Return to sports after pediatric traumatic brain injury: An expert panel survey.
Colby Hansen, Allison N Capizzi, Nick Gavern and 2 others
PMID 39803941WHAT IT FOUND
Expert opinions on when children with serious brain injuries can return to sports vary widely.
Risk of the activity mattered more than injury severity for most scenarios. For severe injuries and high-contact sports, many experts recommended waiting months or never returning, highlighting the need for individualized decision-making.
Key findings
01For complicated mild, moderate, and severe TBI, return-to-play timelines varied significantly based on the risk level of the sport, with higher risk activities requiring longer timelines.
02Injury severity was not significantly associated with return-to-play timelines for low- and moderate-risk activities; only for high-risk activities did severity influence the recommendation.
03Experts did not agree on a single formula for return-to-play, with significant variability in recommendations for the same injury severity and activity risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is based on expert opinion in hypothetical scenarios, not actual patient outcomes or empirical data on safety. The sample was heavily skewed toward US-based practitioners (94%) and male experts (70%), limiting generalizability. Experts were defined by their publication history, which may exclude excellent clinicians who do not publish. The hypothetical scenarios assumed a 'complete recovery,' which many patients with moderate to severe TBI do not achieve, potentially making the timelines unrealistic for complex cases. The number of participants was small (n=30), and sports medicine and emergency medicine experts were largely unrepresented in the final analysis.
Declared interests
The authors report no conflicts of interest. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not interpret these timelines as evidence-based safety guidelines. The study reports expert opinion on hypothetical cases, not actual outcomes. There is no proven 'safe' timeline for return to play in severe TBI, and recommendations varied widely among experts.