The ramifications of neurocognitive and affective sequela associated with sports and recreational-related trauma have come center stage with considerable controversy. In a society where our youth is leaning toward passive entertainment, it becomes paramount to encourage activities that promote health, fitness, and the spirit of competition. This must be balanced with safeguards and precautions to prevent injury. Many have sacrificed and been the flag bearers to bring attention to the topic of brain injury related to sports. This has been partially prompted by a number of tragedies and the unfortunate consequences that resulted in long-term challenges for the athletes and their families, which, at times, may have been prevented. Only by further research can we provide evidence-based guidance to the clinician, athlete, family, and coaches for this entity, which initially may not be so readily detectable. This will lead to further detection of high-risk demographics, patterns of play and task execution, and potential equipment shortcomings, ultimately helping identify needed regulatory changes. Screening and detection tools, neurocognitive imaging, and possibly biochemical markers may add refinement to the process. Despite our most noble efforts, however, there will be risks that must be acknowledged and vigilance must be taken by those allowing their children to participate, especially in contact sports and activities. Career athletes must become educated as to the long-term consequences of not only obvious injuries but also at times subclinically detectable trauma and their potential cumulative effects. Last, clinicians must become acquainted and up-to-date with sideline detection, management, and rehabilitation strategies to counsel and treat these athletes. The emotional inclination of banning at-risk activities must be tempered with the collaborative research and preventive efforts of clinicians, researchers, and amateur and professional sports organizations. Fortunately, such a concerted effort appears in view.
My congratulations go to Dr Laker and his fine team of contributors for making this update a great success. I would encourage clinicians caring for this population to also procure the February 2007 issue of Physical Medicine and Rehabilitation Clinics of North America , which complements this issue.
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Concussion in Sports
The Molecular Pathophysiology of Concussive Brain Injury – an Update
Active Rehabilitation of Concussion and Post-concussion Syndrome
Neuroimaging of Concussion
