Evaluation of current post-concussion protocols.

The growing number of concussions and mild traumatic brain injuries (mTBI) with the lack of evidence-based treatment options is a continuous health concern. This creates problems when evaluating and providing efficacious symptom management to patients suffering from post-concussion syndrome (PCS). Numerous pharmacological and non-pharmacological agents have been utilized in an attempt to treat PCS. Some of these approaches include physical therapy, analgesics, antidepressants, and nutraceuticals. Although these treatments have had some success, there has been inconsistent outcomes, with some examples of patients' symptoms worsening. Among pharmaceutical agents, fluoxetine has been a popular choice for the symptom management of PCS. Although some patients have had symptom resolution with the use of fluoxetine, there is still a lack of conclusive data. Of the several biochemical changes that occur in a patient's brain following a concussion, an increase in reactive oxygen species (ROS) is of particular concern. In order to counteract the responses of the brain, antioxidants, such as ascorbic acid, have been utilized to reverse the damaging cellular effects. However, this may inadvertently cause an increase in ROS, rather than a reduction. Although there is a lack of consistency in exactly when each treatment was used in the post-injury interval, it is important that we analyze the strengths and weaknesses of the most commonly used agents due to the lack of a set protocol. The studies were chosen in a non-exhaustive manner and were not consistent in patients' post-injury intervals, in addition to other baseline characteristics. However, over-arching claims that some treatments may benefit more than others can be made. This review evaluates both the pharmaceutical and non-pharmaceutical protocols that are most commonly utilized in post-concussive patients for their efficacy in treatment of post-concussive syndrome (PCS).

Handling of medical knowledge in sport: Athletes' medical opinions, information seeking behaviours and knowledge sources.

Medical care in sport comprises a variety of treatments, from scientifically proven biomedicine to complementary and alternative medicine. Information and knowledge about these diverse treatment options is spread by different sources. Thus, athletes encounter information of varying content, quality and background. This exploratory pilot study addresses athletes' medical opinions, their health-related information seeking behaviour and the knowledge sources they utilise. Questionnaires were used to examine n = 110 German athletes (n(male) = 69, n(female) = 41; mean(age) = 24.28 ± 4.97 years) at high performance levels (national team and/or European championship and/or World championship n = 22; first national league and/or German championship n = 51, second national league and/or State championship n = 37) from various Olympic sports. A cluster analysis regarding the athletes' attitudes towards sport medicine exhibited four different types of athletes: 'the autonomous athlete', 'the open-minded athlete', 'the functionalistic athlete' and 'the conservative athlete'. In general, our findings show that the most used and trusted information sources are physicians and physiotherapists. However, medical information is trusted the most if it is experience- and field-tested, and comes from the athletes' sport-specific network. Our findings also suggest that professional medical knowledge management in competitive sport is needed.