Return to Sports Following Sports-Related Concussion in Collision Sports: An Expert Consensus Statement Using the...

Area of Science:

• Sports Medicine
• Neurology
• Rehabilitation

Background:

• Sports-related concussions (SRCs) pose significant challenges for athletes' return to play.
• Establishing clear consensus guidelines for return to sports (RTS) is crucial for athlete safety and optimal recovery.

Purpose of the Study:

• To establish a Delphi consensus on criteria and protocols for return to sports (RTS) following sports-related concussion (SRC).

Main Methods:

• A multi-round Delphi process involving open-ended questions and Likert-style questionnaires.
• Consensus was defined as 90% agreement among expert panel members.
• Criteria with less than 80% agreement or significant disagreement were advanced to subsequent rounds.

Main Results:

• Consensus was achieved on 10 of 25 RTS criteria, emphasizing individualized, graduated protocols.
• Early RTS is permissible if athletes are symptom-free with normal clinical, ocular, and balance examinations.
• The Sports Concussion Assessment Tool 5 (SCAT5) and vestibular/ocular motor screening were identified as useful assessment tools.

Conclusions:

• Return to sports (RTS) is primarily a clinical decision, guided by symptom resolution and objective assessments.
• Individualized baseline assessments combining neurocognitive and clinical tests are recommended for collegiate and professional athletes.
• The panel could not reach consensus on the number of recurrent concussions warranting season- or career-ending decisions.