title: Repetitive concussions in adolescent athletes - translating clinical and experimental research into perspectives on rehabilitation strategies.
abstract: Sports-related concussions are particularly common during adolescence, a time when even mild brain injuries may disrupt ongoing brain maturation and result in long-term complications. A recent focus on the consequences of repetitive concussions among professional athletes has prompted the development of several new experimental models in rodents, as well as the revision of guidelines for best management of sports concussions. Here, we consider the utility of rodent models to understand the functional consequences and pathobiology of concussions in the developing brain, identifying the unique behavioral and pathological signatures of concussive brain injuries. The impact of repetitive concussions on behavioral consequences and injury progression is also addressed. In particular, we focus on the epidemiological, clinical, and experimental evidence underlying current recommendations for physical and cognitive rest after concussion, and highlight key areas in which further research is needed. Lastly, we consider how best to promote recovery after injury, recognizing that optimally timed, activity-based rehabilitative strategies may hold promise for the adolescent athlete who has sustained single or repetitive concussions. The purpose of this review is to inform the clinical research community as it strives to develop and optimize evidence-based guidelines for the concussed adolescent, in terms of both acute and long-term management.
authors.affiliation: Department of Neurological Surgery, University of California San Francisco , San Francisco, CA , USA ; Department of Medicine, Royal Melbourne Hospital, University of Melbourne , Parkville, VIC , Australia.
authors.forename: Bridgette D
authors.initials: BD
authors.lastname: Semple
authors.affiliation: Department of Neurological Surgery, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Sangmi
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Neurological Surgery, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Raha
authors.initials: R
authors.lastname: Sadjadi
authors.affiliation: Kennedy Krieger Institute, John Hopkins University , Baltimore, MD , USA.
authors.forename: Nora
authors.initials: N
authors.lastname: Fritz
authors.affiliation: Department of Neurological Surgery, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Carlson
authors.affiliation: San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Carrie
authors.initials: C
authors.lastname: Griep
authors.affiliation: San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ho
authors.affiliation: San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Patrice
authors.initials: P
authors.lastname: Jang
authors.affiliation: San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Annick
authors.initials: A
authors.lastname: Lamb
authors.affiliation: San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Popolizio
authors.affiliation: San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Saini
authors.affiliation: School of Medicine and Dentistry, University of Rochester Medical Center , Rochester, NY , USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Bazarian
authors.affiliation: Department of Neurosurgery, University of California Los Angeles David Geffen School of Medicine , Los Angeles, CA , USA.
authors.forename: Mayumi L
authors.initials: ML
authors.lastname: Prins
authors.affiliation: Department of Pediatrics, University of California San Francisco , San Francisco, CA , USA ; Department of Neurology, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Ferriero
authors.affiliation: School of Health and Rehabilitation Sciences, Ohio State University , Columbus, OH , USA.
authors.forename: D Michele
authors.initials: DM
authors.lastname: Basso
authors.affiliation: Department of Neurological Surgery, University of California San Francisco , San Francisco, CA , USA ; Department of Physical Therapy and Rehabilitation Sciences, University of California San Francisco , San Francisco, CA , USA.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Noble-Haeusslein
keywords: adolescent; athletes; behavior; concussion; exercise; experimental models; pathology; rehabilitation