Pediatric Sport-Related Concussion: Recommendations From the Amsterdam Consensus Statement 2023.

Journal: Pediatrics

Volume: 153

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Murdoch Children's Research Institute, Melbourne, Victoria, Australia. Sport Injury Prevention Research Centre, Faculty of Kinesiology. University of Queensland, Children's Hospital and Health Services,Brisbane, Queensland, Australia. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, Massachusetts. University of Padova, Padova, Italy. University of Michigan Concussion Center, Ann Arbor, Michigan. University Orthopedics Concussion Care Clinic, State College, Pennsylvania. McGill University, Montreal, Quebec, Canada. Children's National Hospital, Rockville, Maryland. UCLA Mattel Children's Hospital, Los Angeles, California. University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York. University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Medical College of Wisconsin, Milwaukee, Wisconsin. KU Leuven, Belgium. Boston Children's Hospital, Boston, Massachusetts. Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. Major League Soccer, Princeton, New Jersey. Sports Concussion Center of New Jersey, Princeton, New Jersey. Hotchkiss Brain Institute. Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada. Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract summary 

The 6th International Consensus Conference on Concussion in Sport, Amsterdam 2022, addressed sport-related concussion (SRC) in adults, adolescents, and children. We highlight the updated evidence-base and recommendations regarding SRC in children (5-12 years) and adolescents (13-18 years). Prevention strategies demonstrate lower SRC rates with mouthguard use, policy disallowing bodychecking in ice hockey, and neuromuscular training in adolescent rugby. The Sport Concussion Assessment Tools (SCAT) demonstrate robustness with the parent and child symptom scales, with the best diagnostic discrimination within the first 72 hours postinjury. Subacute evaluation (>72 hours) requires a multimodal tool incorporating symptom scales, balance measures, cognitive, oculomotor and vestibular, mental health, and sleep assessment, to which end the Sport Concussion Office Assessment Tools (SCOAT6 [13+] and Child SCOAT6 [8-12]) were developed. Rather than strict rest, early return to light physical activity and reduced screen time facilitate recovery. Cervicovestibular rehabilitation is recommended for adolescents with dizziness, neck pain, and/or headaches for greater than 10 days. Active rehabilitation and collaborative care for adolescents with persisting symptoms for more than 30 days may decrease symptoms. No tests and measures other than standardized and validated symptom rating scales are valid for diagnosing persisting symptoms after concussion. Fluid and imaging biomarkers currently have limited clinical utility in diagnosing or assessing recovery from SRC. Improved paradigms for return to school were developed. The variable nature of disability and differences in evaluating para athletes and those of diverse ethnicity, sex, and gender are discussed, as are ethical considerations and future directions in pediatric SRC research.

Authors & Co-authors:  Davis Gavin A GA Schneider Kathryn J KJ Anderson Vicki V Babl Franz E FE Barlow Karen M KM Blauwet Cheri A CA Bressan Silvia S Broglio Steven P SP Emery Carolyn A CA Echemendia Ruben J RJ Gagnon Isabelle I Gioia Gerard A GA Giza Christopher C CC Leddy John J JJ Master Christina L CL McCrea Michael M McNamee Michael J MJ Meehan William P WP Purcell Laura L Putukian Margot M Moser Rosemarie Scolaro RS Takagi Michael M Yeates Keith Owen KO Zemek Roger R Patricios Jon S JS

Study Outcome 

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Statistics
Citations : 
Authors :  25
Identifiers
Doi : e2023063489
SSN : 1098-4275
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
United States