Topic 1 - consensus

Question 1

why was the first CISG meeting held (vienna 2001)

Answer 1

organised by IIHF, FIFA, and IOC
aim to provide recommendations from world leading experts to improve athlete safety and health

Question 2

what were the major items from the first consensus meeting

Answer 2

• revised/standarised concussion definition
• adapted to RTP guidelines
• updated sideline assessment recommendations to include standardised post concussion symptom scale, brief neuro test, time/place/person tests
• major increase in research

Question 3

what was found from the focus on prevention strategies at first consensus meeting

Answer 3

• proposed helmet use in sports with high speed collisions
• safety equipment altering behaviour?
• mouth guards may help with head impacts
• rule changes and referee enforcement
• neck strengthening

Question 4

what is the original management and rehab (acute)

Answer 4

• removed from play (game or practise)
• not left alone - regularly monitored
• medically evaluated
• RTP should be a medically advised step wise process
• players should not RTP while symptomatic
  -when in doubt sit them out

Question 5

what is the original management and rehab (RTP)

Answer 5

1. No activity = complete rest, once asymptomatic, proceed to 2
2. Light aerobic activity (walking/stationary cycling)
3. Sport specific training (skating or running)
4. Non contact training drills
5. Full contact training after medical clearance
6. Game play

Question 6

what is the problem with step 1 of RTP

Answer 6

symptoms from isolation and no activity can present similar to concussion symptoms (depression, headaches, sensitive to light, mood changes, etc)

Question 7

what were the prague 2004 advances

Answer 7

• post concussion symptoms may be prolonged
• abandonment of grading system (no link to recovery trajectories)
• no promotion of CT/MRI use unless more serious TBI expected
• added SCAT (including symptom score, cognitive/memory task, and neurologic testing)

Question 8

what were the prague 2004 stalls

Answer 8

kept complete rest until asymptomatic in RTP guidelines

Question 9

what were the zurich 2008 advances

Answer 9

• sideline assessment done by medical staff in facility
• added balance to SCAT
• different treatment may be needed for youth concussions
• knowledge of previous concussion is valuable
• neuropsych testing should be developmentally sensitive

Question 10

what were the zurich 2008 stalls

Answer 10

• promoted same day RTP for NFL players
• not enough evidence to prove the beneficial use of mouth guards and helmets to prevent concussions

Question 11

what were the zurich 2012 advances

Answer 11

• recognised the difference in youth vs adult recovery times
• no RTP on same day
• symptoms may be delayed
• many types of signs and symptoms of concussion (somatic, physical, behaviour, cognitive, sleep disturbance)
• low level activity may be beneficial in those with delayed recoveries
• developed the child SCAT3 (5-12)

Question 12

what were the zurich 2012 stalls

Answer 12

• still promotes rest is best (physical and cognitive rest until acute symptoms resolve)
• maintained that PPE doesn’t reduce concussion rates by they reduce head impact forces

Question 13

what were the berlin 2016 advances

Answer 13

• SCAT5 is well established sideline assessment
• first inclusion of rehab programs
• brief period of rest during acute phase and then promote gradual activity below symptom exacerbation thresholds

Question 14

what were the amsterdam 2022 advances

Answer 14

• no definite line where athletes are forced to retire by medical pros
• added return to learn strategies
• use HR to moderate recovery in light/moderate aerobic exercise
• updated CRT (immediate and non clinical individuals) and SCAT (up to 1 week)
• developed SCOAT