National Athletic Trainers Association Bridge Statement: Management of Sport-Related Concussion

Objective

• Update recommendations from the 2014 NATA concussion position statement.
• Focus on education, assessment, prognostic factors, mental health, return to academics, physical activity, rest, treatment, and return to sport.

Background

• Previous NATA statements are outdated; new medical literature necessitates updates.
• Significant increases in concussion awareness, recognition, and reporting.
• Annual incidence in the US: 1.1-1.9 million under 18 years, 10,560 in collegiate sports.
• The document bridges 2014 statement to current evidence and practices.

Recommendations

Education and Prevention

• Updated recommendations provided, emphasizing stakeholder involvement.
• Unchallengeable authority of licensed medical personnel in decision-making.
• Social determinants and cultural factors should be considered.

Assessment Advances

• Significant changes in assessment tools and timing.
• Broad approach under biopsychosocial model recommended.
• Mental health screening should be incorporated.

Baseline Testing

• Not essential unless required by specific guidelines.
• Absence of baseline data still allows for effective recovery assessment.

Assessment Domains

• Emphasizes vision/vestibulo-ocular exams as part of assessment.
• Multiple tests available; familiarity with each test’s administration and interpretation is required.

Postinjury Testing

• Clinical examination remains the standard for decision-making.
• Cervical spine evaluation is crucial to rule out severe injuries.

Prognostic Factors for Recovery

• Initial symptom burden closely linked to recovery time.
• Early medical evaluation facilitates faster recovery.

Mental Health Considerations

• New recommendations focus on integrating mental health assessment and support.
• Preexisting mental health conditions can influence recovery.

Cognitive Activity and Return to School

• Individualized return-to-school plans necessary.
• Parallel implementation of return-to-school and return-to-play is advised.

Physical Activity, Rehabilitation, and Return to Sport

• Early, controlled aerobic exercise recommended.
• Protocols should consider unique demands of different sports.
• Clinician monitoring of exercise intensity is crucial.

Conclusion

• Advances in concussion management highlighted.
• Emphasizes adopting biopsychosocial model and integrating social and cultural factors.
• Encourages interprofessional care and staying updated with evolving science.

Acknowledgments

• Previous authors, Pronouncements Committee, and practicing ATs acknowledged.

Disclaimer

• Position statements should be considered as a resource, not an independent basis for care.

References

• Extensive references provided for further reading and validation of data.