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Concussion: Compliance with Return to Play Advice and Follow-up Status

While we are all concerned with the incidence of concussions in sporting activities and return to play decisions, we need to have equal concern for the rate of compliance among individuals who have sustained concussions.

The Canadian Journal of Neurological Sciences, (Volume 36, Number 2 / March 2009) reports the results of a study designed to  determine the compliance rate among hockey players with concussion or other head injuries who were advised by a physician about return to play. To assess compliance of hockey players with return to play advice and to assess the incidence of long-term post-concussion symptoms.

The results were are quite distressing.  Five (33%) of 15 hockey players advised to never return to play were non-compliant and returned to play, and four continued to suffer from post concussion symptoms two or more years later. After repeated concussions, 65% of hockey players had long-term sequelae that prevented return to play and produced long-term post-concussion symptoms.

More effort needs to be placed on educating athletes and their families about the long term dangers associated with concussions.  Just as important, however is the need for teams, coaches and those responsible for the health and safety of athletes to say, “No-you cannot return to play”.  It is ill advised to leave this ultimate decision in the hands of the individual suffering with brain damage.

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