Compliance with return to play guidelines following concussion in US high school athletes, 2005-2008

Citation:  Yard, E. E., & Comstock, R. D. (2011). Compliance with return to play guidelines following concussion in US high school athletes, 2005-2008. Brain Injury, 23(11), 888-898.

Review by Laszlo A. Erdodi, PhD

This was a prospective cohort study including 100 nationally representative American high schools. Concussion data were provided by certified athletic trainers through an online reporting system.  Injuries were retrospectively graded according to AAN and Prague return-to-play (RTP) guidelines. The strengths of the study are a large, demographically representative sample; simultaneous comparison of concussion rates based on AAN and Prague classification; reporting data separately for gender, concussion severity and type of sport. Some of the weaknesses are selection bias (inclusion criteria favor better regulated institutions); imperfection in reporting system (insufficient detail to confidently classify a given incident); and concussion severity classification was performed post hoc.

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