A Prospective Study of Postconcussive Outcomes After Return to Play in Australian Football

BackgroundDecisions regarding safe return to play after concussion in sport remain difficult.ObjectiveTo determine whether a concussed player returned to play using an individual clinical management strategy is at risk of impaired performance or increased risk of injury or concussion.Study DesignCohort study; Level of evidence, 3.MethodsAll elite Australian football players were followed for 4 seasons. Players were recruited into the study after sustaining a concussive injury. Outcome measures included performance statistics (disposals per hour match-time), injury rates, and recurrence of concussion on return to play. A subset of players had brief screening cognitive tests performed at baseline and after their concussion. Noninjured players matched for team, position, age, and size were chosen as controls.ResultsA total of 199 concussive injuries were observed in 158 players. Sixty-one concussive injuries were excluded from analysis because of incomplete data (45 players) or presence of concurrent injury ...