Howland Jonathan, Hackman Holly, Torres Alcy, Campbell Julia, Olshaker Jonathan
Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
Injury Prevention Center, Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts, USA.
BMJ Open Sport Exerc Med. 2021 Jan 6;7(1):e000959. doi: 10.1136/bmjsem-2020-000959. eCollection 2021.
Between 2009 and 2014, all 50 states and the District of Columbia passed legislation to improve the recognition and management of youth concussed in sports. These laws can include requirements for concussion training for school athletic personnel, concussion education for children and their parents, return-to-play (RTP) procedures, and medical clearance to for RTP. Concussion can impact academic learning and performance in children and adolescents. Postconcussion academic accommodations during recovery can be an important component of secondary prevention for mitigating the sequalae of head injury. Few state youth concussion laws, however, include provision of postconcussion return-to-learn (RTL) accommodations and most of those that do address RTL apply to student athletes only. Concussions may occur in youth who are not participating in organised sports (eg, falls, traffic crashes) and thus may not be subjected to RTL accommodations, even if the state mandates such procedures for athletes. Low income and students of colour may be more likely to have non-sports concussions than their more affluent and white peers, thus potentially creating demographic disparities in the benefits of RTL procedures. State youth sports concussion laws should be revised so that they include RTL provisions that apply to all students, athletes and non-athletes alike.
2009年至2014年间，美国50个州以及哥伦比亚特区均通过了立法，以改善对在体育运动中发生脑震荡的青少年的识别与管理。这些法律可能包括对学校体育工作人员进行脑震荡培训的要求、对儿童及其家长开展脑震荡教育、制定复出比赛（RTP）程序以及为复出比赛提供医学许可。脑震荡会影响儿童和青少年的学业学习及表现。恢复期间的脑震荡后学业调整可能是减轻头部损伤后遗症二级预防的一个重要组成部分。然而，很少有州的青少年脑震荡法律包含提供脑震荡后复学（RTL）调整的条款，而且大多数涉及RTL的条款仅适用于学生运动员。脑震荡可能发生在未参加有组织体育运动的青少年身上（例如跌倒、交通事故），因此即便该州为运动员规定了此类程序，这些青少年也可能无法获得RTL调整。与较为富裕的白人同龄人相比，低收入和有色人种学生可能更易发生非运动性脑震荡，从而可能在RTL程序的受益方面造成人口统计学差异。应修订州青少年体育脑震荡法律，使其包含适用于所有学生（无论是否为运动员）的RTL条款。
