Concussion is one of the most common injuries in sport and recreation, accounting for 15% of the overall injury burden in youth and collegiate sports, with the highest risk reported in contact and collision sports.
 The 5th International Consensus Statement on Concussion in Sport defines concussion as a “brain injury that results from a traumatic blow to the head or body with subsequent force transmission to the head”.  It is considered a functional injury (rather than a structural one), and thus neuroimaging findings are typically normal.  As such, no specific test is diagnostic of a concussion, and assessment should be comprised of a history, neurological evaluation, balance tests, cervical spine exam and cognitive assessment.  A multifaceted assessment is recommended as concussions present differently in each patient.  A collaborative approach among family physicians, sports-medicine physicians, physiotherapists, chiropractors, athletic therapists, neurologists, neuropsychologists and others is often the most appropriate care  Differential diagnosis, early management, re-evaluation, rehabilitation and the facilitation of return to school and sport are all critical components in the management of a patient with concussion.  

Concussions can result in a number of symptoms, most commonly headaches, dizziness, fatigue, difficulty concentrating or remembering, neck pain or irritability.  Concussion should be suspected if one or more symptom, physical sign, behavioural changes or cognitive impairment is present.  Proper management requires education of stakeholders (coaches, parents, athletes, officials, etc.) regarding the potential symptoms, so that athletes will be immediately removed and assessed.

A multifaceted assessment including history, neurological evaluation, balance tests, cervical spine exam and cognitive assessment should be conducted. In most cases, an initial period of physical and cognitive rest will be followed by a gradual return to sport and activity. While most patients will recover through this initial phase, in 20-30% of cases, symptoms will persist. In these cases, multidisciplinary rehabilitation may facilitate recovery.

concussion assessment
This 2-part Review summarizes the current state of the evidence regarding the assessment and rehabilitation of concussions, and assist in developing appropriate management plans in the acute and follow-up phases.


“Concussion – Multifaceted Assessment” & “Concussion – Multifaceted Rehabilitation”

Both papers were publisheded in Musculoskeletal Science and Practice (2019) and this Review is posted in Recent Reviews, Concussion and the 2019 Archive.

concussion rehabilitation