This week Indiana joins 38 other states in passing a law aimed at making sure youths do not return to play after suffering a concussion. The law requires schools to remove student-athletes suspected of sustaining a concussion from play or practice immediately and not allow them to return until they have written clearance from a licensed health care provider trained in the evaluation and management of concussions.
Indiana Rules on Concussion Prevention
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The intent is to remove the pressure on athletes to return to play before they are fully healed, said Dr. Joseph O’Neil, a neurodevelopment pediatrician in Indianapolis. “The last person to ask is the athlete, because he is going to want to get back in no matter how bad he feels. This will educate athletes, parents, coaches, teachers, school officials, athletic directors and athletic trainers about what concussions are and their risks, ” said O’Neil in the June 29 news release.
Senator Travis Holdman, one of the law’s authors, said it was modeled after a Washington state law that applies to all youth sports. That law is named after teenager Zackery Lystedt, who suffered a debilitating brain injury in 2006 when he returned to a football game shortly after suffering a concussion.
The NFL supports the new Indiana law and others like it. The Indiana law covers only high school sports because there is no governing body there for middle school sports or youth sports to oversee its implementation.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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