link 51 Asken BM, Houck ZM, Schmidt JD, Bauer RM, Broglio SP, McCrea MA et al.. A Normative Reference vs. Baseline Testing Compromise for ImPACT: The CARE Consortium Multiple Variable Prediction (CARE-MVP) Norms. Sports medicine (Auckland, N.Z.) 2020. link 52 O'Connor S, Warrington G, Whelan G, McGoldrick A, Cullen S. Concussion History, Reporting Behaviors, Attitudes, and Knowledge in Jockeys. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 2020. link 53 Mubayed L, Romme A, Nguyen HH. QT Prolongation After Minor Head Trauma in a Pediatric Patient. Pediatric cardiology 2020. link 54 Provencher MT, Frank RM, Shubert DJ, Sanchez A, Murphy CP, Zafonte RD. Concussions in Sports. Orthopedics 2019. link 55 Hardesty W, Singichetti B, Yi H, Leonard JC, Yang J. Characteristics and Costs of Pediatric Emergency Department Visits for Sports- and Recreation-Related Concussions, 2006-2014. The Journal of emergency medicine 2019. link 56 Linder SM, Cruickshank J, Zimmerman NM, Figler R, Alberts JL. A technology-enabled electronic incident report to document and facilitate management of sport concussion: A cohort study of youth and young adults. Medicine 2019. link 57 Simoneau GG. 2018 JOSPT Award Recipients. The Journal of orthopaedic and sports physical therapy 2019. link 58 Kuemmerle K, Meehan WP. Treatment of Pediatric Concussion. Seminars in pediatric neurology 2019. link 59 Kontos AP, Sufrinko A, Sandel N, Emami K, Collins MW. Sport-related Concussion Clinical Profiles: Clinical Characteristics, Targeted Treatments, and Preliminary Evidence. Current sports medicine reports 2019. link 60 Ho GWK, Leggit JC. Sports Medicine: Sports Event Care and Return to Play. FP essentials 2019. link 61 Doperak J, Anderson K, Collins M, Emami K. Sport-Related Concussion Evaluation and Management. Clinics in sports medicine 2019. link 62 Comeau D, Pfeifer N. Diagnosis of Concussion on the Sidelines. Seminars in pediatric neurology 2019. link 63 Kroshus E, Gonzalez LA, Chrisman SPD, Jimenez N. Availability of Concussion Information in Spanish for Parents of Youth Athletes. Health promotion practice 2019. link 64 Harmon KG, Clugston JR, Dec K, Hainline B, Herring S, Kane SF et al.. American Medical Society for Sports Medicine position statement on concussion in sport. British journal of sports medicine 2019. link 65 Neidecker J, Sethi NK, Taylor R, Monsell R, Muzzi D, Spizler B et al.. Concussion management in combat sports: consensus statement from the Association of Ringside Physicians. British journal of sports medicine 2019. link 66 Baker JG, Willer BS, Leddy JJ. Integrating Neuropsychology Services in a Multidisciplinary Concussion Clinic. The Journal of head trauma rehabilitation 2019. link 67 Lininger MR, Wayment HA, Craig DI, Huffman AH, Lane TS. Improving Concussion-Reporting Behavior in National Collegiate Athletic Association Division I Football Players: Evidence for the Applicability of the Socioecological Model for Athletic Trainers. Journal of athletic training 2019. link 68 Harmon KG, Clugston JR, Dec K, Hainline B, Herring SA, Kane S et al.. American Medical Society for Sports Medicine Position Statement on Concussion in Sport. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 2019. link 69 Hill T, Orchard J, Kountouris A. Incidence of Concussion and Head Impacts in Australian Elite-Level Male and Female Cricketers After Head Impact Protocol Modifications. Sports health 2019. link 70 Breedlove KM, Ortega JD, Kaminski TW, Harmon KG, Schmidt JD, Kontos AP et al.. King-Devick Test Reliability in National Collegiate Athletic Association Athletes: A National Collegiate Athletic Association-Department of Defense Concussion Assessment, Research and Education Report. Journal of athletic training 2019. link 71 Davis GA, Makdissi M, Bloomfield P, Clifton P, Echemendia RJ, Falvey ÉC et al.. International consensus definitions of video signs of concussion in professional sports. British journal of sports medicine 2019. link 72 Clugston JR, Houck ZM, Asken BM, Boone JK, Kontos AP, Buckley TA et al.. Relationship Between the King-Devick Test and Commonly Used Concussion Tests at Baseline. Journal of athletic training 2019. link 73 Hunter-Giordano A, McCulloch KL, Elliott JM. How Do We Meet the Challenges of Assessing and Managing Concussion?. The Journal of orthopaedic and sports physical therapy 2019. link 74 Davis GA, Makdissi M, Bloomfield P, Clifton P, Echemendia RJ, Falvey ÉC et al.. International study of video review of concussion in professional sports. British journal of sports medicine 2019. link 75 Smith AM, Alford PA, Aubry M, Benson B, Black A, Brooks A et al.. Proceedings from the Ice Hockey Summit III: Action on Concussion. Current sports medicine reports 2019. link 76 Scorza KA, Cole W. Current Concepts in Concussion: Initial Evaluation and Management. American family physician 2019. link 77 Broglio SP, Harezlak J, Katz B, Zhao S, McAllister T, McCrea M. Acute Sport Concussion Assessment Optimization: A Prospective Assessment from the CARE Consortium. Sports medicine (Auckland, N.Z.) 2019. link 78 Foster CA, D'Lauro C, Johnson BR. Pilots and athletes: Different concerns, similar concussion non-disclosure. PloS one 2019. link 79 Thompson A, Chechulin Y, Bain D, Bayley M. An Evidence-Based Care Model for Workers With Concussion. The Journal of head trauma rehabilitation 2019. link 80 Zolot J. First Guidelines for Diagnosing and Managing Concussion in Kids. The American journal of nursing 2018. link 81 Sirisena D, Walter J, Ong JH, Probert J. Pilot single-centre cross-sectional study to determine emergency physicians' knowledge and management of sports concussion: an experience from Singapore. Singapore medical journal 2018. link 82 Boutis K, Gravel J, Freedman SB, Craig W, Tang K, DeMatteo CA et al.. The Diagnosis of Concussion in Pediatric Emergency Departments: A Prospective Multicenter Study. The Journal of emergency medicine 2018. link 83 Shirley E, Hudspeth LJ, Maynard JR. Managing Sports-related Concussions From Time of Injury Through Return to Play. The Journal of the American Academy of Orthopaedic Surgeons 2018. link 84 Parsons JT, Baugh C. The evolving landscape of policies, rules, and law in sport-related concussion. Handbook of clinical neurology 2018. link 85 Niederer D, Engeroff T, Lange K, Vogt L, Banzer W. Return-to-play after concussion: state of knowledge, frequency of use and application barriers of guidelines among decision-makers in rugby. Brain injury 2018. link 86 Cripps A, Livingston S, Jiang Y, Mattacola C, Kitzman P, McKeon P et al.. Visual perturbation impacts upright postural stability in athletes with an acute concussion. Brain injury 2018. link 87 Howell DR, Brilliant AN, Storey EP, Podolak OE, Meehan WP, Master CL. Objective Eye Tracking Deficits Following Concussion for Youth Seen in a Sports Medicine Setting. Journal of child neurology 2018. link 88 OʼKeefe KA, Beamon B, Brewer KL, Niceler B. Sports-Related Concussions in Children: Differences in Care and Expectations When Seen in an Emergency Department Versus a Sports Medicine Clinic. Pediatric emergency care 2018. link 89 Ellenbogen RG, Batjer H, Cardenas J, Berger M, Bailes J, Pieroth E et al.. National Football League Head, Neck and Spine Committee's Concussion Diagnosis and Management Protocol: 2017-18 season. British journal of sports medicine 2018. link 90 Echemendia RJ, Bruce JM, Meeuwisse W, Hutchison MG, Comper P, Aubry M. Can visible signs predict concussion diagnosis in the National Hockey League?. British journal of sports medicine 2018. link 91 Asken BM, Bauer RM, Guskiewicz KM, McCrea MA, Schmidt JD, Giza CC et al.. Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes. The American journal of sports medicine 2018. link 92 Kosoy J, Feinstein R. Evaluation and Management of Concussion in Young Athletes. Current problems in pediatric and adolescent health care 2018. link 93 Halstead ME, Walter KD, Moffatt K. Sport-Related Concussion in Children and Adolescents. Pediatrics 2018. link 94 Williamson CL, Norte GE, Broshek DK, Hart JM, Resch JE. Return to Learn After Sport-Related Concussion: A Survey of Secondary School and Collegiate Athletic Trainers. Journal of athletic training 2018. link 95 Davies S, Coxe K, Harvey HH, Singichetti B, Guo J, Yang J. Qualitative Evaluation of High School Implementation Strategies for Youth Sports Concussion Laws. Journal of athletic training 2018. link 96 Russell JA, Daniell BM. Concussion in Theater: A Cross-Sectional Survey of Prevalence and Management in Actors and Theater Technicians. Journal of occupational and environmental medicine 2018. link 97 Elkington LJ, Hughes DC. Australian Institute of Sport and Australian Medical Association position statement on concussion in sport. The Medical journal of Australia 2017. link 98 Podell K, Presley C, Derman H. Sideline Sports Concussion Assessment. Neurologic clinics 2017. link 99 McCrea MA, Nelson LD, Guskiewicz K. Diagnosis and Management of Acute Concussion. Physical medicine and rehabilitation clinics of North America 2017. link 100 Cahill PJ, Refakis C, Storey E, Warner WC. Concussion in Sports: What Do Orthopaedic Surgeons Need to Know?. Instructional course lectures 2017. link

    Original source

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