Return to Play After Spinal Injury

Prevalence of sports-related spinal injury stratified by competition level and return to play guidelines

Reviews in the Neurosciences ◽

10.1515/revneuro-2020-0080 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Brian Fiani ◽

Juliana Runnels ◽

Ashley Taylor ◽

Manraj Sekhon ◽

Daniel Chacon ◽

...

Keyword(s):

High School ◽

Spinal Injury ◽

Full Range ◽

Spinal Injuries ◽

Return To Play ◽

Spine Injury ◽

Post Injury ◽

Search Terms ◽

Post Surgery ◽

Competition Level

AbstractSpinal injury is among the most severe and feared injuries an athlete may face. We present an up-to-date review of the recent literature, stratifying recommendations based on injury location (cervical, thoracic, and lumbar spine) and type, as well as, the level of competitive play (high school, collegiate, professional). A literature search was completed to identify all publications reporting return to play guidelines for athletic injuries or injury-related surgery irrespective of the study design. Publication dates were not restricted by year. Search terms used included “return to play” and “spinal injury” on National Library of Medicine (PubMed) and Google Scholar. Selection criteria for literature included axial spine injury guidelines for athletic participation post-injury or post-surgery. Literature found from the search criteria was sorted based on level of competition and location of axial spine injury involved. It was found that professional athletes are more likely to suffer severe spinal injuries, require surgery, and necessitate a longer return to play (RTP), with high school and college athletes usually returning to play within days or weeks. Injuries occur mainly within contact sports and concordance exists between initial and subsequent spinal injuries. Adequate rest, rehabilitation, and protective equipment alongside the education of athletes and coaches are recommended. In conclusion, a multidisciplinary approach to patient management is required with consideration for the emotional, social, and perhaps financial impact that spinal injury may have upon the athlete. Consensus from the literature states that in order for an athlete to safely return to play, that athlete should not be actively suffering from pain, should have a full range of motion, and complete return of their strength in the absence of neurological deficit.

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Consideration of the Federal Guidelines for Academic Services for Student-Athletes with Sports-Related Concussion

Perspectives on School-Based Issues ◽

10.1044/sbi13.3.70 ◽

2012 ◽

Vol 13 (3) ◽

pp. 70-78 ◽

Cited By ~ 2

Author(s):

Bess Sirmon-Taylor ◽

Anthony P. Salvatore

Keyword(s):

Student Athletes ◽

Section 504 ◽

Return To Play ◽

Behavioral Deficits ◽

Prevention Education ◽

Concussion Management ◽

School Settings ◽

Definition Of ◽

Federal Guidelines ◽

Academic Services

Abstract Purpose: Federal regulations should be implemented to provide appropriate services for student-athletes who have sustained a concussion, which can result in impaired function in the academic setting. Eligibility guidelines for special education services do not specifically address the significant, but sometimes transient, impairments that can manifest after concussion, which occur in up to 10% of student-athletes. Method: We provide a definition of the word concussion and discuss the eligibility guidelines for traumatic brain injury and other health-impaired under IDEA, as is the use of Section 504. Results: The cognitive-linguistic and behavioral deficits that can occur after concussion can have a significant impact on academic function. We draw comparisons between the clinical presentation of concussion and the eligibility indicators in IDEA and Section 504. Conclusion: Speech-language pathologists are well-positioned to serve on concussion management teams in school settings, providing services including collection of baseline data, intervention and reassessment after a concussion has occurred, prevention education, and legislative advocacy. Until the cultural perception of concussion changes, with increased recognition of the potential consequences, student-athletes are at risk and appropriate implementation of the existing guidelines can assist in preservation of brain function, return to the classroom, and safe return to play.

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Spine Impairment Evaluation: Sixth Edition Approaches

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2009.janfeb01 ◽

2009 ◽

Vol 14 (1) ◽

pp. 1-5

Author(s):

Craig Uejo ◽

Marjorie Eskay-Auerbach ◽

Christopher R. Brigham

Keyword(s):

Functional Status ◽

Spinal Injury ◽

Current Medical ◽

Clinical Testing ◽

Medical Evidence ◽

Sixth Edition ◽

Whole Person ◽

Rating Process ◽

Impairment Ratings ◽

Class Assignment

Abstract Evaluators who use the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, should understand the significant changes that have occurred (as well as the Clarifications and Corrections) in impairment ratings for disorders of the cervical spine, thoracic spine, lumbar spine, and pelvis. The new methodology is an expansion of the Diagnosis-related estimates (DRE) method used in the fifth edition, but the criteria for defining impairment are revised, and the impairment value within a class is refined by information related to functional status, physical examination findings, and the results of clinical testing. Because current medical evidence does not support range-of-motion (ROM) measurements of the spine as a reliable indicator of specific pathology or permanent functional status, ROM is no longer used as a basis for defining impairment. The DRE method should standardize and simplify the rating process, improve validity, and provide a more uniform methodology. Table 1 shows examples of spinal injury impairment rating (according to region of the spine and category, with comments about the diagnosis and the resulting class assignment); Table 2 shows examples of spine impairment by region of the spine, class, diagnosis, and associated whole person impairment ratings form the sixth and fifth editions of the AMA Guides.

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