The influence of education in decision making concerning athlete’s return to sport following a concussion injury: a systematic review

Aim: the effects of education and knowledge on the decision to Return to Sport (RTS) following a concussion injury.
Design: A Systematic review.
Methods: The literature review was performed in Pubmed, CINAHL, SPORTDiscus, Embase, and Web of Science looking for articles that discussed concussions and any three of the four following: decision-making; education/knowledge; sport/ return to sport; and risk.
Results: The search yielded 16 relevant studies: 10 cohort studies, four cross sectional studies and two qualitative research studies. There is a good level of evidence to support education’s impact on athletes when reporting concussion-like symptoms and abstaining from play. It has been revealed that a more complicated process between knowledge of concussions, risk assessment, and the significance of sports occurs with decisions to RTS.
Conclusion:   Education can make a difference in athlete’s decision-making process to RTS, however their awareness of the health risks that they put themselves in by returning to sport too soon is influenced by other internal and external factors.
Key Practice Points:
• The difference that education makes to an athlete’s decision-making process when returning to sport is complex and is influenced by internal and external factors.
• There is a paucity of studies that have investigated risk aversion in athletes, which is important for medical practitioners and team support personnel to understand to help guide these athletes in their RTS decision-making process.
• It is currently unknown how risk averse/seeking behaviours affect the decision to RTS following a concussion injury.
Proposed impact, if any, on the health outcomes of Aboriginal and Torres Strait Islander people: The findings of this review have direct relevance to anyone participating in sport from the Aboriginal and Torres Strait Islander Population.