The American Academy of Neurology has released a new position paper that states doctors have an ethical obligation to educate and protect athletes from sports concussion and only give an athlete the "all-clear" to play when medically ready.
Concussions are common in high-speed contact sports, with football, rugby, hockey and soccer posing the greatest risk.
The American Academy of Neurology (AAN), the largest professional association of neurologists and the leading trusted authority in managing sports concussion, have resisted opposition from players, parents and coaches and published the position statement in their online medical journal, Neurology.
The statement has been released ahead of The Sports Concussion Conference taking place July 11-13, 2014, in Chicago, IL, where AAN will present up-to-date scientific developments in the diagnosis and treatment of sports concussion.
According to the AAN, concussion is a form of brain injury, which can happen when the head:
- Hits an object, or a moving object strikes the head
- Experiences a sudden force without being hit directly.
In the US, there are 1.6-3.8 million concussions annually that occur as a result of injury from sport. Currently, concussions account for nearly 9% of all US high school sports injuries. In most cases, concussion results in full recovery, yet some can cause more severe damage.
Lead author Dr. Matthew P. Kirschen, PhD, a neurologist with The Children's Hospital of Philadelphia and a member of the American Academy of Neurology comments:
"With nearly 4 million sports-related concussions in the US each year, it is imperative doctors are educated and protect these athletes who may have sustained a concussion. Concussions can have devastating effects such as short-term impairments in athletes' cognitive and athletic performance. Repeat concussions have been linked to long-term impairments in brain function, such as problems with learning, memory and behavior."
Concussions are common in high-speed contact sports, with football, rugby, hockey and soccer posing the greatest risk and baseball, softball, volleyball and gymnastics involving the least risk.
Athletes may be unable to determine whether they are suffering from concussion and will need clinical evaluation to ensure they are not at risk for health problems.
The AAN position statement appeals for doctors to make safeguarding an athlete's mental and physical health a top priority, together with educating patients and their families alike about recovery duration and concussion dangers to allow for a full recovery before returning to play.
Physicians treating sports-related concussion need adequate training and experience
The official position paper is based on several years of research and analysis of ethical issues, which corresponds with the AAN's sports concussion guidelines. Ethically, the statement concludes that physicians have a duty to ensure adequate training and experience in identification and assessment of both the existence and seriousness of possible brain injury when caring for concussed athletes.
"These strategies could help identify the threshold at which the number and severity of head injuries lead to irreversible brain injury. They may also help to clarify how concussion risk varies with factors like age, gender, puberty stage and ethnicity, so athletes and parents can make informed decisions about playing contact sports," says Kirschen.
In a position statement updated in March 2013 by the AAN, they emphasized that the effect of concussion on children's developing brains is of particular concern. Children with concussion, particularly multiple concussions, are at high risk for developing headaches and suffering from impaired memory, cognitive function, attention, or other behavioral changes.
Other issues covered in the latest position statement include:
- Supporting wider use of baseline cognitive testing
- Recommending that concussion evaluation and management training be added to neurology residency programs
- Development of a national concussion registry with mandatory reporting - to document incidence and recurrence of concussion at all levels of play.
Earlier this year, Medical News Today reported on Concussion risk for football players 'dependent on helmet type.' The research has found that the risk of suffering concussion after a head injury may be dependent on what type of helmet is worn.