An estimated 1.1 million to 1.9 million children and teens in the United States are treated for a recreational or sports-related concussion every year, but the true number of youth concussions likely remains underreported, according to a new report released by the American Academy of Pediatrics (AAP).
In its first update in eight years, the AAP cites the latest research into the incidence and treatment of these injuries in the clinical report, “Sport-Related Concussion in Children and Adolescents,“ published in the December issue of Pediatrics.
“While more families, physicians and coaches are aware of the health risks of a blow to the head — and more concussions are being reported — we remain concerned about players who try to tough it out without seeking help,” Dr. Mark E. Halstead, lead author of the clinical report, said in a statement. “We know from surveys that many high school athletes will continue to play after a head injury out of fear they won’t be allowed back on the field.”
Over the past few years, guidance on treatment and recovery of injured players has evolved. The AAP report reflects the latest research on recommendations, which now call for reducing — but not eliminating — a return to some physical and cognitive activity in the days following a concussion. Effective management of the injury can shorten recovery time and potentially reduce the risk of long-term symptoms and complications that interfere with school, social life, family relationships and emotional wellbeing.
“Athletes absolutely need to take an immediate break from play after a concussion, but we find that, during the recovery process, it is best to encourage a reasonable amount of activity, such as brisk walking,” said Halstead, an associate professor of pediatrics and of orthopedics at Washington University School of Medicine in St. Louis.“Students shouldn’t need to take a prolonged amount of time away from school, though they should work with teachers on lessening the academic workload. These are individual decisions that families should discuss and evaluate with their child’s physician.”
There is also no research that shows that a youth’s use of electronics, such as computers, television, video games or texting, is harmful after concussion. In fact, complete elimination of electronics may lead to a child’s feeling of social isolation, anxiety or depression, the report states.
The report adds that football, lacrosse, ice hockey and wrestling carry the highest concussion risks for boys, with soccer, field hockey and basketball among the highest-risk sports for girls. Concussions also are more likely to occur in competition than during practice for male and female athletes, except for cheerleading.
In other concussion research news:
• A new study highlights a connection between concussions and the risk of suicide. The study,published in JAMA Neurology, found that the risk of suicide is twice as high for people who had at least one concussion compared to those who had not suffered a concussion.
Dr. Michael Fralick, a general internist and trainee in the University of Toronto’s department of medicine’s Eliot Phillipson Clinician Scientist Training Program, led the research team that conducted a systematic review and meta-analysis of several other studies that explored the association between suicide and concussion. They found there was a heightened risk of both suicide and suicidal ideation following a concussion or other forms of mild traumatic brain injury (TBI).
The research team — including researchers from the University of Saskatchewan; University of California, San Diego; Harvard University; and Ohio State University — reviewed data from 17 studies for more than 700,000 people diagnosed with concussion or mild TBI.
“There were a few studies that included the number of concussions, and they suggested that multiple concussions were associated with an even higher rate of suicide-related outcomes,” Fralick said in a statement, emphasizing that although people who have experienced a concussion are at a heightened risk of suicide and suicidal ideation, the reported rate of death by suicide was less than one percent. “It is important to note that the vast majority of people who have a concussion do not experience a suicide-related outcome, and I do hope that is reassuring to people.”
• The world’s most comprehensive concussion study has been expanded significantly with an infusion of nearly $22.5 million in new funding from the U.S. Department of Defense and the NCAA to examine the impacts of head injuries over several years. The NCAA-DOD Concussion Assessment, Research and Education Consortium, known as the CARE Consortium, was established to better understand how concussions affect the brain and identify ways to improve diagnosis, treatment and prevention.Led by Indiana University School of Medicine, the University of Michigan and the Medical College of Wisconsin, in collaboration with the Uniformed Services University, the study has collected data on more than 39,000 student-athletes and cadets at 30 colleges and military service academies — including more than 3,300 who have experienced concussions. That represents the largest sample of concussions ever researched in a single study.
• Another recent study concludes football players hit in the head might suffer a concussion not as a result of that single impact but based on the number and severity of hits to the head sustained in the days, weeks and months prior to the concussion. The findingsof Dr. Brian Stemper, an associate professor of biomedical engineering at Marquette University and the Medical College of Wisconsin, provide further support for limiting head impact exposure during practices and games.
• The NFL awarded more than $35 million in grants to fund brain health and injury research. The grants are part of the $40 million commitment the NFL made in 2016 to fund medical research focused on enhancing player health and safety. For a list of grant recipients, click here.