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Toronto (June 20, 2000) - Having sustained a concussion, when can athletes safely return to the game? According to researchers at the Toronto Rehabilitation Institute and the University of Toronto Faculty of Physical Education and Health (FPEH), no one really knows for sure which is why they are joining forces to study the impact of mild brain injuries such as concussions on athletes at the U of T.
The U of T/Toronto Rehab Varsity Athlete Concussion Program will help determine what the normal recovery period is following a mild brain injury and, more importantly, how soon after an injury athletes can safely get back into the game.
According to Dr. Paul Comper, a psychologist with Toronto Rehab, "The disabling effects of concussions aren't always as obvious or visible as those caused by a broken arm or leg. We're only beginning to understand the potential risks posed by this type of injury over the long term. Based on the results of this study -- which will involve about 500 athletes -- we hope to develop evidence-based guidelines that will ultimately help protect the health, safety and well-being of all those who suffer a concussion no matter how it is sustained."
The concussion study, which began in March 1999, will be conducted over the next 5 to 10 years on consenting male and female Varsity athletes who researchers say are a representative sample of the general population. To date, 30 athletes have been tested to establish baseline measures of their cognitive functioning, which can be adversely affected by a concussion.
"Twenty to 25 per cent, or about one in four athletes involved in higher risk sports, such as football, hockey, rugby and soccer, may experience one or more concussions of varying severity each year," says Dr. Comper, one of the study's four principle investigators.
Dr. Comper is collaborating with Dr. Doug Richards, Medical Director of the David L. MacIntosh Sport Medicine Clinic at the U of T, Dr. Lynda Mainwaring, a U of T psychologist specializing in injury rehabilitation, and Dr. Robin Green, a pyschologist and researcher at Toronto Rehab. While the researchers acknowledge that they aren't the first to venture into this territory, they say this study will monitor injured athletes more closely and over a longer period of time. A variety of different symptoms will be examined in the study that will also look at recovery patterns specific to psychological factors.
Athletes are given a battery of neuropsychological tests to establish baseline measures of motor skills such as coordination, speed, problem-solving abilities, levels of concentration and memory. If an athlete sustains a mild brain injury, he or she will be tested immediately after the injury, then at regular intervals until recovery is deemed to be complete. If symptoms persist, the athlete will be monitored on an ongoing basis.
"What we're really trying to determine with this study," Dr. Comper says, "is when it's safe for concussed athletes to return to their respective sport. Currently, there is little empirical evidence to guide those making return-to-play decisions."
Until such evidence-based guidelines are established, Dr. Richards and his medical colleagues at U of T take a very conservative approach to return-to-play. When post-concussion symptoms have disappeared, he waits 24 hours, then adds the length of time the post-concussion symptoms lasted before allowing the patient to continue with the sport. "Too many athletes," he says, "want to go back too soon without understanding the risks involved. We believe you have to give the brain a chance to get back in sync after the first injury. If you don't give the brain sufficient time to fully recuperate, a second injury can be much more dangerous."
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