Friday, November 17, 2006

Football Players and Concussions: Too Much Too Soon?

Football players who sustain concussions have almost three times the risk of sustaining a second concussion during the same season compared with uninjured players, say investigators from the University of North Carolina at Chapel Hill.

Dr. Kevin M. Guskiewicz and his colleagues attribute this increased risk to the failure of clinicians to follow recommended return-to-play guidelines.

The researchers collected data from 242 high school and collegiate athletic trainers. Of 17,549 players, 5.1% sustained at least one concussion, and 14.7% of these sustained a second concussion during the same season. The second injury tended to be more severe.

The investigators report that 86% of concussed players reported headache, 67% reported dizziness, and 59% reported confusion. Headache persisted beyond 5 days in 10% of the injured players.

Although most grading scales are based on loss of consciousness and amnesia, in this study only 8.9% of those injured lost consciousness and 27.7% exhibited amnesia.

"Clinicians are usually forced to make decisions based on grading scales and return-to-play guidelines that are not inclusive of the most common signs and symptoms," Guskiewicz's group writes in the September-October issue of the American Journal of Sports Medicine.

Nearly a third of injured players returned to participation on the same day of injury, including 14.4% of those who sustained a grade II concussion. For the remainder of the injured players, return to play averaged nearly 3 days earlier than most of the recommended guidelines, the investigators note.

Guskiewicz and his associates conclude that "few clinicians are currently using assessment techniques...useful in identifying lingering signs and symptoms such as concentration deficits, blurred vision, (sensitivity to light), amnesia, dizziness and balance deficits."

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