What are the evidence-based medical management approaches for the concussed youth athlete? A scoping review.
Tom McKeever, Michael Leavitt, Stephanie Valentin and 1 others
PMID 40761665WHAT IT FOUND
Sub-threshold aerobic exercise helps youth athletes recover faster than strict rest or stretching.
Early exercise testing is safe and does not delay recovery. Head and neck cooling may reduce symptoms sooner, but overall recovery time is similar. Evidence for other treatments is weak.
Key findings
01Sub-threshold exercise programs reduce post-concussion symptoms and improve recovery times compared to relative rest or stretching.
02Early aerobic exercise testing, such as the Buffalo Concussion Treadmill Test, is safe and does not delay recovery when performed within 10 days of injury.
03Head and neck cooling therapy may lead to a faster reduction in symptoms early on, but the total recovery trajectory is similar to standard care.
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
A significant proportion of the included studies were case reports or series, which have high risk of bias and low generalizability. Most studies were conducted in North America, so findings may not apply to other healthcare systems. There was a lack of studies focusing on female-only participants, meaning evidence for this group is limited. No studies were found from the United Kingdom, and few from Europe. The review excluded non-English language studies. Many studies had small sample sizes, and the quality of evidence varied widely.
Declared interests
The authors report no conflicts of interest. The research received no specific funding from any agency.
The easy way to misread this
Do not interpret the positive findings for head and neck cooling as evidence that it shortens total recovery time. While it reduced symptoms earlier, the overall recovery trajectory was similar to standard care. Additionally, much of the evidence comes from case reports, which should not be used to justify changing practice without considering the low level of evidence.