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Abstract

Background

Sports-related concussions (SRC) are a prevalent and complex public health issue, with 1.6-3.8 million cases annually in the United States. Increased awareness has led to higher rates of emergency and primary care consultations, yet many healthcare providers lack the resources or training to apply current evidence-based guidelines. The evolving understanding of concussion pathophysiology and long-term outcomes, including chronic traumatic encephalopathy (CTE), highlights the need for updated management strategies.

Objectives

This study aims to review current approaches to SRC management, from initial diagnosis to return-to-play, while exploring advances in biomarkers, neuroimaging, and genetic testing that could improve the prediction and treatment of concussion-related outcomes.

Methods

A comprehensive review of the literature was conducted, focusing on epidemiological data, clinical guidelines, and recent studies on concussion diagnosis, management protocols, and emerging technologies. The Concussion in Sport Group’s (CISG) 13 R’s framework, established at the 6th International Conference on Concussion in Sport, served as a foundational model for evidence-based management.

Results

Evidence supports the transition from historical grading systems to a multifaceted, individualized approach to SRC care. Early recognition using tools like SCAT6 and a gradual return-to-activity protocol improves outcomes while minimizing risks like second-impact syndrome. Advances in neuroimaging and biomarkers show promise for diagnosing CTE, while genetic factors, such as ApoE polymorphisms, are linked to variability in post-concussive symptoms. Persistent knowledge gaps among clinicians and disparities in research representation remain critical challenges.

Conclusions

An evidence-based, multidisciplinary approach is essential for effective SRC management. Early recognition, structured rehabilitation protocols, and emerging diagnostic tools can improve outcomes, while further research is needed to address gaps in pediatric and para-sport populations. Integrating advancements in neuroimaging and genetic testing into clinical practice could revolutionize SRC diagnosis and personalized treatment.

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