Journal CME April 2025, Return to sports after pediatric traumatic brain injury: An expert panel survey-PM R - 2025 - Hansen - Return to sports after pediatric traumatic brain injury An expert panel survey

PM R - 2025 - Hansen - Return to sports after pediatric traumatic brain injury An expert panel survey

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The article details a study conducted through a web-based survey to understand practice patterns regarding return-to-play (RTP) decisions after pediatric traumatic brain injury (TBI). The study aims to fill the gap in standardized guidelines for advising pediatric patients on RTP after TBI, including complicated mild, moderate, and severe cases.<br /><br />Conducted with 30 experts—ranging from physical medicine and rehabilitation, neurology, neurosurgery to sports medicine, and neuropsychology—the survey aimed to assess how these professionals determine injury severity, measure recovery, and decide on RTP timelines. The study revealed significant variability in RTP recommendations based on the risk level of the activity and injury severity, highlighting no significant association between medical specialty and RTP decisions.<br /><br />Key findings include:<br />- Imaging findings, initial Glasgow Coma Scale score, duration of posttraumatic amnesia, and loss of consciousness are commonly used to assess injury severity. However, their relative importance varies among experts.<br />- Recovery assessments often involve a neurologic exam, neuropsychologic evaluation, balance testing, and symptom scores from children and parents.<br />- RTP timelines varied greatly, especially for high-risk activities, underscoring a need for empirical data to inform guidelines.<br />- Other influencing factors in RTP decisions include surgical intervention necessity, sports environment, patients' recovery to pre-injury baseline, and personal and familial considerations.<br /><br />The variability in RTP recommendations points to a crucial need for more research and development of standardized guidelines, especially concerning more severe pediatric TBIs. The study underscores the complexity of RTP decisions, which are influenced by multiple clinical factors and often involve shared decision-making between clinicians, patients, and their families, considering individual circumstances and preferences.

Keywords

pediatric traumatic brain injury

return-to-play decisions

standardized guidelines

injury severity assessment

recovery measurement

RTP timelines

clinical variability

shared decision-making

empirical data

multidisciplinary experts