Association of Ringside Physicians Publish Concussion Management Consensus Statement for Fighters

Recently the British Journal of Sports Medicine Published a consensus statement written by the Association of Ringside Physicians looking to standardize practices for suspension, bout stoppage and return to sport for combat sports athletes suffering concussion.

The full paper can be found here.

The ARP recommended the following:

Suspensions and concussion management

  • If a fighter is exhibiting signs of a concussion during a bout, the fight should be stopped. These signs include but are not limited to headache, confusion, blurred/double vision, nausea/vomiting and balance/gait issues (box 2).

  • If a combat sports athlete sustains a TKO secondary to blows to the head, it is recommended that he or she be suspended from competition for a minimum of 30 days. It is also recommended that the fighter refrain from sparring for 30 days as well.

  • If a combat sports athlete sustains a KO without LOC secondary to blows to the head, it is recommended that he or she be suspended from competition for a minimum of 60 days. It is also recommended that the fighter refrain from sparring for 60 days as well.

  • If a combat sports athlete sustains a KO with LOC secondary to blows to the head, it is recommended that he or she be suspended from competition for a minimum of 90 days. It is also recommended that the fighter refrain from sparring for 90 days as well.

  • All combat sports athletes, including the winners, should be evaluated for signs and symptoms of concussion postbout. Evaluation should be performed immediately postbout ringside but also later repeated in a quieter, controlled environment (eg, dressing room).

  • Combat sports athletes may participate in non-contact training and conditioning 1 week after sustaining a concussion or loss via TKO/KO secondary to head strikes, provided his or her symptoms are improving and do not increase in severity with activity. A gradual activity progression of increased intensity is recommended, starting with light aerobic activity progressing to more rigorous/combat sports-specific activity and finally sparring when symptoms have completely resolved (box 3).

  • Under no circumstances should a combat sports athlete compete or engage in sparring activity or competition if he or she is experiencing signs and symptoms of concussion.

Specialist evaluation

  • In addition to the above-mentioned periods of suspension, we recommended that a combat sports athlete’s suspension continue until a specialist physician trained in concussion management clears the fighter. Specialist physicians trained in concussion management include neurologists, neurosurgeons and primary care sports medicine physicians.

Other baseline testing

  • We recommended that all combat sports athletes undertake a validated NP evaluation with the initial test serving as a baseline. If possible, vestibular/ocular and balance baseline testing is also recommended. Repeat baseline testing should occur annually. If there is any decline, it is recommended that a physician trained in brain injuries and concussion management evaluate the athlete.

Education

  • We recommended that all combat sports athletes and their coaches/trainers be educated and trained to recognise the signs and symptoms of concussion. If a combat sports athlete is experiencing any signs or symptoms of a concussion during training or competition, he or she should remove themselves from contact activities and seek immediate evaluation by a healthcare professional.

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