BMJ
British Journal of Sports Medicine
,  volume 57 ,  issue 12 ,  pages 771-779

Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review

Kathryn J Schneider 1, 2, 3, 4
, 
Meghan L. Critchley 2
, 
Vicki Anderson 5, 6, 7, 8
, 
Gavin A. Davis 9, 10
, 
Chantel T. Debert 2, 11
, 
Nina Feddermann-Demont 12, 13
, 
Isabelle Gagnon 14, 15
, 
Kevin M. Guskiewicz 16, 17
, 
K Alix Hayden 2, 18
, 
Stanley Herring 19, 20
, 
Corson Johnstone 2
, 
Michael Makdissi 21, 22
, 
CHRISTINA L. MASTER 23, 24
, 
Rosemarie Scolaro Moser 25
, 
Jon S. Patricios 26, 27
, 
JOHNA K. REGISTER-MIHALIK 17, 28
, 
Paul E. Ronksley 2, 29
, 
Noah D. Silverberg 30, 31
, 
Keith O. Yeates 2, 3, 4, 7
1
 
Sport Injury Prevention Research Centre, Faculty of Kinesiology
2
 
3
 
Hotchkiss Brain Institute
4
 
5
 
Child Neuropsychology
6
 
7
 
Psychology
8
 
9
 
10
 
Cabrini Health
11
 
Department of Clinical Neurosciences
12
 
13
 
14
 
School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences
15
 
16
 
Sports Medicine Research Laboratory
17
 
18
 
Libraries and Cultural Resources
19
 
Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery
20
 
21
 
Florey Institute of Neuroscience and Mental Health - Austin Campus | 
22
 
Australian Football League
23
 
24
 
25
 
Sports Concussion Center of New Jersey | 
26
 
27
 
28
 
Exercise and Sport Science
29
 
Community Health Sciences
30
 
Department of Psychology
31
 
Publication type: Journal Article
Publication date: 2023-06-15
BMJ
BMJ
scimago Q1
wos Q1
SJR: 4.724
CiteScore: 21.0
Impact factor: 16.2
ISSN: 03063674, 14730480
General Medicine
Orthopedics and Sports Medicine
Physical Therapy, Sports Therapy and Rehabilitation
Abstract
Objectives

We evaluated interventions to facilitate recovery in children, adolescents and adults with a sport-related concussion (SRC).

Design

Systematic review including risk of bias (modified Scottish Intercollegiate Guidelines Network tool).

Data sources

MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL Plus with Full Text, SPORTDiscus and Scopus searched until March 2022.

Study eligibility criteria

(1) Original research including randomised controlled trials (RCTs), quasi-experimental designs, cohort, comparative effectiveness studies; (2) focus on SRC; (3) English; (4) peer-reviewed and (5) evaluated treatment.

Results

6533 studies were screened, 154 full texts reviewed and 13 met inclusion (10 RCTs, 1 quasi-experimental and 2 cohort studies; 1 high-quality study, 7 acceptable and 5 at high risk of bias). Interventions, comparisons, timing and outcomes varied, precluding meta-analysis. For adolescents and adults with dizziness, neck pain and/or headaches >10 days following concussion, individualised cervicovestibular rehabilitation may decrease time to return to sport compared with rest followed by gradual exertion (HR 3.91 (95% CI 1.34 to 11.34)) and when compared with a subtherapeutic intervention (HR 2.91 (95% CI 1.01 to 8.43)). For adolescents with vestibular symptoms/impairments, vestibular rehabilitation may decrease time to medical clearance (vestibular rehab group 50.2 days (95% CI 39.9 to 60.4) compared with control 58.4 (95% CI 41.7 to 75.3) days). For adolescents with persisting symptoms >30 days, active rehabilitation and collaborative care may decrease symptoms.

Conclusions

Cervicovestibular rehabilitation is recommended for adolescents and adults with dizziness, neck pain and/or headaches for >10 days. Vestibular rehabilitation (for adolescents with dizziness/vestibular impairments >5 days) and active rehabilitation and/or collaborative care (for adolescents with persisting symptoms >30 days) may be of benefit.

Found 
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GOST |
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GOST Copy
Schneider K. J. et al. Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review // British Journal of Sports Medicine. 2023. Vol. 57. No. 12. pp. 771-779.
GOST all authors (up to 50) Copy
Schneider K. J., Critchley M. L., Anderson V., Davis G. A., Debert C. T., Feddermann-Demont N., Gagnon I., Guskiewicz K. M., Hayden K. A., Herring S., Johnstone C., Makdissi M., MASTER C. L., Moser R. S., Patricios J. S., REGISTER-MIHALIK J. K., Ronksley P. E., Silverberg N. D., Yeates K. O. Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review // British Journal of Sports Medicine. 2023. Vol. 57. No. 12. pp. 771-779.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1136/bjsports-2022-106685
UR - https://doi.org/10.1136/bjsports-2022-106685
TI - Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review
T2 - British Journal of Sports Medicine
AU - Schneider, Kathryn J
AU - Critchley, Meghan L.
AU - Anderson, Vicki
AU - Davis, Gavin A.
AU - Debert, Chantel T.
AU - Feddermann-Demont, Nina
AU - Gagnon, Isabelle
AU - Guskiewicz, Kevin M.
AU - Hayden, K Alix
AU - Herring, Stanley
AU - Johnstone, Corson
AU - Makdissi, Michael
AU - MASTER, CHRISTINA L.
AU - Moser, Rosemarie Scolaro
AU - Patricios, Jon S.
AU - REGISTER-MIHALIK, JOHNA K.
AU - Ronksley, Paul E.
AU - Silverberg, Noah D.
AU - Yeates, Keith O.
PY - 2023
DA - 2023/06/15
PB - BMJ
SP - 771-779
IS - 12
VL - 57
PMID - 37316188
SN - 0306-3674
SN - 1473-0480
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2023_Schneider,
author = {Kathryn J Schneider and Meghan L. Critchley and Vicki Anderson and Gavin A. Davis and Chantel T. Debert and Nina Feddermann-Demont and Isabelle Gagnon and Kevin M. Guskiewicz and K Alix Hayden and Stanley Herring and Corson Johnstone and Michael Makdissi and CHRISTINA L. MASTER and Rosemarie Scolaro Moser and Jon S. Patricios and JOHNA K. REGISTER-MIHALIK and Paul E. Ronksley and Noah D. Silverberg and Keith O. Yeates},
title = {Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review},
journal = {British Journal of Sports Medicine},
year = {2023},
volume = {57},
publisher = {BMJ},
month = {jun},
url = {https://doi.org/10.1136/bjsports-2022-106685},
number = {12},
pages = {771--779},
doi = {10.1136/bjsports-2022-106685}
}
MLA
Cite this
MLA Copy
Schneider, Kathryn J., et al. “Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review.” British Journal of Sports Medicine, vol. 57, no. 12, Jun. 2023, pp. 771-779. https://doi.org/10.1136/bjsports-2022-106685.