At the OrthTeam Centre, we offer an Interdisciplinary Concussion Service for adults and children, led by Dr John Rogers and Dr Jim Kerss, consultant physicians in sport and exercise medicine. The recently released 6th Consensus Statement on Concussion in Sport summarises the latest published global evidence in the field.
The 12 Rs of concussion management include:
RECOGNISE: sports-related concussion (SRC) is a traumatic brain injury caused by a direct blow to the head, neck or body, resulting in an impulsive force being transmitted to the brain.
REDUCE: prevention strategies include changes in rules, neuromuscular training warm-up programs and personal protective equipment.
REMOVE: signs that warrant immediate removal from play include loss of consciousness, seizure, loss of balance, tonic posturing, behavioural changes, confusion and amnesia.
RE-EVALUATE: there are different tools aimed at better recognition and assessment of SRC, including the SCAT6 (up to one week) and the SCOAT6 (72 hours up to four weeks post-injury).
REST: the best evidence shows that strict rest is not beneficial.
RELATIVE REST including activities of daily living, reduced screen time and early return to light physical activity is indicated in the first 48 hours after injury.
REHABILITATION: if symptoms of dizziness, headache or neck pain remain 10 days following injury, then cervico- vestibular rehabilitation is recommended.
REFER: referral to clinicians with specialised knowledge and skills in concussion management if symptoms persist.
RECOVERY: in the research setting, neuroimaging, genetic testing, biomarkers and other emerging technologies are useful but not yet suited for use in clinical practice.
RETURN TO LEARN and RETURN TO SPORT: strategies to help children and adults return to school, work and sport safely.
RECONSIDER: there are potential long-term effects associated with repetitive brain injuries. These include cognitive difficulties / early dementia and neurological disease.
RETIRE: Decisions regarding retirement are complex, multifaceted and individualised. They should include a comprehensive clinical evaluation that considers the patient, injury and sport along with ethical and psychosocial factors.
REFINE: more concussion research is needed for children in the five to 12 age group and for Paralympic sport athletes and with an inclusive and interdisciplinary approach.
To find out more about our Concussion Clinic or to book a consultation :
Call 0161 447 6888