Sports Medicine Research: In the Lab & In the Field: Three New Statements: Returning to Learning Following a Concussion, Treating Guyon's Canal Syndrome, Treating Knee Osteoarthritis (Sports Med Res)


Friday, November 8, 2013

Three New Statements: Returning to Learning Following a Concussion, Treating Guyon's Canal Syndrome, Treating Knee Osteoarthritis

Returning to Learning Following a Concussion: A Clinical Report from the American Academy of Pediatrics

Halstead ME, McAvoy K, Devore CD, Carl R, Lee M, Logan K; Council on Sports Medicine and Fitness, and Council on School Health. Pediatrics. 2013 Oct 27. [Epub ahead of print]

The American Academy of Pediatrics has released a new clinical report regarding the return to learning following a concussion. The report describes the signs and symptoms of concussion affecting students, the return to learning team, strategies to return to learn in the classroom, prolonged symptoms, future directions, and conclusions and guidance for physicians. The document also lists several helpful resources. The clinical report has also been endorsed by the American Medical Society for Sports Medicine, Brain Injury Association of America, Canadian Paediatric Society, National Association of School Nurses, National Association of School Psychologists, and the National Federation of State High School Associations.

How to Treat Guyon's Canal Syndrome? Results from the European HANDGUIDE Study: a Multidisciplinary Treatment Guideline

Hoogvliet P, Coert JH, Fridén J, Huisstede BM; European HANDGUIDE group. Br J Sports Med. 2013;47(17):1063-70. doi: 10.1136/bjsports-2013-092280.

The British Journal of Sports Medicine has published a new consensus statement regarding the treatment of Guyon’s canal syndrome. The article includes a great 1.5 page handout that describes Guyon’s canal syndrome, symptoms, diagnosis, nonsurgical and surgical treatment, as well as a grading system for duration and severity.

Treatment of Osteoarthritis of the Knee: Evidence-Based Guideline, 2nd Edition

Jevsevar DS. J Am Acad Orthop Surg. 2013 Sep;21(9):571-6. doi: 10.5435/JAAOS-21-09-571.

The American Academy of Orthopaedic Surgeons updated their evidence-based guidelines for the treatment of knee osteoarthritis. The document includes a 13-page summary of the 15 recommendations that cover conservative, pharmacologic, procedural (e.g., corticosteroid injections), and surgical treatments.


Zach Johnson said...

I think the return to learning statement was greatly needed. From personal experience I have dealt with professors and academic advisers and this statement can help with writing policies and procedures for concussion protocols in schools. We are trying to educate everyone that is involved with student-athletes and we cannot forget the student aspect should come first. Communication is the key for academic advisers and teachers/professors.

I really like the line in the statement that says, "Concussion symptoms may vary from student to student and even from concussion to concussion in the same individual who may sustain more than one concussion. Therefor, a 'cookie cutter' approach to managing a concussion and a return to classroom cannot be applied.” It is the sports medicine teams job to make sure that the teachers will understand this. It may be hard to educate every teacher, and this is why I believe that AT’s and the rest of the sports medicine team need to have very good relationships with academic advisors at the college level and/or school counselors at the secondary school level. These are the people that can communicate with every teacher. If first they understand the situation that the student athlete is going through, it will be much easier to have support of the rest of the educational teachers/professors.

Erika Spudie said...

I think the concept of "individualized approach" to return to learning after concussion highlighted in this article is so important. Each student-athlete comes to the table with their own set of unique mental talents or mental problems. Without considering the traits inherent in each student, a decision may be made to return a child too quickly. For example, an extremely intelligent child may be returned to learning because they appear ready in comparison to others, when in reality they are still being affected by the cognitive impairments of a concussion. Like the study states, an early return may worsen the symptoms and prolong recovery.

I definitely agree with Zach's statement that athletic trainers should have a good relationship with counselors and advisors. I see this need especially at the high school level. In my experience with the collegiate setting, there seems to be more access to physicians (especially in Division 1), and there is more ease with getting class and assignment excuses for these athletes. High school students may not readily have access to a physician, making it vital for the athletic trainer to be an advocate for his or her athletes by communicating with the school nurse, guidance counselor, and teachers.

At the high school at which I did my clinical rotation in undergrad, the athletic trainers were a big part of the school community, both working as AT's and teaching health and sports medicine classes. They were known by the staff at the school, and because of this, they were able to communicate information about concussions with little difficulty. In recent years, the NATA (and other organizations) has been pushing to get an athletic trainer in every high school, and I think this is one of the benefits of having an AT hired by a HS.

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