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Updated: Apr 27, 2026
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Concussion guidelines step 1: systematic review of prevalent indicators
Nancy Carney1, Jamshid Ghajar, Andy Jagoda
1*Department of Medical Informatics and Clinical Epidemiology and ‖Center for Spoken Language Understanding, Oregon Health & Science University, Portland, Oregon; ‡Brain Trauma Foundation, New York, New York; §Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; ¶Department of Emergency Medicine and; ‡‡Departments of Psychiatry and Neurology, Icahn School of Medicine at Mount Sinai, New York, New York #Department of Psychology, Portland State University, Portland, Oregon; **US Army Combat Casualty Care Research Program, US Army Medical Research and Materiel Command, Fort Detrick, Maryland.
This systematic review identified key indicators of concussion, including confusion, impaired balance, slower reaction time, and memory deficits. These findings provide an evidence-based foundation for defining and diagnosing concussion.
Area of Science:
- Neuroscience
- Sports Medicine
- Public Health
Background:
- A uniform, evidence-based definition for concussion is currently lacking in clinical and research settings.
- This absence hinders consistent diagnosis and research efforts.
- Establishing a clear definition is crucial for advancing concussion management.
Purpose of the Study:
- To systematically review high-quality literature on concussion.
- To identify prevalent and associated indicators of concussion.
- To establish an evidence base for future concussion definition and diagnostic criteria.
Main Methods:
- Conducted an electronic literature search (1980-2012) for concussion-related studies.
- Assessed studies for bias and confound, excluding those with high potential.
- Included studies with inclusive case definitions and data from fixed time points.
Main Results:
- Analyzed 231 studies, with 11 independent samples contributing to conclusions.
- Identified prevalent concussion indicators: immediate disorientation/confusion.
- Consistent indicators include impaired balance (within 1 day), slower reaction time (within 2 days), and impaired verbal learning/memory (within 2 days).
Conclusions:
- This systematic review identified consistent and prevalent concussion indicators.
- The findings provide a strong evidence base for developing diagnostic criteria.
- This work lays the foundation for future concussion definition and prognostic indicators.
