Post-concussion return to play and return to school guidelines for children and youth: a scoping methodology

DeMatteo, Carol; McCauley, Dayle; Stazyk, Kathy; Harper, Jack; Adamich, John; Randall, Sarah; Missiuna, Cheryl

doi:10.3109/09638288.2014.952452

Cited by 34 publications

(32 citation statements)

References 58 publications

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“…63 Only 1 research group, 64À66 to date, has aimed to develop pediatric-specific protocols for return to activity and return to school. Using scoping methods, DeMatteo et al 64 aimed to identify and describe the management strategies used by health care providers and the evidence supporting or refuting each strategy. The review of 400 possible articles included information from 10 studies and 3 Web sites; however, none of the guidelines were specific to the younger population.…”

Section: Discussionmentioning

confidence: 99%

Rest and Return to Activity After Sport-Related Concussion: A Systematic Review of the Literature

McLeod

Lewis

Whelihan

et al. 2017

Journal of Athletic Training

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Our main findings suggest that rest is underused by health care providers, recommendations for rest are broad and not specific to individual patients, an initial period of moderate physical and cognitive rest (eg, limited physical activity and light mental activity) may improve outcomes during the acute postinjury phase, significant variability in the use of assessment tools and compliance with recommended return-to-activity guidelines exists, and additional research is needed to empirically evaluate the effectiveness of graded return-to-activity progressions. Furthermore, there is a significant need to translate knowledge of best practices in concussion management to primary care providers.

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Section: Discussionmentioning

confidence: 99%

Rest and Return to Activity After Sport-Related Concussion: A Systematic Review of the Literature

McLeod

Lewis

Whelihan

et al. 2017

Journal of Athletic Training

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“…Taken together, the results from this study support an early return to exercise and socialization after paediatric mTBI. The timeframe of return in our animal studies roughly correlates to the ‘clinical’ 5–7 days of rest (rat to human timeline correlation) currently validated by concussion experts (McCrory et al ., ), but which are largely based on adults and does not consider ‘return‐to‐school’ (DeMatteo et al ., ). Further, in experienced concussion/mTBI centres, it has become increasing recognized that the approach to timing of ‘return‐to‐learn/play’ should be individualized (Purcell, ; McCrory et al ., ).…”

Section: Limitations Clinical Implications and Conclusionmentioning

confidence: 97%

Reducing the time interval between concussion and voluntary exercise restores motor impairment, short‐term memory, and alterations to gene expression

Mychasiuk

Hehar

et al. 2016

Eur J of Neuroscience

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Despite the most common form of brain injury, there has been little progress in the prognosis and treatment of concussion/mild traumatic brain injury (mTBI). Current 'return-to-play' guidelines are conservative, deterring the initiation of physical and social activity until patients are asymptomatic; but the effects of post-injury exercise have not been adequately investigated. Therefore, this study examined the effects of voluntary exercise on concussion recovery. Using a translational rodent model of concussion, we examined the influence of exercise on injury-associated behaviours that comprise post-concussive syndrome (PCS) and gene expression changes (bdnf, dnmt1, Igf-1, pgc1-a, Tert) in prefrontal cortex and hippocampus. In addition, as we have previously demonstrated telomere length (TL) to be a reliable predictor of mTBI prognosis, TL was also examined. The results suggest that exercise initiated within 1-3 days post-concussion significantly improved motor and cognitive functioning, but had limited efficacy treating emotional impairments. What is more, when deprived of social interaction and exercise, a combination similar to clinical recommendations for rest until symptom resolution, animals did not recover and exhibited impairments similar to typical mTBI animals. Exercise aided in restoration of mTBI-induced modifications to gene expression in both brain regions. An inverse relationship between the exercise return interval and TL was identified, indicating greater recovery with acute exercise reinstatement. Although additional strategies may need to be employed for emotional functioning, these findings support re-evaluation of 'returnto-play' guidelines, suggesting that exercise is valuable for the treatment of concussion.

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“…Scoping reviews are literary searches that are used to provide a preliminary assessment of the size and scope of a body of literature as well as identify strengths, weaknesses and gaps in the research 18 19. Scoping reviews have been used to summarise bodies of literature on concussion rehabilitation strategies20 and on other health-related issues like Alzheimer's disease,21 HIV rehabilitation22 and in settings such as trauma centres23 and intensive care facilities 24. Because research on concussion education programmes is relatively new, a scoping review is ideal to determine the state of these education programmes.…”

Section: Introductionmentioning

confidence: 99%

An examination of concussion education programmes: a scoping review methodology

et al. 2015

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ObjectivesThe primary purpose was to review the literature on concussion education programmes. The secondary purpose was to inform knowledge translation strategies for concussion researchers and practitioners. Design Research on concussion education programmes is relatively new. As a result, the current study implemented a scoping review methodology, which is a type of literary search used to provide a preliminary assessment of the size and scope of a body of literature, as well as identify strengths, weaknesses and gaps in the research. Methods A five-stage process for conducting a scoping review was followed for this study: (a) identifying the research questions, (b) identifying relevant studies, (c) identifying the study selection criteria, (d) charting the data and (e) reporting the results. Results Concussion education programmes have been developed and implemented with populations ranging in age from 9 to 49 years and have used interactive oral presentations, educational videos and computer-based learning programmes. Although the content of these programmes varied, the topics generally addressed salient aspects of concussion injury and recovery. Quantitative instruments have been the preferred methods for assessment. Conclusions Education programmes aimed at improving participants' long-term concussion knowledge, behaviours and attitudes of concussions are needed. Researchers must consider using a knowledge translation framework to enhance concussion education programmes. The application of such a framework can lead to novel and interesting ways of disseminating information about concussive injury and recovery.

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Post-concussion return to play and return to school guidelines for children and youth: a scoping methodology

Cited by 34 publications

References 58 publications

Rest and Return to Activity After Sport-Related Concussion: A Systematic Review of the Literature

Rest and Return to Activity After Sport-Related Concussion: A Systematic Review of the Literature

Reducing the time interval between concussion and voluntary exercise restores motor impairment, short‐term memory, and alterations to gene expression

An examination of concussion education programmes: a scoping review methodology

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