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When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review

Michael Makdissi Orcid Logo, Meghan L Critchley Orcid Logo, Robert C Cantu, Jeffrey G Caron Orcid Logo, Gavin A Davis Orcid Logo, Ruben J Echemendia Orcid Logo, Pierre Fremont Orcid Logo, K Alix Hayden Orcid Logo, Stanley A Herring, Sidney R Hinds Orcid Logo, Barry Jordan, Simon Kemp Orcid Logo, Michael McNamee Orcid Logo, David Maddocks, Shinji Nagahiro, Jon Patricios Orcid Logo, Margot Putukian Orcid Logo, Michael Turner Orcid Logo, Stacy Sick, Kathryn J Schneider Orcid Logo

British Journal of Sports Medicine, Volume: 57, Issue: 12, Pages: 822 - 830

Swansea University Author: Michael McNamee Orcid Logo

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DOI (Published version): 10.1136/bjsports-2023-106815

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Objective To systematically review the scientific literature regarding factors to consider when providing advice or guidance to athletes about retirement from contact or collision sport following sport-related concussion (SRC), and to define contraindications to children/adolescent athletes entering...

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Published in: British Journal of Sports Medicine
ISSN: 0306-3674 1473-0480
Published: BMJ 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa63689
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A systematic review</title><swanseaauthors><author><sid>85b0b1623e55d977378622a6aab7ee6e</sid><ORCID>0000-0002-5857-909X</ORCID><firstname>Michael</firstname><surname>McNamee</surname><name>Michael McNamee</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-06-22</date><deptcode>STSC</deptcode><abstract>Objective To systematically review the scientific literature regarding factors to consider when providing advice or guidance to athletes about retirement from contact or collision sport following sport-related concussion (SRC), and to define contraindications to children/adolescent athletes entering or continuing with contact or collision sports after SRC.Data sources Medline, Embase, SPORTSDiscus, APA PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials were searched systematically.Study eligibility criteria Studies were included if they were (1) original research, (2) reported on SRC as the primary source of injury, (3) evaluated the history, clinical assessment and/or investigation of findings that may preclude participation in sport and (4) evaluated mood disturbance and/or neurocognitive deficits, evidence of structural brain injury or risk factors for increased risk of subsequent SRC or prolonged recovery.Results Of 4355 articles identified, 93 met the inclusion criteria. None of the included articles directly examined retirement and/or discontinuation from contact or collision sport. Included studies examined factors associated with increased risk of recurrent SRC or prolonged recovery following SRC. In general, these were low-quality cohort studies with heterogeneous results and moderate risk of bias. Higher number and/or severity of symptoms at presentation, sleep disturbance and symptom reproduction with Vestibular Ocular Motor Screen testing were associated with prolonged recovery and history of previous concussion was associated with a risk of further SRC.Conclusion No evidence was identified to support the inclusion of any patient-specific, injury-specific or other factors (eg, imaging findings) as absolute indications for retirement or discontinued participation in contact or collision sport following SRC.</abstract><type>Journal Article</type><journal>British Journal of Sports Medicine</journal><volume>57</volume><journalNumber>12</journalNumber><paginationStart>822</paginationStart><paginationEnd>830</paginationEnd><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0306-3674</issnPrint><issnElectronic>1473-0480</issnElectronic><keywords/><publishedDay>14</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-06-14</publishedDate><doi>10.1136/bjsports-2023-106815</doi><url>http://dx.doi.org/10.1136/bjsports-2023-106815</url><notes>Systematic review</notes><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This systematic review was prepared for presentation at the 6th International Conference on Concussion in Sport in Amsterdam, October 2022. An education grant was received from the Concussion in Sport International Consensus Conference Organising Committee through Publi Creations for partial administrative and operational costs associated with the writing of the systematic reviews.</funders><projectreference/><lastEdited>2023-11-14T16:24:02.2547412</lastEdited><Created>2023-06-22T12:15:15.0095206</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Sport and Exercise Sciences</level></path><authors><author><firstname>Michael</firstname><surname>Makdissi</surname><orcid>0000-0003-0334-7133</orcid><order>1</order></author><author><firstname>Meghan L</firstname><surname>Critchley</surname><orcid>0000-0001-6803-1231</orcid><order>2</order></author><author><firstname>Robert C</firstname><surname>Cantu</surname><order>3</order></author><author><firstname>Jeffrey G</firstname><surname>Caron</surname><orcid>0000-0002-4972-2704</orcid><order>4</order></author><author><firstname>Gavin A</firstname><surname>Davis</surname><orcid>0000-0001-8293-4496</orcid><order>5</order></author><author><firstname>Ruben J</firstname><surname>Echemendia</surname><orcid>0000-0001-6116-8462</orcid><order>6</order></author><author><firstname>Pierre</firstname><surname>Fremont</surname><orcid>0000-0003-2810-8382</orcid><order>7</order></author><author><firstname>K Alix</firstname><surname>Hayden</surname><orcid>0000-0002-0057-1327</orcid><order>8</order></author><author><firstname>Stanley A</firstname><surname>Herring</surname><order>9</order></author><author><firstname>Sidney R</firstname><surname>Hinds</surname><orcid>0000-0003-2231-6770</orcid><order>10</order></author><author><firstname>Barry</firstname><surname>Jordan</surname><order>11</order></author><author><firstname>Simon</firstname><surname>Kemp</surname><orcid>0000-0002-3250-2713</orcid><order>12</order></author><author><firstname>Michael</firstname><surname>McNamee</surname><orcid>0000-0002-5857-909X</orcid><order>13</order></author><author><firstname>David</firstname><surname>Maddocks</surname><order>14</order></author><author><firstname>Shinji</firstname><surname>Nagahiro</surname><order>15</order></author><author><firstname>Jon</firstname><surname>Patricios</surname><orcid>0000-0002-6829-4098</orcid><order>16</order></author><author><firstname>Margot</firstname><surname>Putukian</surname><orcid>0000-0002-1478-8068</orcid><order>17</order></author><author><firstname>Michael</firstname><surname>Turner</surname><orcid>0000-0003-2323-2456</orcid><order>18</order></author><author><firstname>Stacy</firstname><surname>Sick</surname><order>19</order></author><author><firstname>Kathryn J</firstname><surname>Schneider</surname><orcid>0000-0002-5951-5899</orcid><order>20</order></author></authors><documents><document><filename>63689__28379__99d6600afaf2407bb1fa076c396d66b2.pdf</filename><originalFilename>63689AM.pdf</originalFilename><uploaded>2023-08-25T09:10:48.4759864</uploaded><type>Output</type><contentLength>414120</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling v2 63689 2023-06-22 When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review 85b0b1623e55d977378622a6aab7ee6e 0000-0002-5857-909X Michael McNamee Michael McNamee true false 2023-06-22 STSC Objective To systematically review the scientific literature regarding factors to consider when providing advice or guidance to athletes about retirement from contact or collision sport following sport-related concussion (SRC), and to define contraindications to children/adolescent athletes entering or continuing with contact or collision sports after SRC.Data sources Medline, Embase, SPORTSDiscus, APA PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials were searched systematically.Study eligibility criteria Studies were included if they were (1) original research, (2) reported on SRC as the primary source of injury, (3) evaluated the history, clinical assessment and/or investigation of findings that may preclude participation in sport and (4) evaluated mood disturbance and/or neurocognitive deficits, evidence of structural brain injury or risk factors for increased risk of subsequent SRC or prolonged recovery.Results Of 4355 articles identified, 93 met the inclusion criteria. None of the included articles directly examined retirement and/or discontinuation from contact or collision sport. Included studies examined factors associated with increased risk of recurrent SRC or prolonged recovery following SRC. In general, these were low-quality cohort studies with heterogeneous results and moderate risk of bias. Higher number and/or severity of symptoms at presentation, sleep disturbance and symptom reproduction with Vestibular Ocular Motor Screen testing were associated with prolonged recovery and history of previous concussion was associated with a risk of further SRC.Conclusion No evidence was identified to support the inclusion of any patient-specific, injury-specific or other factors (eg, imaging findings) as absolute indications for retirement or discontinued participation in contact or collision sport following SRC. Journal Article British Journal of Sports Medicine 57 12 822 830 BMJ 0306-3674 1473-0480 14 6 2023 2023-06-14 10.1136/bjsports-2023-106815 http://dx.doi.org/10.1136/bjsports-2023-106815 Systematic review COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University This systematic review was prepared for presentation at the 6th International Conference on Concussion in Sport in Amsterdam, October 2022. An education grant was received from the Concussion in Sport International Consensus Conference Organising Committee through Publi Creations for partial administrative and operational costs associated with the writing of the systematic reviews. 2023-11-14T16:24:02.2547412 2023-06-22T12:15:15.0095206 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Michael Makdissi 0000-0003-0334-7133 1 Meghan L Critchley 0000-0001-6803-1231 2 Robert C Cantu 3 Jeffrey G Caron 0000-0002-4972-2704 4 Gavin A Davis 0000-0001-8293-4496 5 Ruben J Echemendia 0000-0001-6116-8462 6 Pierre Fremont 0000-0003-2810-8382 7 K Alix Hayden 0000-0002-0057-1327 8 Stanley A Herring 9 Sidney R Hinds 0000-0003-2231-6770 10 Barry Jordan 11 Simon Kemp 0000-0002-3250-2713 12 Michael McNamee 0000-0002-5857-909X 13 David Maddocks 14 Shinji Nagahiro 15 Jon Patricios 0000-0002-6829-4098 16 Margot Putukian 0000-0002-1478-8068 17 Michael Turner 0000-0003-2323-2456 18 Stacy Sick 19 Kathryn J Schneider 0000-0002-5951-5899 20 63689__28379__99d6600afaf2407bb1fa076c396d66b2.pdf 63689AM.pdf 2023-08-25T09:10:48.4759864 Output 414120 application/pdf Accepted Manuscript true true eng
title When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review
spellingShingle When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review
Michael McNamee
title_short When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review
title_full When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review
title_fullStr When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review
title_full_unstemmed When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review
title_sort When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review
author_id_str_mv 85b0b1623e55d977378622a6aab7ee6e
author_id_fullname_str_mv 85b0b1623e55d977378622a6aab7ee6e_***_Michael McNamee
author Michael McNamee
author2 Michael Makdissi
Meghan L Critchley
Robert C Cantu
Jeffrey G Caron
Gavin A Davis
Ruben J Echemendia
Pierre Fremont
K Alix Hayden
Stanley A Herring
Sidney R Hinds
Barry Jordan
Simon Kemp
Michael McNamee
David Maddocks
Shinji Nagahiro
Jon Patricios
Margot Putukian
Michael Turner
Stacy Sick
Kathryn J Schneider
format Journal article
container_title British Journal of Sports Medicine
container_volume 57
container_issue 12
container_start_page 822
publishDate 2023
institution Swansea University
issn 0306-3674
1473-0480
doi_str_mv 10.1136/bjsports-2023-106815
publisher BMJ
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
url http://dx.doi.org/10.1136/bjsports-2023-106815
document_store_str 1
active_str 0
description Objective To systematically review the scientific literature regarding factors to consider when providing advice or guidance to athletes about retirement from contact or collision sport following sport-related concussion (SRC), and to define contraindications to children/adolescent athletes entering or continuing with contact or collision sports after SRC.Data sources Medline, Embase, SPORTSDiscus, APA PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials were searched systematically.Study eligibility criteria Studies were included if they were (1) original research, (2) reported on SRC as the primary source of injury, (3) evaluated the history, clinical assessment and/or investigation of findings that may preclude participation in sport and (4) evaluated mood disturbance and/or neurocognitive deficits, evidence of structural brain injury or risk factors for increased risk of subsequent SRC or prolonged recovery.Results Of 4355 articles identified, 93 met the inclusion criteria. None of the included articles directly examined retirement and/or discontinuation from contact or collision sport. Included studies examined factors associated with increased risk of recurrent SRC or prolonged recovery following SRC. In general, these were low-quality cohort studies with heterogeneous results and moderate risk of bias. Higher number and/or severity of symptoms at presentation, sleep disturbance and symptom reproduction with Vestibular Ocular Motor Screen testing were associated with prolonged recovery and history of previous concussion was associated with a risk of further SRC.Conclusion No evidence was identified to support the inclusion of any patient-specific, injury-specific or other factors (eg, imaging findings) as absolute indications for retirement or discontinued participation in contact or collision sport following SRC.
published_date 2023-06-14T16:24:06Z
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