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Tamara C. Valovich McLeod, Megan N. Houston and Cailee E. Welch

Concussions resulting from sports and recreational activities are a significant concern in the pediatric population. The number of children and adolescents sustaining sport-related concussions is increasing and, as a result, legislation has been passed in all 50 states to ensure appropriate recognition and referral of pediatric athletes following concussion. The developing brain may make the diagnosis, assessment, and management of concussion more challenging for health care providers and requires the use of specific age-appropriate assessment tools. Concussion management must also include considerations for cognitive and physical rest, a collaborative concussion management team that includes medical and school personnel, and more conservative stepwise progressions for returning to school and to physical activity.

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Michael Dressing, Jillian Wise, Jennifer Katzenstein and P. Patrick Mularoni

symptoms, leading to different recovery timelines. The return to school and sports after concussions depends on many variables, and is evaluated with different tools and neurocognitive tests in different practices, making it very difficult to predict a “physiologic time window” for concussion recovery

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Nicholas Hattrup, Hannah Gray, Mark Krumholtz and Tamara C. Valovich McLeod

demonstrated that initiating aerobic exercise had a positive effect on returning to school/work and sport sooner rather than delayed exercise. • All 5 articles 14 – 18 demonstrated that implementing early controlled aerobic exercise did not have a detrimental effect on recovery. • One article 17 demonstrated

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Tamara C. Valovich McLeod and Johna K. Register-Mihalik

Patient Scenario:

An adolescent female youth soccer athlete, with a previous concussion history, suffered a second concussion 4 wk ago. Her postconcussive symptoms are affecting her school performance and social and family life.

Clinical Outcomes Assessment:

Concussion is typically evaluated via symptoms, cognition, and balance. There is no specific patient-oriented outcomes measure for concussion. Clinicians can choose from a variety of generic and specific outcomes instruments aimed at assessing general health-related quality of life or various concussion symptoms and comorbidities such as headache, migraine, fatigue, mood disturbances, depression, anxiety, and concussion-related symptoms.

Clinical Decision Making:

The data obtained from patient self-report instruments may not actively help clinicians make return-to-play decisions; however, these scales may be useful in providing information that may help the athlete return to school, work, and social activities. The instruments may also serve to identify issues that may lead to problems down the road, including depression or anxiety, or serve to further explore the nature of an athlete’s symptoms.

Clinical Bottom Line:

Concussion results in numerous symptoms that have the potential to linger and has been associated with depression and anxiety. The use of outcomes scales to assess health-related quality of life and the effect of other symptoms that present with a concussion may allow clinicians to better evaluate the effects of concussion on physical, cognitive, emotional, social, school, and family issues, leading to better and more complete management.

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Christine C. Center, Samuel J. Wilkins, Ross Mathiasen and Adam B. Rosen

was discharged the following day. He continued extensive rehabilitation with a 10-lb lifting restriction and returned to school 3 months postinjury. He returned to weightlifting and working out approximately 4 months postinjury. He was instructed to avoid high-impact activities for 1 year from the

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Tracey Covassin, Kyle M. Petit and Morgan Anderson

, youth athletes with abnormal vestibular function took longer to return to school than did those without ( Corwin et al., 2015 ). Future research should continue to examine the utility of the Vestibular and Ocular Motor Screening as an assessment tool in youth athletes. Given that it is dependent on

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Cailee E. Welch Bacon, Gary W. Cohen, Melissa C. Kay, Dayna K. Tierney and Tamara C. Valovich McLeod

well as varying levels of expertise among community physicians resulted in discrepancies across concussion cases. To minimize these discrepancies, participants described how school concussion management policy safeguarded concussed student-athletes from returning to school or activity based on

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Liezel Hurter, Anna M. Cooper-Ryan, Zoe R. Knowles, Lorna A. Porcellato, Stuart J. Fairclough and Lynne M. Boddy

returned to school for collection. The results synchronized automatically with the SSA when connected to WiFi. Once synchronized, the study could be downloaded again for the next round of participants using the same tablets but with new participant numbers. Audio files from voice recordings were

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Ashley L. Santo, Melissa L. Race and Elizabeth F. Teel

, athletes with CI had lower scores on measures of verbal memory, visual motor speed, and reaction time. 16 The symptoms and combination of visual and cognitive deficits caused by receded NPC can result in difficulty returning to school or working, especially when completing tasks that require reading and

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Shaunna M. Burke, Jennifer Brunet, Amanda Wurz, Christina Butler and Andrea Utley

received radiotherapy and surgery. All of the participants were at least 1-month postintensive treatment. Three participants were on a 2-year course of maintenance therapy. Participants were no longer in regular contact with their oncologist and had all returned to school. Participants had some experience