Thread by @DPT2Go

🧠 The NEW Consensus statement on concussion in sport: the 6th International Conference on #Concussion in Sport from the Amsterdam, October 2022 interdisciplinary meeting is OFFICIALLY out via @BJSM_BMJ 📄

🧵 Here are the key takeaways summarized by the article:

#FOAMed

Individuals with persisting symptoms (ie, symptom duration >4 weeks) should be evaluated with a MULTIMODAL CLINICAL ASSESSMENT including the use of standardized and validated symptom rating scales. 2/

The potential long-term effects of Sports Related Concussion & repetitive head impacts (RHI) are areas of ongoing public health interest and concern among both healthcare professionals and the general public. 3/

It is proposed that a working group representing multiple disciplines and perspectives be established to guide appropriate research in this area. 4/

🔑Point: Strong evidence exists regarding the benefits of physical activity and aerobic exercise treatment as early interventions.

#Physio #PhysicalTherapy #AthleticTraining #AT4All #Fisio #Fisioterapia #PhysioTherapy #fysio 5/

Cervicovestibuar rehabilitation is indicated for athletes with neck pain, headaches, dizziness and/or balance problems. 6/

#Physio #PhysicalTherapy #AthleticTraining #AT4All #Fisio #Fisioterapia #PhysioTherapy #fysio

✅The Concussion Recognition Tool-6 (CRT6),

✅Sport Concussion Assessment Tool-6 (SCAT6) and

✅Child SCAT6

provide updated iterations of the acute sport-related concussion (SRC) tools best used in the first 72 hours (and up to 1 week) after injury.

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✨🆕✨ office tools:

✅ The Sport Concussion Office Assessment Tool-6 (SCOAT6) &

✅ Child SCOAT6

were designed to better guide evaluation & management in an office setting from 72 hours after injury and for serial evaluations in the following weeks.

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🔑 Point:

🧰 The overlap between the SCAT6 & SCOAT6 is INTENTIONAL & designed to facilitate easy transitions across tools.

9/

📊 The results of computerized neurocognitive tests should be interpreted in the context of broader clinical findings and are NOT BE USED in isolation to inform management or diagnostic decisions.

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✍️ The Concussion in Sport Group (CISG) definition of concussion was updated while work continues toward a unified conceptual and operational definition.

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The conceptual definition, accepted as a majority decision (78.6%) but not reaching an 80% consensus, is:

Sport-related concussion 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...

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(definition continued)...

that occurs in sports and exercise-related activities. This initiates a neurotransmitter and metabolic cascade, with possible axonal injury, blood flow change and inflammation affecting the brain. ...

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(definition contd)

Symptoms & signs may present immediately, or evolve over minutes or hours, & commonly resolve within days, but may be prolonged.

... 14/

(definition contd) ...

No abnormality is seen on standard structural neuroimaging studies (CT or MRI T1- & T2-weighted images), but in the RESEARCH SETTING, abnormalities may be present on functional, blood flow or metabolic imaging studies...

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(definition contd) ...

SRC results in a range of clinical symptoms & signs that may or may not involve loss of consciousness. The clinical Sx's & signs of concussion cannot be explained solely by (but may occur concomitantly w/) drug, alcohol, or med use...

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(definition contd) ...

other injuries (such as cervical injuries, peripheral vestibular dysfunction) or other comorbidities (such as psychological factors or coexisting medical conditions).

Definitions btw CISG + @ACRMtweets ARE still active and evolving.

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🔑 point: Concussion diagnosis and management in para athletes is challenging with limited data, requiring further research and dedicated clinical recommendations that consider a range of impairments.

Excited to see the work of @osmanhahmed et al continue here 18/

👏Bravo to @Kat_Schneider7 @jonpatricios @griz1 @osmanhahmed @UMichConcussion's Steve Broglio, @KevinGuskiewicz @MPutukian @BrianHainline @CarolynAEmery @stanherringmd et al for reaching across the aisle and providing a true interdisciplinary conversation after 7 years 19/

🤔Remember that:

#Concussion is a REHABILITATIVE injury

Concussion continues to be a CLINICAL diagnosis only

Research is evolving & requires an all hands on deck approach to study the most complex organ in the body

🤝Interdisciplinary = key for complex patients

🧵20/20