Topic 1 - consensus Flashcards
why was the first CISG meeting held (vienna 2001)
organised by IIHF, FIFA, and IOC
aim to provide recommendations from world leading experts to improve athlete safety and health
what were the major items from the first consensus meeting
- revised/standarised concussion definition
- adapted to RTP guidelines
- updated sideline assessment recommendations to include standardised post concussion symptom scale, brief neuro test, time/place/person tests
- major increase in research
what was found from the focus on prevention strategies at first consensus meeting
- proposed helmet use in sports with high speed collisions
- safety equipment altering behaviour?
- mouth guards may help with head impacts
- rule changes and referee enforcement
- neck strengthening
what is the original management and rehab (acute)
- removed from play (game or practise)
- not left alone - regularly monitored
- medically evaluated
- RTP should be a medically advised step wise process
- players should not RTP while symptomatic
-when in doubt sit them out
what is the original management and rehab (RTP)
- No activity = complete rest, once asymptomatic, proceed to 2
- Light aerobic activity (walking/stationary cycling)
- Sport specific training (skating or running)
- Non contact training drills
- Full contact training after medical clearance
- Game play
what is the problem with step 1 of RTP
symptoms from isolation and no activity can present similar to concussion symptoms (depression, headaches, sensitive to light, mood changes, etc)
what were the prague 2004 advances
- post concussion symptoms may be prolonged
- abandonment of grading system (no link to recovery trajectories)
- no promotion of CT/MRI use unless more serious TBI expected
- added SCAT (including symptom score, cognitive/memory task, and neurologic testing)
what were the prague 2004 stalls
kept complete rest until asymptomatic in RTP guidelines
what were the zurich 2008 advances
- sideline assessment done by medical staff in facility
- added balance to SCAT
- different treatment may be needed for youth concussions
- knowledge of previous concussion is valuable
- neuropsych testing should be developmentally sensitive
what were the zurich 2008 stalls
- promoted same day RTP for NFL players
- not enough evidence to prove the beneficial use of mouth guards and helmets to prevent concussions
what were the zurich 2012 advances
- recognised the difference in youth vs adult recovery times
- no RTP on same day
- symptoms may be delayed
- many types of signs and symptoms of concussion (somatic, physical, behaviour, cognitive, sleep disturbance)
- low level activity may be beneficial in those with delayed recoveries
- developed the child SCAT3 (5-12)
what were the zurich 2012 stalls
- still promotes rest is best (physical and cognitive rest until acute symptoms resolve)
- maintained that PPE doesn’t reduce concussion rates by they reduce head impact forces
what were the berlin 2016 advances
- SCAT5 is well established sideline assessment
- first inclusion of rehab programs
- brief period of rest during acute phase and then promote gradual activity below symptom exacerbation thresholds
what were the amsterdam 2022 advances
- no definite line where athletes are forced to retire by medical pros
- added return to learn strategies
- use HR to moderate recovery in light/moderate aerobic exercise
- updated CRT (immediate and non clinical individuals) and SCAT (up to 1 week)
- developed SCOAT
