title: Concussion in hockey: compliance with return to play advice and follow-up status.
abstract: OBJECTIVE
  To determine the compliance rate among hockey players with concussion or other head injuries who were advised by a physician about return to play. To assess compliance of hockey players with return to play advice and to assess the incidence of long-term post-concussion symptoms.
  
  
  METHODS
  A retrospective chart review, telephone questionnaire and follow-up analysis of income, level of education and professional aspirations. The study examined 40 hockey players with concussion or other head injury treated at a neurosurgical ambulatory clinic, who had initial visits between 1995 and 2003, and had been seen at least two years prior to completing the questionnaire.
  
  
  RESULTS
  There was a 58% (23 of 40) participation rate in the study. Fifteen (65%) of the 23 participants were advised to never return to play, and 5 (33%) were non-compliant and returned to play. Four (80%) of the five noncompliant players continued to suffer from post concussion symptoms. Overall, 15 (65%) of the 23 players participating in the study continued to suffer post concussion symptoms at least two years after the clinic visit.
  
  
  CONCLUSIONS
  Five (33%) of 15 hockey players advised to never return to play were non-compliant and returned to play, and four continued to suffer from post concussion symptoms two or more years later. After repeated concussions, 65% of hockey players had long-term sequelae that prevented return to play and produced long-term post-concussion symptoms.
authors.affiliation: ThinkFirst Canada, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alun
authors.initials: A
authors.lastname: Ackery
authors.forename: Christine
authors.initials: C
authors.lastname: Provvidenza
authors.forename: Charles H
authors.initials: CH
authors.lastname: Tator
mesh_terms: D001924:Brain Concussion / Q000209:etiology* / Q000503:physiopathology*; D006688:Hockey / Q000293:injuries*; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D038223:Post-Concussion Syndrome / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires