![]() ![]() The restrictive nature of many current management plans has resulted in a longer recovery period and a delay in return to participation compared with older management plans and has created controversy. Researchers 1 have recommended that neurocognitive performance must revert to baseline or better before the patient returns to participation to reduce the possibility of a more serious, cumulative injury during the vulnerable recovery period. If an athlete is concussed, serial evaluations are conducted postinjury to determine when neurocognitive deficits and clinical symptoms are no longer present. These tests are usually administered before the sport season to obtain baseline data. Many clinicians use neurocognitive tests, such as Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT ImPACT Applications, Inc, Pittsburgh, PA), as assessment and management tools. ![]() Current strategies for injury management suggest that abnormalities in any 1 or more of these domains should exclude an athlete from training and competition. Concussions are typically diagnosed after several clinical domains are assessed, including self-reported symptoms, physical signs, and cognitive functioning. Numerous states have adopted or are in the process of adopting legislation that mandates evaluation procedures and return-to-participation criteria for interscholastic athletics, and many sport governing bodies have adopted similar policies. The management of mild traumatic brain injury, typically referred to in the United States as a concussion, has become an area of great concern and controversy in the athletic setting. ![]()
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