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Does removal from play post-concussion really make a difference in overall recovery time? :

October 7, 2016

We are all aware of the importance of recognizing the signs and symptoms of concussion on an athletic field and recommending that a child be removed from play immediately.

We are all aware of the importance of recognizing the signs and symptoms of concussion on an athletic field and recommending that a child be removed from play immediately. But as we also know, concussions often occur without loss of consciousness, and if the concussion occurs during a practice when a trained medical specialist may not be present, a child or teen may insist they are ok and want to return to play immediately. Given that they say they are OK, does an immediate return to play affect overall concussion recovery time?

Elbin et al. (10.1542/peds.2016-0910) wanted to study this question, and have done so using a prospective study design comparing athletes who were and were not immediately removed from play after experiencing a sports-related concussion.  The authors looked at neurocognitive performance and symptom scores at baseline and a week to one month after the head injury as well as overall recovery time in these athletes.  The results are dramatic, showing substantive and significant differences in neurocognitive abilities, symptoms and twice the duration to recover (44 days versus 21 days) if athletes are returned to play immediately.  

If you are looking for some solid evidence to convince your patients (and their parents) why a concussion requires immediate removal from play even without loss of consciousness, then heads-up on this article which provides strong supporting evidence for the concussion policies that coaches and athletes should be adhering to.

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