The National Athletic Trainers' Association (NATA) has presented highlights of a position statement on sport-related concussions, in preparation for publication of that statement in the September 2004 issue of The Journal of Athletic Training.

The position state ment, authored by a group led by Kevin M. Guskiewicz of the Sports Medicine Research Laboratory at the University of North Carolina, Chapel Hill, was previewed June 16 during NATA's 55th annual meeting in Baltimore.

Guskiewicz and Ro bert C. Cantu, chief of neurosurgery service and director of sports medicine at Emerson Hospital in Concord, Massachusetts, and an adjunct professor of exercise and sport science at North Carolina, summarized the statement advocating prompt recognition of symptoms and dangers and proposing ways of implementing a plan to effectively manage concussions.

The position statement is the result of 20 months of research, interpretation and writing by the team that included Guskiewicz, Cantu and six other health-care professionals representing the fields of athletic training, sports medicine, neurology, neuropsychology and general medicine.

"This statement should provide valuable information for certified athletic trainers, physicians and other medical professionals caring for athletes at the youth, high-school, collegiate and elite levels, as well as educating parents and coaches," Guskiewicz said.

"The focus on most of the current research is to help eliminate the guesswork involved with treating athletes with concussion."

Among the highlights of the statement:

The term "ding" should not be used to describe a sport-related concussion because it generally diminishes the seriousness of the injury. An athlete who shows concussion-like signs and reports symptoms after a contact to the head has at the very least sustained a mild concussion.

"Most people believe that if you haven't lost consciousness, then you have not sustained a concussion," Guskiewicz explained during a news conference scheduled to present the statement. "The most recent study found that only 9 percent of all concussions involved loss of consciousness."

Formal cognitive and postural-stability testing is recommended to assist in determining injury severity and readiness to return to play.

Once symptom-free, the athlete should be reassessed to establish that cognition and postural stability have returned to normal for that player.

An athlete with a concussion should be referred to a physician on the day of injury if he or she lost consciousness or experienced amnesia lasting longer than 15 minutes.

A team approach involving input from the certified athletic trainer, physician, athlete and any referral sources should be used in making return-to-play decisions after concussion.

Athletes who experience loss of consciousness or amnesia should be disqualified from returning to participation in a sport on the day of the injury, as should athletes who are symptomatic at rest and after exertion for at least 20 minutes.

Because damage to the maturing brain of a young athlete can be catastrophic, athletes under age 18 should be managed more conservatively, using stricter return-to-play guidelines than those applied to more mature athletes.

Any athlete with a concussion should be instructed to rest, but complete bed rest is not recommended.

Because of an increased risk of future concussions, as well as slowed recovery, athletes with a history of three concussions should be advised that terminating participation in contact sports may be in their best interests.

Guskiewicz said the position statement "really emphasizes the need to do a better job of educating athletes, parents and coaches about concussions and the danger of playing while still symptomatic."

The statement also seeks to teach clinicians how to implement an effective concussion management plan, he added.

"Bridging the gap between research and clinical practice is the key to reducing the incidence and severity of sport-related concussion and improving return-to-play decisions," writing team member Cantu said.

The news conference also featured remarks by former New York Giants linebacker Harry Carson, who suffered from post-concussion syndrome after sustaining several concussions during his 13-year National Football League career, and Ozzie Newsome, general manager and executive vice-president of the Baltimore Ravens.

Carson estimated that he sustained between 15 to 18 concussions during 21 years of high-school, college and professional football.

Carson said he is not surprised by findings that nearly three-fourths of college football players surveyed did not report concussion symptoms.

"I never really acknowledged I sustained concussions with the trainer," he said. "I just wanted to play."