Consensus statement on concussion in sport the 5th ...

1 BJSM Online First, published on April 26, 2017 as Consensus statement Consensus statement on concussion in sport the 5th Br J Sports Med: first published as on 26 April 2017. Downloaded from on October 22, 2019 by guest. Protected by copyright. international conference on concussion in sport held in Berlin, October 2016. Paul McCrory,1 Willem Meeuwisse,2 Ji Dvorak,3,4 Mark Aubry,5 Julian Bailes,6. Steven Broglio,7 Robert C Cantu,8 David Cassidy,9 Ruben J Echemendia,10,11. Rudy J Castellani,12 Gavin A Davis,13,14 Richard Ellenbogen,15 Carolyn Emery,16.

2 Lars Engebretsen,17 Nina Feddermann-Demont,18,19 Christopher C Giza,20,21. Kevin M Guskiewicz,22 Stanley Herring,23 Grant L Iverson,24 Karen M Johnston,25. James Kissick,26 Jeffrey Kutcher,27 John J Leddy,28 David Maddocks,29. Michael Makdissi,30,31 Geoff Manley,32 Michael McCrea,33 William P Meehan,34,35. Sinji Nagahiro,36 Jon Patricios,37,38 Margot Putukian,39 Kathryn J Schneider,40. Allen Sills,41,42 Charles H Tator,43,44 Michael Turner,45 Pieter E Vos46. Additional material is PREAMBLE articles were screened by the expert panels for the published online only.

3 To view The 2017 concussion in sport Group (CISG) Berlin meeting. The details of the search strategies please visit the journal online (http:// dx. doi. org/ 10. 1136/ Consensus statement is designed to build on the and findings are included in each of the systematic bjsports- 2017- 097699) principles outlined in the previous statements1 4 reviews. and to develop further conceptual understanding The details of the conference organisation, For numbered affiliations see of sport -related concussion (SRC) using an expert methodology of the Consensus process, question end of article.

4 Development and selection on expert panellists and Consensus -based approach. This document is devel- oped for physicians and healthcare providers who observers is covered in detail in an accompanying Correspondence to Dr Paul McCrory, The Florey are involved in athlete care, whether at a recre- paper in this A full list of scientific committee Institute of Neuroscience and ational, elite or professional level. While agreement members, expert panellists, authors, observers and Mental Health, Heidelberg exists on the principal messages conveyed by this those who were invited but could not attend are 3084, Victoria, Australia; detailed is at the end of the summary document.

5 Document, the authors acknowledge that the paulmccrory@ icloud. com The International Committee of Medical Journal science of SRC is evolving and therefore individual Accepted 6 March 2017 management and return-to-play decisions remain in Editors conflict of interest declaration for all the realm of clinical judgement. authors is provided in Appendix 1. This Consensus document reflects the current Readers are encouraged to copy and freely state of knowledge and will need to be modified as distribute this Berlin Consensus statement on new knowledge develops.

6 It provides an overview concussion in sport , the concussion Recognition of issues that may be of importance to healthcare Tool version 5 (CRT5), the Sports concussion providers involved in the management of SRC. Assessment Tool version 5 (SCAT5) and/or the This paper should be read in conjunction with the Child SCAT5. None of these are subject to copy- systematic reviews and methodology paper that right restriction, provided they are used in their accompany it. First and foremost, this document complete format, are not altered in any way, not sold for commercial gain or rebranded, not is intended to guide clinical practice; however, the converted into a digital format without permission, authors feel that it can also help form the agenda and are cited correctly.

7 For future research relevant to SRC by identifying knowledge gaps. A series of specific clinical questions were devel- Medical legal considerations oped as part of the Consensus process for the Berlin The Consensus statement is not intended as a clin- 2016 meeting. Each Consensus question was the ical practice guideline or legal standard of care, and subject of a specific formal systematic review, which should not be interpreted as such. This document is is published concurrently with this summary state- only a guide, and is of a general nature, consistent ment.

8 Readers are directed to these background with the reasonable practice of a healthcare profes- papers in conjunction with this summary statement sional. Individual treatment will depend on the facts as they provide the context for the issues and include and circumstances specific to each individual case. To cite: McCrory P, the scope of published research, search strategy and It is intended that this document will be formally Meeuwisse W, Dvorak J, citations reviewed for each question. This 2017 reviewed and updated before 31 December 2020.

9 Et al. Br J Sports Med Published Online First: Consensus statement also summarises each topic [please include Day Month and recommendations in the context of all five SRC AND ITS MANAGEMENT. Year]. CISG meetings (that is, 2001, 2004, 2008, 2012 The paper is laid out following the CISG's 11 R's bjsports-2017-097699 as well as 2016). Approximately 60 000 published of SRC management to provide a logical flow of McCrory P, et al. Br J Sports Med 2017;0:1 10. 1. Copyright Article author (or their employer) 2017.

10 Produced by BMJ Publishing Group Ltd under licence. Consensus statement Br J Sports Med: first published as on 26 April 2017. Downloaded from on October 22, 2019 by guest. Protected by copyright. clinical concussion management. The new material recommen- characteristics including frequency, head kinematics, head-im- dations determined at the Berlin 2016 meeting are italicised, and pact location, and injury outcome. In these studies, the use of any background material or unchanged recommendations from instrumented helmets has provided information on head-im- previous meetings are in normal text.