A Scoping Review to Address the Culture of Concussion in Youth and High School Sports.
Kelly Sarmiento, Zoe Donnell, Rosanne Hoffman
PMID 28876477WHAT IT FOUND
Youth athletes often miss concussion symptoms and keep playing.
In reviewed United States studies, many could not identify signs such as confusion, nausea, or sleep trouble, and many did not report symptoms to coaches or trainers.
Key findings
01Young athletes often cannot recognize concussion symptoms. In one survey of 8 to 14 year old football players, only 23% recognized confusion, 42% recognized nausea, and 57% recognized sleep disturbances.
02Many athletes continued playing with concussion symptoms. Cohort studies found that 58.6% of middle school athletes and 69% of high school athletes reported playing with symptoms.
03Concussion education was associated with more symptom reporting in one survey. Athletes who received concussion education were more likely to report symptoms to a coach or athletic trainer, 72% compared with 36% of athletes with no education.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 33 articles, so it cannot show how common these problems are across all youth sports. It did not appraise study quality, so weak studies count the same as strong ones. Most studies were about high school athletes, not elementary or middle school athletes, and nonscholastic sports were underrepresented. It excluded publications about treatment, recovery, and ongoing care, so it does not address clinical management. Many studies were surveys or cross-sectional reports, so they show associations at one time, not cause. No included intervention was shown to improve athlete reporting behavior. The review was limited to United States studies and English publications, so it may not apply elsewhere. Little research addressed race, ethnicity, rural or urban residence, and socioeconomic status.
The easy way to misread this
Do not conclude that concussion education reliably changes reporting behavior. The review found associations between education and reporting, but it did not identify interventions that improved reporting behaviors.